Balanced.
Restored.
Prescribed.

The most comprehensive single-product HRT available as a compounded formulation. This bioidentical cream delivers both estradiol and progesterone transdermally — applied once daily to the inner arm or thigh — addressing the full spectrum of perimenopause and menopause symptoms in a single application. Estradiol, the primary estrogen lost during the menopause transition, directly resolves hot flashes, night sweats, sleep disruption, mood instability, brain fog, and accelerated bone loss. Progesterone, the hormone that typically declines first in perimenopause, provides endometrial protection for women with a uterus (preventing the uterine lining overstimulation that estrogen-only therapy can cause), and additionally improves sleep quality, reduces anxiety, and stabilizes mood through its interaction with GABA receptors in the brain — independently of estrogen. Bioidentical hormones are molecularly identical to the hormones your body produces naturally, derived from plant-based precursors and structurally indistinguishable from endogenous estradiol and progesterone.

Oral micronized progesterone in a slow-release (SR) capsule formulation — taken nightly for sleep-focused hormone support. Progesterone SR is prescribed for two distinct patient profiles. The first is women already on estradiol therapy (patch, gel, or prescribed elsewhere) who need a separate progesterone to protect the uterine lining and complete their HRT regimen. The second is women whose primary symptom is sleep disruption, anxiety, or mood instability — for whom progesterone's neurosteroid activity is the primary therapeutic target rather than estrogen replacement. The slow-release formulation is a meaningful clinical distinction: standard immediate-release oral progesterone peaks rapidly and clears quickly, giving a short sedative window. SR releases progesterone gradually over the sleep period, producing a sustained effect that aligns with the full sleep cycle — and without the next-day grogginess that higher single-dose oral progesterone can cause. 100mg is appropriate for patients new to progesterone or on lower-dose estradiol; 200mg is the standard dose for patients with a uterus on moderate to higher estradiol.

The estradiol patch is the most physician-recommended first-line HRT delivery format according to current guidelines from The Menopause Society (NAMS). Applied to the lower abdomen twice weekly, the patch delivers estradiol steadily and continuously through the skin directly into the bloodstream — bypassing first-pass liver metabolism entirely. This is a meaningful clinical advantage over oral estrogen: because transdermal estradiol does not pass through the liver before entering circulation, it does not trigger the liver's production of clotting factors or sex hormone-binding globulin — making the patch significantly safer for cardiovascular health and carrying a substantially lower blood clot risk compared to oral estrogen tablets. The patch is the format most commonly prescribed by OB/GYNs and menopause specialists, and the format most familiar to patients who have previously discussed HRT with a physician. Patients coming off brand-name patches (Vivelle-Dot, Climara, Alora) will recognize this format and are typically cost-shopping. We offer two strengths: 0.05mg/day (standard starting dose) and 0.1mg/day (step-up for patients requiring higher estradiol or transitioning from a higher brand-name dose). Each supply is a 13-week (3-month) box of 26 patches, applied on a twice-weekly schedule.

A low-dose estradiol cream applied directly to vaginal tissue to treat genitourinary syndrome of menopause (GSM) — the constellation of vaginal and urinary symptoms driven by local estrogen deficiency that affects more than half of postmenopausal women and is chronically undertreated. GSM symptoms include vaginal dryness and irritation, pain or discomfort during intercourse (dyspareunia), urinary urgency and frequency, and recurrent urinary tract infections — all of which result from the thinning and reduced lubrication of vaginal and urethral tissue that occurs when local estrogen drops. Unlike systemic HRT, low-dose vaginal estradiol has minimal systemic absorption — the estradiol acts locally on vaginal and urethral tissue without meaningfully affecting systemic hormone levels. This is why vaginal estradiol is appropriate for many women who cannot or prefer not to use systemic HRT, including some patients with a history of hormone-sensitive cancer (with oncologist approval). It is typically applied nightly for 2 weeks initially, then reduced to twice weekly for maintenance — and unlike systemic HRT, it can be used indefinitely without cycling.