The two main hormones in HRT
HRT replaces the hormones that fall during menopause. The two building blocks are estrogen, which treats most of the symptoms, and a progestogen (progesterone or a synthetic version), which protects the lining of the uterus when you take estrogen. Some women also discuss testosterone, mainly for low libido. Bodies like the NHS set out these options in detail.
Combined HRT vs estrogen-only
The main split is simple. If you still have your uterus, you generally need combined HRT, estrogen plus a progestogen, because estrogen alone can thicken the uterine lining. If you have had a hysterectomy, estrogen-only HRT is usually appropriate. Combined HRT can be cyclical (with a monthly bleed) or continuous (no bleed), often depending on whether you are peri- or postmenopausal.
Delivery methods: patch, gel, spray, or tablet
- Patches, gels, and sprays. Estrogen absorbed through the skin. Often preferred because it carries a lower risk of blood clots than tablets.
- Tablets. Convenient and familiar, taken daily.
- Vaginal estrogen. A low-dose, local option (cream, pessary, or ring) for vaginal dryness and urinary symptoms, with minimal absorption into the rest of the body. It can be used alongside other HRT.
- The progestogen. Delivered as a tablet, as part of a combined patch, or via a hormonal IUD.
What does body-identical HRT mean?
Body-identical HRT uses hormones with the same molecular structure as the ones your body makes, such as estradiol and micronized progesterone, and is regulated and widely prescribed. It is not the same as the custom-mixed compounded bioidentical hormones that menopause bodies generally advise against, because those are not regulated or quality-controlled in the same way.
Which type, dose, and delivery is right for you is a clinical decision based on your symptoms, your health history, and your preferences. This is general information, not medical advice.
How Phaes helps
If you change type, dose, or delivery, Phaes keeps a record of your regimen over time alongside how you feel, so you and your clinician can see what actually helped when you adjust it. See when to start HRT, HRT side effects, and training and HRT.