Menopause & HRT
Hormone therapy and non-hormonal treatment for perimenopause and menopause.
Treatment requires a consultation with a licensed provider. A prescription is not guaranteed — the provider decides what, if anything, is appropriate and safe for you.
About menopause & hrt
Perimenopause and menopause happen as ovarian estrogen production declines, usually between the mid-40s and mid-50s. Symptoms can include hot flashes, night sweats, disrupted sleep, mood changes, brain fog, joint aches, vaginal dryness, and pain with sex. Hormone therapy is the most effective treatment for hot flashes and genitourinary symptoms. Current guidance from menopause specialists is that for most healthy people under 60, or within 10 years of their final period, the benefits of systemic hormone therapy generally outweigh the risks — but the decision is individual and belongs with a provider who knows your history.
Treatment options
Plain-language summaries. Your provider decides what is appropriate for you.
Systemic estradiol
The most effective treatment for hot flashes and night sweats. Transdermal forms carry a lower clot risk than oral forms.
Micronized progesterone
Required alongside systemic estrogen for anyone who still has a uterus, to protect the uterine lining. Often also improves sleep.
Vaginal estrogen
Cream, tablet, or ring for vaginal dryness, irritation, painful sex, and recurrent urinary symptoms. Very little is absorbed systemically, so it is suitable for many people who cannot take systemic hormones.
Non-hormonal options
SSRIs/SNRIs, gabapentin, or newer non-hormonal agents can reduce hot flashes for people who cannot or prefer not to take hormones.
How it works
- 1
Tell us the basics
State, service interest, and contact details.
- 2
Clinical visit
A licensed provider reviews your symptoms, cycle history, cardiovascular and cancer history, and current medications.
- 3
Personalized plan
If appropriate, the lowest effective dose is prescribed and dispensed by a licensed pharmacy.
- 4
Review regularly
Hormone therapy is reviewed at least annually, alongside routine mammography and blood pressure checks.
Realistic timeline
What people typically experience. Individual results vary and are never guaranteed.
- Weeks 2-4Hot flashes and night sweats often begin to improve.
- Weeks 6-12Sleep, mood, and vaginal symptoms typically improve; vaginal estrogen can take several weeks.
- OngoingDose is adjusted to the lowest amount that controls symptoms.
Safety, side effects & interactions
You deserve this information before you decide, not after.
Common side effects
- Breast tenderness
- Bloating
- Irregular spotting in the first months
- Headache
- Skin irritation from patches
Serious risks
- Oral estrogen increases the risk of blood clots and stroke; transdermal routes carry a lower risk.
- Estrogen without adequate progesterone in someone with a uterus increases the risk of endometrial cancer.
- Combined estrogen-progestogen therapy has been associated with a small increase in breast cancer risk with longer duration of use.
- Any unexplained vaginal bleeding after menopause must be evaluated — do not assume it is the hormones.
Interactions
- Certain anticonvulsants and rifampin can reduce hormone levels.
- Thyroid medication doses sometimes need adjusting after starting oral estrogen.
Who this is — and isn't — for
May be a fit if
- Adults with perimenopausal or menopausal symptoms
- Generally most favorable when under 60 or within 10 years of the final menstrual period
Not appropriate if
- History of breast cancer, estrogen-dependent cancer, or unexplained vaginal bleeding
- History of blood clots, stroke, or heart attack
- Active liver disease
- Known or suspected pregnancy
Pricing
Common questions
Isn't HRT dangerous?
Much of that reputation comes from early reporting of the Women's Health Initiative, which studied older participants and oral formulations. Later analysis showed the risk-benefit balance is far more favorable for people who start near menopause. It is still a personal decision made with a provider who knows your history.
Is a prescription guaranteed?
No. Treatment requires a consultation with a licensed provider, who may recommend non-hormonal treatment or in-person evaluation.
Do you prescribe compounded bioidentical pellets?
No. Major menopause societies advise against compounded hormone pellets because dosing is unpredictable and they are not FDA-regulated. FDA-approved body-identical estradiol and micronized progesterone are available.
Can I use vaginal estrogen if I can't take systemic hormones?
Often yes — systemic absorption is minimal. Your provider will review your history, including any cancer history.
Ready to see if this is right for you?
Start with a few basics — state, service, and how to reach you. The medical questionnaire is completed with a licensed provider.
Start your visitThis page is general health education, not medical advice, diagnosis, or treatment. It is not a substitute for care from your own clinician. If this is an emergency, call 911.