Menopause Hormone Therapy: The Main Options, Explained Plainly

The two hormones at the center

Estrogen is the hormone whose decline drives most menopause symptoms — hot flashes, night sweats, vaginal dryness, and sleep disruption among them. Most hormone therapy regimens are built around replacing it to some degree.

Progesterone (or a synthetic form called a progestin) is typically included for women who still have a uterus, because estrogen taken alone can over-stimulate the uterine lining. Women who have had a hysterectomy generally do not need it.

Ways estrogen can be delivered

• —Patches worn on the skin and changed on a schedule
• —Gels or creams applied to the skin
• —Oral tablets
• —Vaginal preparations for local symptoms such as dryness

Why the route matters

Transdermal options — patches, gels, creams — deliver estrogen through the skin rather than through the digestive system first. Providers often weigh route of delivery alongside your history when choosing a regimen, because different routes behave differently in the body. This is a clinical decision, not a marketing one, and it belongs in the conversation with your provider.

What shapes the decision

• —Which symptoms bother you most, and how much
• —Your personal and family medical history
• —Whether you have a uterus
• —How long it has been since your final period
• —Your preferences about daily versus less frequent dosing
• —Lab results and other medications you take

It should be a decision, not a default

Hormone therapy is appropriate for many women and not appropriate for some. A careful provider reviews your history and labs, explains the options and their trade-offs, and reaches the decision with you — and is willing to say no when it isn't the right fit.

Enrolling in a program is not a guarantee of any prescription. Treatment is prescribed only when a Vitality provider determines it is medically appropriate.