Help finding HRT over 10 years post menopause

During my initial video visit medical history was discussed along with my medications and cardiac risk factors. I have a cardiac risk score of 0 and no vascular problems.

Did you try other telehealth menopause providers?

You could try Alloy Health or Geneve
https://gennev.com/
among others.

You could get a Coronary Artery Calcium (CAC) Scan to help determine if you are a good candidate for hormone therapy if you are outside the 10 year window.

Avoid Functional Medicine doctors and pellets. Pellets are not FDA approved.

@cliffdweller Why do you say to avoid functional medicine doctors? That is who prescribed HRT (regular Estradiol patches) to me being 63 and 13 years post menopause. He ordered the CAC Test and many others before prescribing and to determine if there could be any discernible cause of my osteoporosis. I felt he was very thorough and knowledgeable and helpful.

@mwallj
I think I spoke too broadly there and I apologize. A lot of the people who mention getting hormonal pellets (which are not recommended and can be unsafe) mention getting them from functional medicine doctors. That does not mean all functional medicine doctors do that.

@mwallj

I have the same experience of my functional medicine provider. Extremely thorough and attentive. I have nothing negative to say! I feel well cared for.

@cliffdweller thanks for clarifying.

@mwallj

Are not recommended by whom? Is there some research you can refer me to?

This may be helpful:
https://www.napgo.org/article/147434-comparison-of-two-delivery-methods-of-bioidentical-hormone-replacement-therapy

@gravity3

I am going by the discourse I’ve read from menopause experts like Dr. Jen Gunther and Dr. Lauren Stricher. I have not done a deep dive as far as research articles from NIH.
Pellets are not FDA approved; you may be getting more or less of the product because there isn’t strict FDA regulation on pellets. This can be dangerous. Here’s an article to start with:
https://open.substack.com/pub/vajenda/p/what-you-need-to-know-about-pellet

@cliffdweller

Risks of compounded “bioidentical” hormone therapy:
https://www.acog.org/clinical/clinical-guidance/clinical-consensus/articles/2023/11/compounded-bioidentical-menopausal-hormone-therapy

Dr. Lauren Stricher on risks of hormone pellets:
https://www.drstreicher.com/media/wgn-news/hormone-pellets-for-menopause-and-more