Menopause Hormonal Replacement Therapy
Individualized Treatments
Prometrium®
micronized progesterone
- Bioidentical progesterone capsule, usually taken at bedtime (may cause drowsiness).
- If you have a uterus and are using systemic estrogen, you must also take a progestogen like Prometrium to protect the uterine lining.
- Not needed if you’ve had a hysterectomy.
- Contains peanut oil — avoid if allergic.
Estrogel®
transdermal estradiol
- Applied to clean, dry, unbroken skin (e.g., arm from wrist to shoulder).
- Apply a thin layer, let it dry fully, and wash hands afterward.
- Avoid lotions or creams on the application site for about 1 hour.
- Transdermal estrogen is associated with a lower blood clot risk compared to oral estrogen.
Local Estrogen Therapy
(vaginal)
- For symptoms of genitourinary syndrome of menopause (GSM) such as vaginal dryness, discomfort with intercourse, and urinary irritation.
- Comes as tablets, creams, rings, or inserts.
- Can be used on its own or with systemic hormone therapy.
- At low doses, does not usually require a progestogen.
- Report any new vaginal bleeding.
Important Notes
- Hormone therapy is the most effective treatment for hot flashes and night sweats.
- Treatment choice, dose, and route are individualized — discuss with your healthcare provider.
- Regular follow-up is important to monitor benefits, side effects, and ongoing need for therapy.
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