Menopausal hormone therapy comes in several forms, each suiting different needs and risk profiles. Step through the options below — from transdermal patches to vaginal estrogen — to understand what fits where.
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Transdermal estradiol patch
Applied to skin once or twice weekly. Bypasses first-pass liver metabolism, so it carries lower clot/stroke risk than oral estrogen. NAMS-preferred first-line for most women under 60. Doses 0.025-0.1 mg/day.
Daily gel applied to arms or thighs. Same transdermal liver-bypass advantage as the patch, with more dose-titration flexibility. Good for women who dislike patch adhesive. Let it dry before skin contact with others.
Once-daily tablet. Convenient and inexpensive, but first-pass liver metabolism raises VTE/stroke risk vs transdermal. Reasonable for low-risk women who prefer a pill. Doses 0.5-2 mg daily.
Cream, tablet, or ring for genitourinary symptoms — dryness, painful sex, urinary urgency. Minimal systemic absorption, so safe for many women who can't take systemic estrogen (including some breast-cancer survivors per ACOG).
Required alongside estrogen if you have a uterus — protects the endometrium. Bioidentical (Prometrium), taken at bedtime for its mild sedative effect. NAMS-preferred over synthetic progestins.
Transdermal estradiol + micronized progesterone is the current evidence-preferred combination for most women under 60 within 10 years of menopause. Your clinician tailors the route to your risk profile. Telehealth providers can prescribe and monitor all of these.