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Hormone Delivery Systems (HRT)

From the Menopause and Hormones Articles List

HRT Delivery SystemsWhat delivery system options do I have for taking hormone replacement therapy (HRT)?


Because women metabolize hormones differently, there is no one-size fits all hormone replacement therapy (HRT). Hormone differences, such as bio-identical versus synthetic, can also affect hormone choices and delivery system options.

In an attempt to create successful options for all women, a wide variety of delivery methods have been developed over the years. Part of finding the right HRT balance for you includes finding the delivery system and type of hormone that works well with your body.

There can be several reasons why one method may be preferred over another for some women. For sensitive skin, a cream or patch may be too irritating. If you are forgetful, you may not want to try to remember a daily choice. An oral pill may not be best if you already take several other oral medications. Certain health conditions may also play a role in which choice is best for you as different methods are processed by the body differently. If you have a history of blood clots, you may be able to use a patch but not a pill.

Here is a list of some of the delivery systems you can consider for your HRT:

Injections Hormones are inserted into the muscle using a needle. The hormones are delivered systemically through the body without making a first pass through the digestive system.

Oral Pills Hormones in oral pill form are swallowed and pass through the digestive system and liver before hormones enter your bloodstream where they are delivered systemically to the body.

Pellets Hormones are compacted into a tiny pellet that is then placed in the fat beneath the skin by a doctor in a medical facility. The hormones are delivered systemically to the body in a steady dose for approximately three months.

Sublingual Drops and Troches Hormones in sublignual drops and troches are dissolved in your mouth to minimize a first pass through the digestive system. They provide systemic menopause symptom relief once the hormones enter your bloodstream.

Transdermal Creams, Gels, and Ointments
Hormones in transdermal creams, gels, and ointments are absorbed through the skin so they bypass the digestive system. They provide systemic symptom relief.

Transdermal Patches Hormones in patches are absorbed through the skin so they do not make a first pass through the digestive system. Patches are usually worn for several days on the buttocks/hip area or abdomen.

Transdermal Sprays Hormone sprays allow the hormones to be absorbed through the skin so they don't first pass through the digestive system. They provide a low dose of hormones for systemic relief of some menopause symptoms.

Vaginal Creams
Hormones in vaginal creams are absorbed locally by the vaginal walls for localized treatment, so only a small amount of hormones may enter the bloodstream.

Vaginal Pill
Hormones can be applied locally to the vagina by using an applicator to insert a tiny vaginal pill. The vaginal pill then sticks to the vaginal walls so it can be absorbed locally with only a small amount entering the bloodstream.

Vaginal Suppositories Hormones in vaginal suppositories are absorbed without first passing through the digestive system. They usually provide localized symptom relief but could be made with higher doses of hormones for systemic relief.

Vaginal rings After a vaginal ring has been inserted, hormones are released over a three month period. There are both localized and systemic vaginal ring options.


Women are all different and what works for one may not work at all for another. There is no one delivery method that is safer or more effective than another across a population of patients, though clearly an individual may do better on one form than another. There are pros and cons with each delivery system, and your specific needs and health issues will play a role in the choices which are available for you. It may take some trial and error to find the right hormone therapy for you. Be patient and give each choice some time, and you should be able to find a delivery system that works for you.


This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

10-07-2014 - 01:19 PM


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