HRT is prescribed in different formulations, these being:

• Synthetic – older types of HRT such as Premarin and Premique contains equine oestrogens. All combined HRT patches or oral tablets contain synthetic progestogens, not natural progesterone.
• Bio-identical or body identical – these are derived from yams and soy but are licensed for use in HRT. These hormones can best be described as body identical rather than bio-identical as their molecular compounds resemble hormones produced within the body. Oestradiol, the type of oestrogen that decreases at menopause, progesterone and testosterone are all available as body identical hormones.
• Natural progesterone cream. A widely-available cream but not recommended as it is not absorbed into the body well and also many contain too little amounts of hormone to be effective.

HRT is available to use via the following options:

• Oral tablets – Oestrogen and progesterone are available separately or as combined tablets
• Patches – Some patches contain oestrogen, while others contain a combination of both oestrogen and progesterone
• Gels – oestrogen and testosterone is available as gels
• Creams – oestrogen can be prescribed as a topical cream and natural progesterone is also available as a cream
• Localised pessaries or rings inserted into the vagina containing oestrogen or progestogen (a synthetic version of progesterone)
• Hormonal implants – oestrogen or progesterone formulations which last around 3-6 months.

As previously mentioned, these can be provided in synthetic, bio-identical/body identical or natural formulations.