How should the choice between oral and transdermal estrogen be made?

When deciding between oral and transdermal estrogen, here at Alloy, we focus on what works best for you, your health profile, and your lifestyle. Both forms are effective for relieving menopause symptoms, but there are some key factors to consider:

Personal Preference & Consistency: The most important factor is choosing a method you can use consistently. Some people prefer a daily pill, while others like the convenience of a patch (changed twice weekly), a daily spray, or a gel. The best option is the one you’ll remember and feel comfortable using.
Health Considerations: Transdermal estrogen (patch, spray, or gel) is often preferred if you have certain risk factors, such as:
- High blood pressure
- Sedentary lifestyle
- Type-2 diabetes or high risk for it
- Family history of heart attack, stroke, or blood clotting disorders
- Age over 70, starting MHT after age 60, or more than 10 years after your last period
Transdermal options bypass the liver and do not increase clotting factors, so they are associated with a lower risk of blood clots compared to oral estrogen.
Cost: Oral estrogen pills are usually less expensive than transdermal options, which may be a deciding factor for some.
Side Effects & Special Circumstances: Some people with migraines or those who are sensitive to hormone fluctuations may do better with transdermal forms, which provide more stable hormone levels.
Skin Sensitivity: If you have sensitive skin or allergies to adhesives, you might prefer a spray or gel over a patch.

You can explore Alloy’s options for:

For a deeper dive into this topic, check out these helpful resources:

Watch Dr. Sharon Malone discuss how to choose the right form of estrogen in this YouTube chapter: Choosing the Right Form
Dr. Mary Jane Minkin explains the health risks and benefits of oral vs. transdermal estrogen in this YouTube chapter: Health Risks and Benefits of Oral vs. Transdermal Estrogen

If you’d like personalized guidance, take our quick health assessment and connect with a menopause-trained Alloy doctor who can help you choose the best option for your needs.

This answer was created using the following resources: