Transdermal (Patch / Gel)
- Route
- Skin (patch / gel)
- Liver First-Pass
- Avoided
- VTE Risk
- Lower, similar to no HRT
- Adherence
- High for patches (twice weekly)
- Best For
- First-line in modern practice
HRT for Menopause
Hormone replacement therapy is the most effective treatment for menopausal symptoms. Eros MD provides physician-guided HRT with comprehensive lab evaluation, personalized prescribing, and structured monitoring.
Evidence-Based Modern HRT
Lab-Confirmed Prescribing
Personalized Protocols
Discreet Delivery
about HRT
What Is Hormone Replacement Therapy for Menopause?
Hormone replacement therapy replaces the estrogen and progesterone that decline during and after menopause. It is the most effective treatment available for vasomotor symptoms (hot flashes, night sweats) and has well-documented benefits for sleep quality, mood stability, bone density preservation, and genitourinary health. Clinical studies consistently demonstrate that HRT reduces vasomotor symptom frequency by 70 to 90 percent.
HRT is not a one-size-fits-all prescription. The type of hormone, the dose, the delivery method, and whether estrogen is combined with progesterone all depend on your individual clinical picture. Women who still have a uterus require progesterone alongside estrogen to protect against endometrial hyperplasia. Women who have had a hysterectomy may use estrogen alone. Your Eros MD provider determines the most appropriate regimen based on your lab results, symptoms, health history, and risk profile.
What HRT does
HRT replaces the estrogen and progesterone that decline during and after menopause. It is the most effective treatment available for vasomotor symptoms (hot flashes, night sweats), with documented benefits for sleep quality, mood stability, bone density preservation, and genitourinary health. Clinical studies consistently demonstrate that HRT reduces vasomotor symptom frequency by 70 to 90 percent.
treatment options
HRT Options Available Through Eros MD
HRT is not one-size-fits-all. Type, dose, delivery method, and combination depend on your individual clinical picture. Women who still have a uterus require progesterone alongside estrogen to protect against endometrial hyperplasia. Women who have had a hysterectomy may use estrogen alone. Some women also benefit from low-dose testosterone alongside estrogen and progesterone for fatigue, libido, or low mood that does not fully resolve with estrogen alone.
Important Note
Eros MD does not prescribe HRT without a thorough clinical evaluation. Contraindications including active breast cancer, undiagnosed vaginal bleeding, and active liver disease are screened for during the intake and evaluation process.
Estrogen Therapy
Transdermal (patch or gel) is the preferred route for most women, as it bypasses liver first-pass metabolism and produces lower VTE risk than oral. Oral estradiol is also effective and is offered when appropriate.
Progesterone
Oral micronized progesterone is the preferred form for most women on HRT. Required for women with an intact uterus. Documented benefits for sleep quality and mood. Synthetic progestogen is an alternative when clinically indicated.
Low-Dose Testosterone (Off-Label)
Prescribed off-label for women experiencing persistent fatigue, reduced libido, and low mood that do not fully resolve with estrogen and progesterone therapy alone. Doses used in women are significantly lower than in men.
evidence base
Is HRT Safe? What the Current Evidence Shows
The earlier concerns about HRT and breast cancer risk were largely driven by the Women's Health Initiative study published in 2002, which used a specific oral estrogen and synthetic progestogen combination in a population of predominantly older women (average age 63). Subsequent reanalysis and decades of follow-up research have substantially refined the clinical picture. Current evidence and updated guidance from major menopause societies (NAMS, IMS, NICE) support that HRT, when initiated within 10 years of menopause onset in women under 60, has a favorable benefit-risk profile. Transdermal estrogen carries lower VTE risk than oral. Micronized progesterone carries a more favorable breast cancer risk profile than synthetic progestogens. Individualized prescribing based on a woman's specific risk factors is the standard of care. Your Eros MD provider evaluates contraindications, discusses your individual risk profile, and monitors your response throughout treatment. HRT is not appropriate for every woman, and responsible prescribing means saying so when it is not.
route comparison
Transdermal vs Oral Estrogen: Why Route Matters
Oral Estradiol
- Route
- Oral pill
- Liver First-Pass
- Present
- VTE Risk
- Somewhat elevated vs baseline
- Adherence
- High for daily pill
- Best For
- Patients with strong oral preference or specific clinical factors
Feature
Route
Liver First-Pass
VTE Risk
Adherence
Best For
Transdermal (Patch / Gel)
Skin (patch / gel)
Avoided
Lower, similar to no HRT
High for patches (twice weekly)
First-line in modern practice
Oral Estradiol
Oral pill
Present
Somewhat elevated vs baseline
High for daily pill
Patients with strong oral preference or specific clinical factors
the fine print
HRT Side Effects and Safety Information
Common Side Effects
Breast tenderness (often resolves in 4 to 8 weeks)
Mild nausea or headache (more common with oral estrogen)
Vaginal bleeding or spotting early in therapy
Mood fluctuations as hormones stabilize
Most side effects resolve within the first 2 to 3 months
Serious Considerations
Contraindicated in: personal history of breast cancer, estrogen-sensitive cancers, active or recent VTE, certain clotting disorders, active liver disease, or unexplained vaginal bleeding. Transdermal estrogen has a better VTE profile than oral. Your Eros MD provider screens all of these at intake.
Eros MD Safety Process
Review includes personal and family history of breast and estrogen-sensitive cancers, VTE history, cardiovascular profile, liver status, and current medications. Labs may be ordered when clinically indicated. Follow-up at 3 months initially, then periodically long-term.
How it works
How to Start HRT Through Eros MD
Physician evaluation, modern evidence-based protocol, ongoing monitoring.
01
Complete your confidential women's health intake covering symptoms, menstrual history, health conditions, medications, and family history.
02
Your physician reviews your intake and orders the appropriate hormone and metabolic lab panel.
03
Lab work completed locally. Results reviewed by your physician in the context of your full clinical picture.
04
Your physician discusses findings, risk factors, and treatment options with you. If HRT is appropriate, your personalized prescription is sent to a licensed pharmacy.
05
Medications delivered to your door. Ongoing monitoring, follow-up labs, and provider access built into your plan.
Questions worth asking
Frequently Asked Questions About HRT for Menopause
Most women notice improvement in vasomotor symptoms within two to four weeks. Sleep and mood benefits often follow within the first month. Full symptom stabilization typically occurs over two to three months as hormone levels reach steady state.
Treatment duration is individualized. Current guidelines do not impose an arbitrary time limit. Your provider reassesses annually based on symptom status, health changes, and your preferences. Many women benefit from HRT for five to ten years or longer.
HRT does not cause weight gain. Some women experience minor fluid retention in the first few weeks, which typically resolves. Estrogen therapy may actually help counteract the shift in fat distribution (from hips to abdomen) that occurs during menopause.
Bioidentical hormones are structurally identical to the hormones your body produces. Estradiol (the estrogen used in most modern HRT) and micronized progesterone are bioidentical. Eros MD uses FDA-regulated bioidentical formulations as the standard approach. Compounded bioidentical hormones are also available but are not FDA-regulated and lack the standardized quality controls of pharmaceutical-grade products.