Evidence first, marketing never.

For most healthy women under 60 or within ten years of menopause, the benefits of hormone therapy outweigh the risks. Here is what the major trials and current guidelines say — and what they do not.

“Bioidentical” is a marketing word, not a safety claim. Estradiol and progesterone manufactured to a tested, standardized product are body-identical and rigorously tested. Here is how to tell the categories apart — and where compounding has a legitimate, narrow role.

Vaginal dryness, painful intimacy, and recurrent urinary symptoms rarely improve on their own — but they respond well to low-dose local therapy. Here is how vaginal estrogen and DHEA work.

Estradiol can be delivered through the skin or swallowed as a pill — and the difference is not cosmetic. Transdermal routes bypass the liver's first pass, which appears to lower clot risk. Here is the mechanism and the evidence behind that difference.

Estrogen helps keep bone strong, and its decline drives the fastest bone loss of a woman's life in the years around menopause. Hormone therapy is an established option to prevent that loss — within an individualized, risk-aware decision.