The most common methods to replace female hormone imbalances aim to replace deficient estrogen or progesterone levels through systemic oral tablets, intravaginal tablets, patches, creams, or pellet implants. During your consultation, your provider will choose the best option based on your symptoms. ​ Hormone Replacement Pills: Oral pills are one of the most common and easiest ways to give hormone replacement therapy to women. There are estrogen-only tablets or estrogen combined with progesterone. There are also intravaginal estrogen tablets, which are inserted daily for two weeks and then titrated down to 2-4 days a week. Hormone Replacement Patches: Topical patches are applied to the skin and are very common and convenient. You place them on your skin and replace them daily. Estrogen Cream: Estrogen Cream is similar to the patches. The topical application of estrogen cream is applied vaginally daily and then titrated down to 2-3 times per week. Estrogen Vaginal Rings: This estrogen ring is inserted vaginally and replaced every three months. This brings the convenience of replacing it every three months. Estrogen Implants: These small pellets are placed under the skin, usually on the stomach. The process involves numbing the skin with a local anesthetic. The implant keeps releasing estrogen. They are replaced every 3-4 months.​​​​​​

There are certain conditions and potential risks associated with hormone replacement therapy, and it may be best to avoid treatment if you have unexplained vaginal bleeding, severe active liver disease, a history of estrogen-sensitive cancers (including breast cancer), prior coronary heart disease, or a history of stroke, heart attack (MI), or venous thromboembolism (blood clots). Hormone replacement therapy may also not be recommended for individuals with a personal history or an inherited high risk of blood clots.

Potential risks of bioidentical hormone replacement therapy may include a rare increased risk of breast cancer with combined estrogen-progesterone therapy, endometrial hyperplasia or endometrial cancer when estrogen is used without adequate progesterone, and an increased risk of venous thromboembolism (blood clots), particularly in certain individuals. Some women may also experience fluid retention, breast tenderness, mood changes, headaches, or bloating, especially during dose adjustments. Additionally, hormone therapy may require careful consideration in individuals with a history of fibroids or uterine polyps, as hormones can sometimes stimulate tissue growth.

​Testosterone Replacement Therapy (TRT) utilizes hormones that are molecularly identical to those our bodies naturally produce. Derived mainly from plant sources like soy or yams, these hormones are tailored by pharmacists into specific doses for each individual. This customization, known as compounding, ensures that the hormones match the body’s natural chemistry. While some standardized bioidentical hormones have FDA approval, custom-compounded ones do not. TRT is often preferred due to its potential for reduced side effects, given the hormones’ natural compatibility with the body. Additionally, the ability to fine-tune dosages allows for more personalized treatment and potentially fewer adverse effects compared to synthetic hormones.