how do you know which is best for you HRT or Bio-identicals ?

Good luck finding someone in your area. I haven’t been to find anyone that will consider prescribing me either. I’m still searching.

Do you have any cardiac or stroke risk factors- previous TIA, stroke, angina or MI, high cholesterol, family history of heart attack or stroke, history of smoking, high blood pressure, diabetes or metabolic syndrome ? If so, estrogen may not be a good choice for you as it increases risk of heart attack and stroke. Definitely worth talking to a good internist about before you start.

What state are you in? I am in the mid-South and can give you the name of a GYN who prescribes both traditional and bio-identical hormones. In my case, I am using a bio-identical cream because my biggest complaint is atrophic skin that cracks and, then, can bleed from time to time. I asked the pharmacist at the compounding pharmacy what in his cream produces the estrogenic component. The answer: wild yam.
The Big Pharma cream the doc first prescribed has methylparabins in it which was an unwelcome surprise. No, no, no.

I am 49 and recently post-op for a total hysterectomy. I wear an Estradiol patch; it helps my joint pain amd inflammation immensely. I take oral Progesterone for insomnia. Progesterone cream was no longer enough for my symptoms. I also use compounded Estradiol vaginal cream.

@barbaradh, thanks. I’m in NC. I have consulted with my PCP….he says he isn’t informed on it. He does prescribe me local Estradiol cream. But that doesn’t count as HRT, I don’t think. And my Endo and Gynecologist don’t prescribe it either. I got the impression they don’t do it for anyone. I asked my previous endo too. They discount it quickly too. No discussion. So, I don’t think it’s due to my type 1 diabetes.

@barbaradh
I'm in Alabama. Interesting information about the wild yam.

@laura1970
My primary feels I may have familial hypercholesterolmia, after several rounds of blood work done, monitoring my food intake . I don't fit the "profile" or lifestyle of one who would have elevated cholesterol. So not a definite answer and my primary doesn't feel I need any medications since my eating habits/lifestyle can lower it.
So crazy something our body produce(s) naturally can stop making. Then our bodies start breaking down, due to lack of the hormones and when we try to find "things" to bring balance we end up with illnesses and possibly dying from stroke/heart attack.
My GYN years ago gave me estradiol cream but that was for dryness only, she never mentioned hormone balance. I never truly used the cream .

@kris1130 I am on the Mississippi in TN. A bit of a drive for you to use my doc.

@celia16
I'm in the Atlanta area.
There are NPs here who have their own HRT/weight loss/supplements businesses now. If Kennesaw, GA is not too far for you to drive, there's an NP there that I used to use. I now use an NP closer to my house. Both run bloodwork so they make sure the amount of hormones they prescribe are correct.

The brand of Estradiol patch I use is Mylan; Kroger fills it. Both of my obgyns have been happy to prescribe it.

I prefer a compounded Estradiol vaginal cream over the commercial one. It's gentler on my skin. My first NP prescribed it. My second took over calling it in.

For vaginal Estradiol suppositories, I've used Vagifem 10mcg tablets and Imvexxy 10mcg pearls. I'm post-op total hysterectomy right now, so I'm not sure which I'll return to. If you have already ample moisture, Vagifem can be enough. If not, then Imvexxy might absorb better. My urologist is actually the one who started me on this as my first vaginal estrogen because I was getting UTIs.

For oral Progesterone/Prometrium, I like the micronized pearls that all the major pharmacies fill. Compounding pharmacies will make in-between/any dosages in capsules in extended release form.

I hope this helps.