HORMONE REPLACEMENT THERAPY-How Do You Decide Whether to Use Oral, Transdermal or Vaginal Estrogen?

Once you and your doctor decide that hormone replacement therapy is indicated for you, the mode of delivery has to be decided.

The options are oral (a pill by mouth), transdermal (medicine delivered by patch or via a cream or lotion) or vaginal estrogen (in the form of a vaginal ring called Femring). Delivery of estrogen by the transdermal or vaginal route bypasses the need for the liver to break down the estrogen and may be associated with less changes in blood clotting and triglycerides.

Some also report a more beneficial effect on libido with transdermal as opposed to oral therapy. Remember that if you have a uterus you must use a progesterone in addition to the estrogen to protect the lining of the uterus, so if you are using a patch, a skin cream or lotion or a vaginal ring and you have a uterus, you will also have to take a progesterone which is often given in oral form.

Oral hormone replacement regimens are safe and efficacious as well and often come as one combined estrogen plus progesterone pill (Activella, FemHRT, prempro) but can also be given as two separate pills (estrace and Prometrium). Speak to your doctor about what regimen is best for you.


Schedule an in-office appointment to chat with us. We'd love to meet you! Call us at 516-365-6100 to set up a convenient appointment. We're located right off the Northern State Parkway here in North Hills, Long Island, just a few minutes away from North Shore University Hospital & Northwell Health.

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