There is a growing body of evidence to support the use of transdermal (applied to skin) estrogens and oral natural progesterone. The Standard of care in the United States has been to prescribe oral synthetic estrogen and oral synthetic progestogens for the treatment of menopause and its symptoms. Even to this day, most physicians still prescribe synthetic oral hormones to treat menopause while refusing to consider bio-identical hormone replacement therapy. However, there is a growing body of evidence to support the use of transdermal estrogen and oral natural progesterone, which is what we have been prescribing at Nouveau Health for years.

A recent review article published in The European Menopause Journal Maturitas, Nov 2015, reasserted that there is increasing evidence in peer review journals that transdermal estrogen does not increase the risk of blood clots in the lower extremities or the lungs while oral estrogens of any type and synthetic progestogens both independently increase the risk of blood clots in the deep veins of the legs and resultant pulmonary embolus. Their conclusion was that “trans- dermal estrogens alone or combined with micronized progesterone may represent the safest alternative for women who require HT.”

At Nouveau Health we have been saying this for years. It makes obvious intuitive sense that the body can recognize natural substances and that the hormones should be prescribed in a way that mimics the body’s natural process as much as possible. Bio-identical estrogen is prescribed across the skin and is released slowly over a 24-hour period. Natural progesterone is given orally because large molecules are not well absorbed across the skin. A Link to a recent Peer Review article is located below and  is one of many articles that support bio-identical hormone replacement therapy as the safest method of hormone replacement therapy.

Judith Rubin, MD