When doing hormone replacement therapy for women, there are about four different ways we can get hormones into the body, especially estrogen. So our estrogens drop, and that’s what gives us the main symptoms of menopause, like hot flashes, night sweats, insomnia, mood changes and so on. Vaginal dryness, all those things. So getting estrogen into the body in some way is super crucial. So there’s different types of estrogens and there’s different ways of getting them into the body.
So our main estrogen is estradiol, and estradiol comes with a regular prescription through a patch, and it comes at many different dosages. We can also get estradiol in a pill, which we try not to do because we don’t want it to go first through the liver, slightly increasing the chance of some side effects like blood clotting, for example. And then there’s also topical estrogens that are creams that we can put on. And then, lastly, there’s a lozenge that we can take that dissolves through the mucous membranes so you’re not swallowing a pill, but it’s dissolving through the mouth. So those are the four different ways we can prescribe estrogens. Then we can do different types of estrogens if we’re doing a cream or a lozenge, we can do a combination of estradiol and estriol. Estriol is a weaker estrogen than estradiol, and sometimes the combination of the two can really help smooth things out.
