Menopause / HRT Medications Guide

Estradiol (17-beta estradiol) — Available in oral tablets (0.5mg, 1mg, 2mg daily), transdermal patches (applied once or twice weekly depending on formulation), topical gels, and sprays. Dosing is individualized based on symptoms and provider assessment. Most guidelines recommend starting at the lowest effective dose.

Women experiencing moderate to severe vasomotor symptoms (hot flashes, night sweats) and other estrogen-deficiency symptoms during perimenopause or menopause

Micronized progesterone — Typically 100mg or 200mg taken orally at bedtime. Dosing schedule varies — may be taken daily (continuous) or for 12-14 days per month (cyclical) depending on the treatment approach and whether estrogen is taken continuously. Always taken as directed by a provider.

Women with an intact uterus who take systemic estrogen and need progesterone to protect the uterine lining

Estradiol + micronized progesterone (combination therapy) — Combination products vary. Bijuva is a single capsule containing estradiol 1mg + progesterone 100mg taken once daily. Other combinations may use separate pills or a patch plus oral progesterone. Dosing is determined by the provider based on symptoms and individual health factors.

Women with an intact uterus who want the convenience of a single combined product or a coordinated estrogen-progesterone regimen

Estradiol (vaginal formulations) — Available as vaginal tablets (typically 10mcg inserted 2x/week after initial loading), vaginal cream (applied 2-3x/week as directed), vaginal ring (inserted every 3 months), or vaginal inserts. Dosing varies by product and is determined by a provider based on symptom severity.

Women experiencing vaginal dryness, painful intercourse, urinary symptoms, or vaginal atrophy who may prefer localized treatment over systemic HRT