Hormone Therapy (HRT)

There are two main categories of hormone therapy: systemic hormone therapy and local vaginal estrogen therapy. Treatment is always individualized based on your symptoms, goals and medical history.

Systemic hormone therapy works throughout the body and may be prescribed as oral capsules, patches, topical gels, sprays or certain vaginal rings. These therapies are commonly used to help support symptoms like hot flashes, night sweats, sleep disruption, mood changes and brain fog.

Local vaginal estrogen therapy works primarily within the vaginal and urinary tissues with minimal absorption into the bloodstream. These therapies may be prescribed as creams, tablets or inserts and are commonly used to help support vaginal dryness, discomfort with intimacy and urinary symptoms associated with menopause.

As of March 1, 2026, many menopausal hormone therapy (MHT/HRT) medications are now fully covered under BC’s National Pharmacare Plan NP for eligible BC residents enrolled in MSP. Covered medications can be filled at the pharmacy without a deductible, dispensing fee or special authority paperwork.

Covered therapies may include oral micronized progesterone, estradiol patches and gels, vaginal estrogen creams and inserts, oral estradiol tablets and other commonly prescribed hormone medications. Many of these, including micronized progesterone and estradiol, are considered bioidentical hormones.

Custom-compounded bioidentical hormone therapies prepared through specialty pharmacies are not currently covered under Plan NP and remain a private expense. If you are unsure what options may be covered for you, I can help guide you through the different treatment approaches available.

Yes. Many women begin hormone therapy during perimenopause, which is often when symptoms like poor sleep, anxiety, irregular cycles, brain fog and hot flashes first begin showing up. You do not need to wait until your periods have completely stopped to discuss treatment options.

There is no one-size-fits-all timeline for hormone therapy. The right duration depends on your symptoms, health history, risk factors, goals and how you respond to treatment over time. Some women use HRT for a few years, while others continue longer with ongoing monitoring and reassessment.

Current guidelines no longer recommend automatically stopping HRT at a certain age or after a fixed number of years. Instead, I look at how you’re feeling, how your body is responding, and whether the benefits still outweigh any risks for your specific situation. The goal is always to use the lowest effective treatment approach that keeps you feeling well and supports your long-term health.

Before BC’s new National Pharmacare Plan NP coverage, menopausal hormone therapy was often an out-of-pocket expense, with many women paying roughly $100 per month for commonly prescribed hormone medications. More complex bioidentical hormone therapy regimens, especially compounded therapies, could cost $150–$200 per month or more once laboratory testing and practitioner fees were included.

As of March 1, 2026, many commonly prescribed hormone therapy medications are now fully covered for eligible BC residents enrolled in MSP through Plan NP. That means many women can now access covered hormone therapies directly through their pharmacy without deductibles or dispensing fees, making treatment far more accessible than it has been in the past.

If you still have a uterus, estrogen therapy is usually paired with progesterone because estrogen on its own can stimulate the uterine lining over time and increase the risk of endometrial thickening and uterine cancer. Progesterone helps protect the uterine lining and balance this effect.

If you have had a hysterectomy, progesterone may not always be necessary. The right combination, dose and delivery method depends on your symptoms, health history, risk factors and treatment goals. In my practice, hormone therapy is always individualized rather than using the same protocol for everyone.