Hormone Therapy
Every formulation on the table. The right one for you.
The differences between a patch and a pill, or one progestogen and another, are not cosmetic — they change both safety and results. Here is the full toolkit.
The full toolkit
The "right" hormone therapy is the one matched to the individual woman — her uterine status, her cardiovascular risk, her preferences, and any contraindications. These are the options we work with:
| Component | Forms available |
|---|---|
| Estrogen — transdermal | Patch, gel, spray. Preferred when VTE risk, hypertension, diabetes, obesity, migraine with aura, or hypertriglyceridemia is present. |
| Estrogen — oral | Estradiol or conjugated estrogens. Effective and convenient; first-pass liver metabolism makes it less appropriate for some patients. |
| Estrogen — vaginal | Cream, tablet, soft-gel insert, or ring — for genitourinary symptoms specifically, with minimal systemic absorption. |
| Progestogen (with a uterus) | Micronized progesterone (preferred), dydrogesterone, or a levonorgestrel IUD; synthetic progestins as alternatives. |
| Combination products | Estradiol–progesterone capsules, estradiol–norethindrone patches, or conjugated estrogens with bazedoxifene (which protects the uterus without a progestogen). |
| Testosterone | Off-label in the U.S. for hypoactive sexual desire in postmenopausal women; transdermal preferred, with levels monitored. |
How we choose
Route first (driven by your risk profile), then dose (the lowest effective, adjusted upward or downward by response), then the progestogen question if you have a uterus. Most women feel substantially better within weeks; fine-tuning the regimen can take a visit or two. Follow-up is part of the treatment, not an add-on.