HRT formulations explained
This page explains what the delivery routes are. It does not contain doses, and it will not tell you which is right for you.
Menopausal hormone therapy reaches the body several ways: transdermal patches, gels and sprays; oral tablets; and local vaginal preparations such as creams, pessaries and rings. There are also combined preparations and separate progestogen components where one is needed.
Which route is appropriate is a clinical decision that turns on factors only a prescriber can weigh. Delivery route is not merely a convenience choice, which is exactly why changing formulation is a real treatment change rather than a swap, and why the date it happened is one of the most useful things you can write down.
The routes, in outline
| Route | Forms | Notes |
|---|---|---|
| Transdermal | Patch, gel, spray | Applied to skin. Application site, frequency and how it interacts with heat, bathing and sweating are practical variables worth recording |
| Oral | Tablet | Taken by mouth |
| Local vaginal | Cream, pessary, ring | Acts at the site applied; commonly used for urogenital symptoms |
| Progestogen component | Tablet, combined preparation, intrauterine system | Where one is indicated, prescribed alongside oestrogen |
Deliberately absent: doses, strengths, and which route suits which person. Those are prescribing decisions. A website that offers them is giving medical advice, and this one does not.
Why the formulation belongs in your record
Three practical reasons, all about being able to answer a question later.
A change of route is a change of treatment. If symptoms shift after moving from tablet to patch, the route change is a candidate explanation and you need the date to reason about it at all.
Practical detail affects adherence, and adherence affects interpretation. A patch that will not stay on in hot weather, a gel that is inconvenient in the morning routine, a tablet that is easy to forget: these are ordinary facts, they are worth recording, and they are useful context for whether something "did not work" or was not consistently taken.
Symptom domains respond differently. Urogenital symptoms and vasomotor symptoms are separate domains, and a change can help one while leaving another unchanged. A record separating them shows that; a single "better or worse" does not. What symptom scales measure.
What to record when something changes
DATE OF CHANGE 2 September 2026
FROM <product / route / strength as written on the prescription>
TO <product / route / strength as written on the prescription>
WHY, if you were told e.g. "skin reaction to patches"
WHAT I EXPECT TO SEE e.g. "fewer night sweats, unclear over what period"Then keep recording symptoms as you already were. The comparison that matters is the weeks before against the weeks after, and it only exists if the before was recorded before you knew what would happen.
Copy the product name and strength exactly as written, rather than paraphrasing. Preparations with similar names are not interchangeable, and a prescriber reading your record needs the actual string.
How to log an HRT change. · Preparing for a review appointment.
What the guidance says about reviews
NICE NG23 sets out a review cadence, including a review after starting or changing treatment and annual review thereafter. Check the current guideline text for the exact wording.
Two things worth knowing alongside it, because both are widely misstated:
- NG23 does not recommend symptom diaries, scores or questionnaires. They are not in the recommendations. The source that supports writing symptoms down is The Menopause Society, which advises making a list of symptoms with their frequency and timing. What NG23 actually says.
- NG23 is guidance for the NHS in England. It is widely read elsewhere and is a high-quality evidence synthesis, but it is not the governing guidance in other health systems.
Where HormoneLog draws its line
HormoneLog logs a regimen: product, route, strength as prescribed, start date, change dates, and how you felt around them.
It does not calculate doses, recommend doses, suggest a change, or interpret whether a treatment is working. Those are clinical judgements, and an app making them is a different category of product operating under different rules.
The output is a record you can hand over, which is a narrow and useful thing to be.
Information, not medical advice. This page describes delivery routes in general terms and deliberately contains no dosing guidance. Nothing here diagnoses or treats any condition or substitutes for a consultation. HormoneLog is not affiliated with, endorsed by, or licensed by any organisation named on this page.
Questions and answers
What are the different forms of HRT?
Menopausal hormone therapy is delivered through several routes including transdermal patches, gels and sprays, oral tablets, and local vaginal preparations such as creams, pessaries and rings. Which is appropriate depends on clinical factors that only a prescriber can weigh.
Does the form of HRT matter or is it just preference?
Both. Delivery route is a clinical decision with real differences, not only a convenience choice, and it is one of the reasons a change of formulation is a genuine treatment change rather than a swap. Your prescriber decides it; your job is to record what you were given and when.
Is a change of HRT formulation a treatment change I should log?
Yes, and it is one of the most useful entries in a record. Changing route, product or dose resets the clock on what a subsequent symptom change can be attributed to, so the date matters as much as the change.
Why does this page not list doses?
Because dosing is a prescribing decision and publishing dose guidance would be giving medical advice. HormoneLog logs what you were prescribed and does not calculate or recommend doses, and this site holds to the same line.
How long before a change of HRT shows an effect?
That varies by symptom, person and preparation, and it is exactly the sort of question worth asking your prescriber directly so you know what window to judge it over. Recording the change date is what lets you answer it for yourself afterwards.
HormoneLog. “HRT formulations explained.” Baker Ventures LLC, September 6, 2026. https://hormonelog.bakerventuresstudio.com/guides/hrt-formulations-explained/