Hormone therapy made for your body, not the average one
Somewhere along the way, somebody told you this is just what your forties look like. Maybe you've been handed the one dose the manufacturer makes and told to see how it goes. We prepare bioidentical hormones at the strength and in the form your provider writes for you.
When you know something has changed
Symptoms do not always arrive with a clear explanation. Changes in sleep, weight, mood, mental clarity, energy, or sexual health can have many possible causes.
You know your own baseline and can often recognize when something has changed. Laboratory results are an important part of the picture, but they are considered alongside symptoms, health history, current medications, and your provider's clinical judgment.
Hormones are not the explanation for everything, but evaluating them may provide useful information and help guide a more informed conversation with your provider.
What bioidentical hormones actually are
Bioidentical hormones are structurally identical to the hormones your body already produces: the same molecule, not an analog. Estradiol, estriol, progesterone, testosterone, and DHEA all exist as bioidentical preparations. Compounding lets a pharmacist prepare them at a specific strength, in a specific form, to your provider's prescription.
The word "bioidentical" describes the molecule, not the manufacturing. Some bioidentical hormones are available as FDA-approved commercial products; others are compounded when the strength, the combination, or the dosage form a patient needs isn't made commercially. Compounded preparations are not FDA-approved: that pathway applies to mass-manufactured products, not to a preparation made for one person.
The hormones we compound
| Hormone | Commonly prepared as | Typically used for |
|---|---|---|
| Estradiol | Cream, capsule, troche, suppository | The primary estrogen in hormone therapy |
| Estriol | Cream, often combined with estradiol (Bi-Est) | A weaker estrogen, frequently used in combination |
| Progesterone | Cream, capsule, troche, suppository | Prescribed alongside estrogen, and on its own |
| Testosterone | Cream, gel, troche | Hormone therapy for men, and low-dose for women |
| DHEA | Capsule, cream | A precursor hormone, prescribed by some providers |
| Compounded thyroid | Capsule | T3/T4 combinations at prescriber-specified ratios |
Which form should you use?
Most people don't know this is a question they get to ask. Your provider decides, but here's what separates the options.
| Form | How it works | Why a provider might choose it | Things to know |
|---|---|---|---|
| Cream or gel | Applied through the skin | May be useful when a customized strength or combination is prescribed | Needs a consistent application site; can transfer by skin contact until dry |
| Capsule | Swallowed, absorbed through the gut | Simple and familiar; the standard for oral progesterone | Passes through the liver first, which changes how much reaches circulation |
| Troche or sublingual | Designed to dissolve in the mouth | Allows some medication to be absorbed through the oral mucosa | Some medication may also be swallowed; has a taste and must be held in place |
| Suppository | Inserted, absorbed locally or systemically | Useful when the target is local, or when oral and topical aren't options | Less convenient; usually prescribed for a specific reason |
Estradiol cream and progesterone cream are the two we prepare most often. Both are made to your prescribed strength, including strengths that aren't manufactured commercially, and both can be combined into a single preparation when your provider wants that.
Compounded bioidentical hormones vs. conventional HRT
Both are real hormone therapy and both are prescribed by providers. The differences are about the molecule, the dose, and who the product was made for.
| Dimension | Compounded bioidentical | Conventional / commercial HRT |
|---|---|---|
| The molecule | Structurally identical to what your body produces | Some are identical; others are synthetic analogs or animal-derived |
| FDA approval | Not FDA-approved — compounded for one patient | FDA-approved products |
| Regulated by | State board of pharmacy, USP standards, your prescription | FDA |
| What can be customized | Strength, dosage form, combinations, and inactive ingredients — all specified by your provider | Fixed as manufactured |
What that table doesn't say is that one is better. For plenty of patients a commercial product is exactly right, and if that's you, your provider will say so. Compounding matters when the commercial version doesn't fit: the dose is wrong, the form is impossible, there's an ingredient you react to, or your provider wants something specific that nobody manufactures, like estradiol and estriol together at a set ratio.
If you already have a prescription
Send it to us and we'll prepare it. Your provider can e-prescribe, fax, or call it in. If they haven't worked with us before, we'll take care of that on our end.
If you don't have a prescription yet
Four steps, in this order, and testing comes before the consultation, so there's nothing to book today.
Tell us what's going on
Fill out the short form below. A sentence is enough. No payment, no appointment.
We reach out and set up testing
Marie or Amy will walk you through it. We'll send a saliva test kit or you can pick one up here: you pay what it costs us, we don't mark it up. We'll also ask for recent blood work if you have it; if you don't, we'll tell you what to ask your provider for.
Your results come back
Once we have them, we'll get you on Marie's calendar.
You meet with Marie
She'll go through your results, answer your questions, and, if hormone therapy looks appropriate, work with your provider on a plan. The consultation is scheduled and paid for at that point, not before.
Where your provider fits
We don't prescribe and we don't diagnose. A compounding pharmacy prepares what your provider orders, and a consulting pharmacist can help you understand your results and the options that exist. The decision to start hormone therapy is made between you and your provider.
If you have a provider you like, we'll work with them, including talking through formulation options with them directly if that's useful. If you're between providers, tell us and we'll help you figure out the next step.
That's the triad: you, your prescriber, and your pharmacist. Each doing the part they're qualified for.
Looking for something that isn't hormone therapy: a vaginal preparation, a pigmentation cream, fertility support? That's our women's health compounding page.
What patients say
Just wanted to thank you for your time, care, and support with my recent ZRT test. I greatly appreciate your input and willingness to help me navigate the results and next steps. I also appreciate that you worked with Dr. Dubose to modify my prescription. Your kindness and patient care did not go unnoticed and I wanted to share my thankfulness, especially when most often complaints are voiced more than compliments. Kindness matters!
Consultations with Marie Elam, RPh
Marie has specialized in hormone consultations since 2008. She reviews your test results with you, explains what the options actually are, and works with your provider on a plan.
Reviewed by Tommy Martincic, PharmD
Owner at Greenhill Specialty Pharmacy. He has been a pharmacist since 2001 and earned his HRT Specialist Certification in 2016. Hormone compounding is what Greenhill Pharmacy does most.
Tell us what's going on
You don't need to have it figured out. A sentence about what you're experiencing is enough to start. We'll take it from there and tell you what the next step looks like.
No prescription required to reach out. No payment today. No appointment to schedule yet.
Rather talk to someone?
- Phone
- 864-520-1550
- info@greenhillrx.com
Once you send it, Marie or Amy will reach out, typically within one to two business days, to walk you through testing. You can also email info@greenhillrx.com or call 864-520-1550.