Related Topics: Bioidentical Hormones, Hormones

Transdermal Creams Confirmed As Best For Hormone Use

The New York Times reported on how best to tackle menopausal symptoms, and transdermal progesterone gets a thumbs up. If you want to know why applying to the skin is more effective than other methods read on ..

AnnA Rushton

There is often some doubt about whether applying a simple cream can help with menopause symptoms, but if the cream contains bioidentical hormones, then that is indeed the case.

Of all the methods of taking hormones, applying to the skin has been shown to be the most effective.

Why bioidentical hormones?

Ever since the report of the WHI (women Health Initiative) raised concerns about the use of HRT both for its high and often unopposed levels of oestrogen, and the side effects associated with the synthetic progestins that are often in included in it.

In the UK the maximum recommended time on HRT is five years, and the American Congress of Obstetricians and Gynecologists has also revised its guidelines for effective treatment of the symptoms of menopause.

Hot flushes are the most troublesome symptom of menopause and simply replacing oestrogen, which has been the standard practice, was largely discredited by the findings of the long-term clinical trial called the Women’s Health Initiative.

It found that the most popular form of hormone replacement, a pill that combined oestrogen and synthetic progestin called Prempro, increased a woman’s risk of heart disease, breast cancer, stroke and blood clots.

This caused many women to rethink HRT and to look for more natural methods to help with flushes. Alternatives from soy products to herbs such as black cohosh and sage are popular, but there has been no conclusive evidence to say there were effective against menopause symptoms.

New information on treatments for menopause symptoms

At the time of the WHI report, bioidentical hormones were not being widely used and the work of Dr John Lee – the pioneer of progesterone cream usage – was not well known. Now bioidentical progesterone and a combined bioidentical progesterone and oestrogen cream are available to help women with symptoms of menopause in a more natural way.

However, now there is a bulletin, prepared by Dr. Clarisa R. Gracia, an associate professor of obstetrics and gynaecology at the University of Pennsylvania, which has examined the various claims and scores of studies.

It offers treatment recommendations based on the best available evidence and it seems that oestrogen alone, or in combination with a natural progesterone for women who still have a uterus, is the “most effective therapy” for curbing hot flushes, the report found.

They made no comment on the known health risks of cancer, stroke and heart disease associated with unopposed oestrogen and the synthetic progestins which are well enough known to warrant a mention I would have thought.

Approval for transdermal hormone creams

However, the report also said that the transdermal route is considered safer as when absorbed through the skin, the hormones bypass the liver, which would otherwise create substances that might raise the risk of heart attack or cancer.

Also hormones given orally have to be in much higher dosages to compensate for the loss that occurs as they are processed through the liver, and bioidentical cream formula hormones can be in much smaller doses to be effective.

The report found little or no data to support the use of herbal remedies, vitamins, phytoestrogens (like isoflavones, soy and red clover) or acupuncture to relieve hot flushes although many women anecdotally do find such remedies helpful for less severe symptoms.

It did recommend “common sense lifestyle solutions” like dressing in layers, lowering room temperatures, consuming cool drinks, and avoiding alcohol and caffeine. For overweight and obese women, weight loss can also help.

These are sensible ideas, and ones most women will certainly already be aware of, and the issue of being overweight is related to the fact that oestrogen is produced in the fat cells so the more weight on the stomach, abdomen and thighs at menopause then the more oestrogen is being produced there – which will increase signs of oestrogen dominance and the associated risks.

The report did not specify it, but rebalancing with progesterone to oppose excess oestrogen is also recommended by Doctors experienced in bioidentical hormone usage.  Also bioidentical progesterone cream can be used vaginally to help with dryness for women who cannot tolerate oestrogen, though a combined progesterone/oestrogen cream is more specifically helpful for this condition.


The report is a major step forward in acknowledging that transdermal creams are the most effective method of delivering hormones. However they stop short of acknowledging the effect and benefit that bioidentical hormones like progesterone, or progesterone combined with oestrogen, have.

The medical profession is still focused on the widespread use of synthetic progestins and using only oestrogen as the most effective solution for menopause. But for those who wish to avoid HRT, and have found herbal remedies or dietary changes to be largely ineffective, then using bioidentical hormones is the solution an increasing number of women are turning to.

The positive from the report from those wishing a natural alternative to HRT is the acknowledgement that transdermal application of hormones is the most effective method – and that is exactly what you get with bioidentical hormone creams.

Helpful information:

Not sure which hormone you might need? This article can help.

Which hormone or hormones might you need?


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Comments 5
Sorted by:  Date | Recommended
AnnA Rushton | 9:44 am, March 11th, 2018

Pauline severe symptoms usually respond best to 20-1, which is a combination of bioidentical progesterone and two natural oestrogens with the progesterone being the largest ingredient. This article may be helpful:

Pauline | 8:53 am, March 11th, 2018

Despite taking 3 different projesterone creams over almost two years I suffer from hot flushes day and night in frequent intervals. I really need help. P.S. I had been on HRT, eg PREMPRO and others for more than 25 years before stopping because of cancer scares.

AnnA Rushton | 6:54 pm, March 6th, 2018

You order from our website Bernadette and yes you can use Serenity (not 20-1) if on Tamoxifen as progesterone helps oppose the excess oestrogen associated with breast cancer. This article will be helpful Bernadette:

Bernadette | 3:28 pm, March 5th, 2018

How do I order this I am on tamoxifen can I used it.

Dr. Theresa Ramsey | 7:29 pm, April 3rd, 2014

Cream progesterones are not at all uterine protective. Historically when premarin came on the market in 1942, many women went on it only to find 10 years later they all had uterine cancer because progesterone is essential to protect the uterus. Estrogen stimulates both breast and uterine tissue and progesterone opposes it. Creams do not create systemic levels of progesterone and therefore all of the tissues that have progesterone receptors, waiting to be stimulated, are left dormant. Progesterone receptors are in many tissues and in particular breast tissue. Oral progesterone in my practice has been the reason in 18 years of practice I have only seen breast cancer 3 times. Two were lumpectomies and the women stayed on their hormones and the other was a female I recently met. It takes 8 years to develop a cancer. Progesterone cream in no way will protect women like oral does. No research supports the use of topical progesterone cream in women who take estrogen in any form.

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