Other than surgically inserted pellets and injections, there are two ways to use bioidentical hormones: transdermally and orally.
Transdermally means the hormone goes directly through your skin by the use of a cream, gel, patch, sublingual preparation,or suppository. Orally means taking a pill or capsule that contains the hormones.
I believe that the transdermal method is far superior in many ways. Hormones are never meant to be metabolized by the liver, which is what happens when you swallow a pill or capsule. Normally, the human body releases its hormones directly into the bloodstream. The transdermal method does exactly that. The disadvantages are that absorption can differ between women, hormones can be transferred to other people from the skin, and hormones can accumulate over time in the fatty tissue where they can be released for long periods of time even when you don't want them to be.
The oral method requires the hormones to pass through the digestive system and be metabolized by the liver. This puts a burden on the liver. Plus, it is very inefficient because only a small amount of the hormone will actually make it into the bloodsteam. For example, if a 200 mg capsule of Prometrium (progesterone) is taken orally, only about 10% of it will actually be used after it is metabolized, or about 20 mg. However, if a 20 mg dose of progesterone cream is applied to the skin, almost all of it should be absorbed. Also, some researchers say it is the metabolytes from the hormones passing through the liver that causes blood clots and strokes.
I use a combination of transdermal and oral methods. This is a compromise, but after years of experimenting, I have found this to be the best solution for my particular needs.
