Treatments
Understanding your options.
Treatment for menopause symptoms is personal. The clinicians you connect with through Soha consider your symptoms, history, and preferences to determine whether hormone therapy or another approach is right for you.
Hormone therapy (HRT)
Hormone therapy uses estrogen, and for many people a progestogen alongside it, to address symptoms associated with menopause. For people who still have a uterus, clinicians generally prescribe a progestogen together with estrogen, because estrogen taken alone increases the risk of cancer of the uterine lining.
Hormone therapy is prescribed in several forms, including pills, skin patches, gels, and creams, as well as products applied vaginally. No single form is presented here as better than another. Which form, dose, and duration a clinician considers depends on your medical history, your symptoms, and your preferences, and is a decision you make together.
Hormone therapy is not appropriate for everyone, and it carries risks. Please read our Important Safety Information before starting an assessment.
What we prescribe
What a clinician may prescribe
If a clinician determines that hormone therapy is appropriate for you, they prescribe from three FDA-approved medications. All three are FDA-approved, and none of them is compounded.
- 01
Estradiol transdermal system
FDA-approvedSkin patch, applied twice weekly
A systemic estrogen, for symptoms associated with menopause.
- 02
Progesterone, micronized
FDA-approvedOral capsule, taken at bedtime
A progestogen, prescribed alongside estrogen for a person who has a uterus, to protect the lining of the uterus.
- 03
Estradiol vaginal cream
FDA-approvedApplied vaginally
A low-dose vaginal estrogen, for vaginal symptoms associated with menopause.
Your clinician decides which of these, if any, is appropriate for you. Some people are prescribed one, some are prescribed all three, and some are not prescribed hormone therapy at all. Dose and duration are decided for you individually, not set by a plan.
FDA approval means a medication has been reviewed for safety and effectiveness for this use. It does not mean it is right for everyone.
What you need to know about these medications
Hormone therapy is not right for everyone, and it carries serious risks. These are the most important ones.
- Estrogen used without a progestogen increases the risk of cancer of the uterine lining in a person who has a uterus.
- Systemic hormone therapy has been associated with an increased risk of blood clots, stroke, and, in some populations, heart attack.
- Estrogen plus progestin therapy has been associated with an increased risk of invasive breast cancer, and the risk appears to increase with longer use.
- In studies of women 65 and older, hormone therapy was associated with an increased risk of probable dementia.
Hormone therapy should not be used to prevent heart disease or dementia.
A clinician will generally not prescribe systemic hormone therapy if you have or have had breast cancer or another hormone-sensitive cancer, blood clots, stroke or heart attack, liver disease, or unexplained vaginal bleeding, or if you are pregnant.
Common side effects include headache, breast tenderness, irregular bleeding or spotting, nausea, bloating, fluid retention, and mood changes.
This is a summary, not a complete list of risks, warnings, or side effects. Read the Important Safety Information and the information supplied with any medication you are prescribed, and tell your clinician about your full medical history.
Compounded hormone therapy
Soha does not currently offer compounded hormone therapy. Every medication a clinician prescribes through Soha is FDA-approved.
You may see compounded hormone therapy offered elsewhere, often described as “bioidentical”. Compounded medications are mixed by a pharmacy for an individual patient rather than manufactured to an FDA-approved application, and that distinction matters:
Who hormone therapy is not for
Hormone therapy is not appropriate for some people. A clinician will generally not prescribe systemic hormone therapy through telehealth if you have:
- A history of breast cancer or another hormone-sensitive cancer
- A history of blood clots, such as deep vein thrombosis or pulmonary embolism
- A history of stroke, mini-stroke, or heart attack
- Liver disease
- Unexplained vaginal bleeding
- Pregnancy, or trying to become pregnant
This list is not complete, and your clinician will review your full history. Other conditions — including high blood pressure, migraines with aura, diabetes, gallbladder disease, and smoking — may affect whether hormone therapy is appropriate for you, or which form a clinician would consider.
If a clinician determines that you need an in-person evaluation, they will tell you. Read our Important Safety Information for a fuller summary of the risks.
Where a questionnaire is not enough
In some states the law does not allow a clinician to prescribe based on a questionnaire alone. If you live in one of them, we will contact you to arrange a live visit with your clinician — by video or phone — before any prescribing decision is made. There is no additional charge for it, and you will not be charged for medication unless a clinician prescribes.
Other approaches
Hormone therapy is one option among several. Depending on your history and preferences, a clinician may discuss non-hormonal prescription options, vaginal-only treatments, or changes you can make outside of medication. A clinician may also determine that no prescription treatment is appropriate for you.
Completing an assessment does not guarantee a prescription. A licensed clinician determines whether treatment is appropriate for you.