How is BHRT dosed?
BHRT dosing is individualized to estradiol, progesterone, and FSH baseline plus symptom mapping. Common forms include transdermal estradiol and oral micronized progesterone, titrated on recalibration cadence.
Full answer
BHRT (bioidentical hormone optimization) dosing begins with a confirmed baseline: estradiol, progesterone, FSH, TSH, and SHBG. Provider review individualizes the regimen based on symptom severity, menopausal stage, breast and cardiovascular risk, and patient preference. Typical components include transdermal estradiol (patch, gel, or cream) and oral micronized progesterone in women with a uterus. Dosing is titrated on recalibration cadence using symptom response and follow-up estradiol levels. There is no universal dose — the principle is the lowest effective dose to resolve symptoms with safety monitoring.
Educational. Not a substitute for individualized provider review.
- BHRT pathway — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-05-29