A Guide to Different Types of HRT: Pills, Patches, Creams & More

Different Types of HRT: Pills, Patches, Creams & More

Hormone Replacement Therapy Doesn’t Have to Be ConfusingI

f you’re reading this, chances are you’re navigating the rollercoaster of perimenopause or menopause, and you’re looking for answers. First of all, let me just say—welcome. You are not alone. This phase of life is normal, natural, and totally manageable when you have the right information in your back pocket.

So let’s cut through the confusion and get down to brass tacks: Hormone Replacement Therapy (HRT). Maybe you’ve heard about it from your doctor, your best friend, or that one wellness influencer on Instagram who swears by it. But what is it, really? And more importantly, which type is right for YOU?

I’ve got you covered. Let's break down the different forms of HRT—pills, patches, creams, and more—so you can make the best decision for your body, your lifestyle, and your sanity.

What Is HRT and Why Would You Consider It?

HRT is exactly what it sounds like: a therapy that replaces the hormones (primarily estrogen and progesterone) your body stops making as you transition into menopause. Some women sail through menopause with little more than a few hot flashes, while others get hit with the full storm—mood swings, brain fog, night sweats, vaginal dryness, and that fun little thing called osteoporosis risk.

HRT can help alleviate these symptoms by giving your body back what it’s missing. But here’s the thing—HRT isn’t one-size-fits-all. There are different delivery methods, different dosages, and different formulations. Let’s break them down.

The Main Types of HRT:

Pills: The Classic Choice

How They Work: You take them orally, just like your multivitamin. They contain either estrogen alone (for women who’ve had a hysterectomy) or a combination of estrogen and progesterone (for women who still have their uterus).

Pros:

Easy to take and widely available.

Regulates hormone levels effectively.

Can improve mood, energy, and sleep.

Cons:

Can increase the risk of blood clots and stroke in some women.

Must be taken daily (which can be a hassle if you forget!).

May not be the best choice for women with liver issues.

Patches: The Set-It-and-Forget-It Option

How They Work: You stick the patch onto your skin (usually on your lower abdomen or butt) and it slowly releases hormones into your bloodstream over time.

Pros:

Bypasses the liver, reducing clotting risks.

Only needs to be changed once or twice a week.

Stable hormone delivery means fewer mood swings.

Cons:

Can cause skin irritation or allergic reactions.

May fall off if you sweat a lot (hello, hot yoga lovers!).

Some people just don’t like the idea of wearing a patch.

Creams, Gels, and Sprays: The Skincare Routine for Your Hormones

How They Work: You apply them to your skin (arms, thighs, or abdomen), and the hormones absorb directly into your bloodstream.

Pros:

Super easy to apply.

Bypasses the liver, lowering certain health risks.

Flexible dosing—can be adjusted more easily than pills.

Cons:

Can be messy or transfer onto others (your partner, kids, or pets!).

Absorption isn’t always consistent.

May take longer to feel the effects compared to pills or patches.

Vaginal Rings, Tablets, and Creams: Localized Relief

How They Work: These options deliver hormones directly to your vaginal tissue, which can help with dryness, irritation, and painful sex.

Pros:

Targets symptoms directly where they’re needed.

Lower systemic absorption means fewer overall side effects.

Some options last for weeks at a time (like vaginal rings!).

Cons:

Won’t help with whole-body symptoms like mood swings or hot flashes.

Some women find application awkward or uncomfortable.

Must be used consistently for best results.

Hormone Pellets: The Long-Term Option

How They Work: Tiny pellets (about the size of a grain of rice) are implanted under your skin (usually in your hip or buttocks), releasing hormones slowly over months.

Pros:

No daily hassle—just set it and forget it for 3-6 months.

Provides a steady release of hormones.

No risk of transferring hormones to others like with creams.

Cons:

Requires a minor medical procedure.

Harder to adjust dosage if you’re not happy with your levels.

Some women report inconsistent effectiveness over time.

Choosing the Right HRT for You: Questions to Ask Yourself

What are your biggest symptoms? If hot flashes are wrecking your life, a systemic option like pills or patches may be best. If vaginal dryness is your only issue, a local treatment may be enough.

Do you have a history of blood clots or liver disease? If so, avoid oral estrogen and opt for a transdermal option like patches, gels, or sprays.

Are you looking for convenience? If you’re forgetful, a patch or pellet might be a better choice than a daily pill.

Do you have sensitive skin? Patches and topical treatments can sometimes cause irritation.

Do you still have a uterus? If yes, you’ll need progesterone along with estrogen to protect your endometrial lining.

HRT Is a Personal ChoiceThere is no “best” form of HRT—only what works best for YOU.

Your body, your symptoms, your preferences. And remember, HRT isn’t the only tool in your menopause toolkit. Lifestyle changes, diet, exercise, and stress management all play a role in how you feel.

If you’re considering HRT, talk to your doctor. Bring this guide with you. Ask questions. Advocate for yourself. And most importantly, give yourself grace as you navigate this new chapter.

Because guess what? You’re not just surviving menopause—you’re thriving through it. Let’s go!