Treatment Index
A conservative overview of common medication categories and related options people compare in HRT-focused care. Sorted by evidence strength.
Informational only; consult a clinician. This content does not constitute medical advice and is not a substitute for professional diagnosis or treatment.
If you have a uterus and take estrogen, you need progestogen. This is non-negotiable. The question is which one, and how to take it.
If patches irritate your skin or fall off in the shower, topical gels and sprays give you the same liver-bypass advantage without anything stuck to your body.
If you have any risk factor for blood clots - and obesity alone qualifies - the estrogen patch should be your default, not an alternative.
The first non-hormonal medication designed specifically for menopausal hot flashes. An NK3 receptor antagonist that targets the neural pathway driving vasomotor symptoms.
Pellet therapy uses compounded hormone implants placed under the skin. It is not FDA-approved, not endorsed by NAMS, and carries risks that other HRT routes avoid.
Testosterone for women is prescribed off-label for hypoactive sexual desire disorder. No FDA-approved testosterone product exists for women in the US. Evidence is limited to specific indications.
Generic oral estradiol is the most prescribed, most affordable, and most accessible form of HRT. At $4-15/month, it costs less than most copays.
Micronized progesterone is the progestogen most menopause specialists prefer, and for good reason: it may carry lower breast cancer risk than the synthetic progestin the WHI studied, and it doubles as a sleep aid.
Antidepressants that also reduce hot flashes. Not as effective as HRT, but a real option for women who cannot or prefer not to take hormones.
Vaginal dryness, painful sex, and recurrent UTIs are not things women should “just live with.” They are progressive symptoms that respond dramatically well to local estrogen.