Data table · Reference
FDA-Approved HRT Reference
A structured map of the categories of menopause hormone therapy approved by the US Food and Drug Administration, organized by route and drug class. This reference describes product categories and their general use, not doses or individual brand recommendations.
Systemic estrogen (estradiol)
Estrogen that circulates through the body to treat hot flashes and night sweats. Transdermal routes (patch, gel, spray) bypass first-pass liver metabolism.
| Form | Route | FDA-approved formats | Reference notes |
|---|---|---|---|
| Estradiol transdermal patch | Transdermal | Once- or twice-weekly matrix patches | Applied to skin; steady delivery. Common transdermal option. |
| Estradiol topical gel | Transdermal | Metered-dose gel / gel packets | Applied daily to arm or thigh; dose by pump or packet. |
| Estradiol topical spray | Transdermal | Metered-dose skin spray | Applied to the forearm once daily. |
| Oral estradiol | Oral | Estradiol tablets | Once-daily pill; undergoes first-pass liver metabolism. |
| Conjugated estrogens | Oral | Conjugated equine estrogen tablets | An older systemic estrogen still FDA-approved for VMS. |
| Systemic vaginal ring | Vaginal (systemic) | Higher-dose estradiol ring | A ring delivering systemic-level estrogen for VMS — distinct from low-dose local rings. |
Progestogens (endometrial protection)
When systemic estrogen is used and a uterus is present, a progestogen is added to protect the uterine lining from overgrowth.
| Agent | Route | FDA-approved formats | Reference notes |
|---|---|---|---|
| Micronized progesterone | Oral | Oral capsules | Structurally identical to the body's own progesterone; often taken at bedtime. |
| Medroxyprogesterone acetate | Oral | Tablets | A synthetic progestin used for endometrial protection. |
| Progestin-containing IUD | Intrauterine | Levonorgestrel IUD | Used off-label by some clinicians for endometrial protection; approved indication is contraception. |
Combination products (estrogen + progestogen)
Single products that pair estrogen with a progestogen for women who have a uterus, simplifying a two-drug regimen into one.
| Product type | Route | FDA-approved formats | Reference notes |
|---|---|---|---|
| Estradiol + progestin patch | Transdermal | Combination transdermal patches | Delivers both hormones through the skin. |
| Estradiol + progesterone capsule | Oral | Fixed-dose oral capsule | First FDA-approved combination of bioidentical estradiol and progesterone in one pill. |
| Conjugated estrogens + progestin | Oral | Combination tablets | An older oral combination product. |
| Conjugated estrogens + bazedoxifene | Oral | Estrogen paired with a SERM | Uses a SERM instead of a progestogen for endometrial protection. |
Local (vaginal) estrogen for GSM
Low-dose estrogen applied directly to vaginal tissue for genitourinary symptoms, with minimal systemic absorption. Not intended to treat hot flashes.
| Form | Route | FDA-approved formats | Reference notes |
|---|---|---|---|
| Vaginal estradiol cream | Vaginal (local) | Estradiol or conjugated estrogen cream | Applied with an applicator on a tapering schedule. |
| Vaginal estradiol insert | Vaginal (local) | Low-dose vaginal tablets / softgel inserts | Pre-measured inserts placed vaginally, typically twice weekly after an initial phase. |
| Low-dose vaginal ring | Vaginal (local) | Low-dose estradiol ring | A flexible ring replaced about every 90 days; local delivery. |
| Vaginal DHEA (prasterone) | Vaginal (local) | Prasterone inserts | A daily vaginal insert for painful sex due to menopause; converts locally to hormones. |
More in the library
Reference material only — not medical advice, and not a complete list of every individual product. Approval status and available formats change; verify against the current FDA prescribing label before relying on any detail. Sources: FDA / DailyMed prescribing labels and The Menopause Society. Last updated July 1, 2026.