HRT, Testosterone & Progestogen Equivalence
Not all progestogens are the same, and not all estrogen routes carry the same risk. OvaHarmony lays out dose equivalence, progestogen scaling and GSM-focused management so you can compare what you are being offered.
Progestogen dose-scaling
If you have a uterus, progesterone or a progestogen is required to protect the endometrium — and the required dose scales with the estrogen dose. Understanding this equivalence is the difference between adequate protection and under-dosing.
GSM: the symptoms nobody mentions
Genitourinary syndrome of menopause (GSM) — vaginal dryness, irritation, urinary urgency — is common, progressive without treatment, and frequently untreated because it is awkward to raise. Local vaginal estrogen is the evidence-based first line and is different from systemic HRT. Know the difference.
Dose equivalence basics
If you have a uterus, a progestogen is required to protect the endometrium — and the required dose scales with the estrogen dose. Understanding that equivalence is the difference between adequate protection and under-dosing.
Routes are not interchangeable
Estrogen comes as patches, gels, sprays, tablets and vaginal preparations, and they carry different risk profiles — transdermal routes avoid first-pass liver metabolism. Genitourinary symptoms are usually managed with local estrogen rather than systemic therapy.
Common questions
Is local vaginal estrogen the same as HRT?
No. It delivers a very low local dose, and the risk profile is different. Discuss with your clinician which is right for your symptoms.
Are compounded hormones safer?
Not necessarily — they are less regulated and can vary in dose. Regulated prescription products are the evidence-based default.