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The Lowdown on Various Types of Hormone Replacement Therapy


Feeling off-kilter recently? It could be an imbalance in your sex hormones such as testosterone, estrogen or progesterone. From as early as age 35, a loss of hormones can cause a flurry of unpleasant symptoms in both men and women.

Hormone replacement therapy (HRT) is a treatment option worth discussing with your primary care physician. HRT comes in many forms. In this blog post, we cover the various delivery methods and types of HRT and what they could mean for your health and well-being.


Menopause and the period preceding it can give rise to a host of symptoms beyond hot flashes and unpredictable menstruation. These symptoms include but are not limited to:

  • Hair loss
  • Mood swings
  • Thinning bones
  • Trouble sleeping
  • Urinary issues
  • Vaginal dryness
  • Problems with memory and focus

To address these causes for concern, your GP will recommend lifestyle changes where symptoms are mild.

If, however, hormone loss is the source of considerable discomfort, your doctor will analyze your medical history to determine if you’d make a good candidate for HRT.

HRT is a viable choice for those who have a low risk of:

  • heart disease
  • high blood pressure
  • breast cancer
  • blood clots
  • liver disease

Different Types of Hormone Replacement Therapy

The range of HRT types is a result of varying hormone combinations and dosages. What you’re prescribed depends in part on how far into menopause you are, or what individual circumstances dictate.


Post-menopause, i.e. when you haven’t had a period for a year or longer, continuous combined HRT providing both estrogen and progesterone may be necessary. Or you may need only a continuous dose of estrogen.


If you’re a woman who still gets her period, HRT can work in tandem with your cycle. Every month, during the last two weeks of your menstrual cycle, you’ll need to take progestogen along with your daily estrogen. If your period comes once every three months, then you take progestogen once every three months during the same fortnight.


In scenarios where you’ve had a hysterectomy and no longer have your womb and ovaries, you may need only estrogen.

Local Estrogen

Here, low-dose estrogen is applied directly to the vaginal area via either a cream, tablet or the placement of a hormone ring in the upper part of the vagina.

Forms of HRT


Many women of childbearing age are used to taking contraceptive pills with hormones. Tablets are a common mode of HRT delivery and, in general, they only need to be taken once per day.

HRT use comes with risks although the odds of these effects occurring are slim if you’re deemed a sound candidate. Pills are a convenient option for some but other forms of HRT are even safer.


A fairly straightforward form of HRT, skin patches adhere to skin and only need replacing twice a week or so. You can stick one on and forget about it for a couple of days which you can’t do with a daily pill.

Unlike tablets, patches don’t present a risk of blood clots and they also eliminate side effects of the medication such as feeling bloated and having heartburn.

Creams, Gels, and Sprays

Another simple mode of HRT delivery, estrogen gels are popular because they tend to cause fewer skin reactions than patches. They also aren’t as likely to cause blood clots as pills are.

In cases where your uterus hasn’t been removed, consuming progestogen is a notable precaution to prevent cancer of the uterus lining.

Testosterone gels are also available for both men and women. They may be able to address a low libido that persists even after HRT.

But they can also lead to acne and unwelcome hair growth. Rather unusually, the gel’s side effects can be transmitted to others who come into contact with it.


Estrogen injections are administered by a healthcare professional once every few weeks and symptoms should improve within a few days of getting the shot.

Implanted Pellets

A minor procedure is all it takes to place an estrogen implant under the skin near your stomach. The pellets last for many months which makes them a practical, hassle-free option.

Again, if your uterus hasn’t been removed, you have to take progestogen too.

An intrauterine system (IUS) is another kind of implant. It delivers progestogen into the womb should you need it while taking some form of estrogen. An IUS is similar to an IUD except for the fact that the latter releases copper. Both are contraceptives that can last for as long as five years.

Bioidentical Hormone Replacement Therapy (BHRT)

BHRT is a solution for both men and women. Part of its appeal is that it is derived from plant estrogens. Premarin, a popular brand of HRT, gets its name because it is derived from pregnant mare urine, for example. BHRT is also chemically identical to what your body makes.

Like HRT, BHRT may leave you feeling more energized. It can improve how you feel during cancer treatment and it may treat prediabetes and thyroid disorders.

HRT is usually prescribed at low doses that are just enough to make a difference for the patient. In most cases, hormone replacement therapy serves as a temporary measure.

Trust Blue Sky MD to Improve Your Quality of Life

At Blue Sky MD in North Carolina, we take a whole-body approach to helping you feel and look your best. Our teams in Asheville, Hendersonville, Greensboro, Winston-Salem and Charlotte comprise doctors who are well-versed in medical weight loss and hormone therapy, as well as registered dietitians, behavioral therapists and wellness coaches.

The synergy between our healthcare professionals ensures that you are supported holistically. This builds a sustainable foundation for optimal long-term outcomes. Reach out to learn more about how we can help you live life to the fullest or schedule an appointment online today.

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