How is menopausal hormone replacement therapy (HRT) administered?

Updated: Sep 13, 2021
  • Author: Nicole K Banks, MD; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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HT can be prescribed as local (creams, pessaries, rings) or systemic therapy (oral drugs, transdermal patches and gels, implants). Hormonal products available in such preparations may contain the following ingredients:

  • Estrogen alone

  • Combined estrogen and progestogen

  • Selective estrogen receptor modulator (SERM)

  • Gonadomimetics, such as tibolone, which contain estrogen, progestogen, and an androgen

The estrogens most commonly prescribed are conjugated estrogens that may be equine (CEE) or synthetic, micronized 17β estradiol, and ethinyl estradiol. The progestins that are used commonly are medroxyprogesterone acetate (MPA) and norethindrone acetate.

The various schedules of hormone therapy include the following:

  • Estrogen taken daily

  • Cyclic or sequential regimens: Progestogen is added for 10-14 days every 4 weeks

  • Continuous combined regimens: Estrogen and progestogen are taken daily

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