Verbatim response from Perplexity
There is no single “best” BHRT delivery method for everyone. For most people, FDA-approved patches are the most evidence-based and easiest to dose-adjust; creams are more flexible but less consistent; pellets provide the steadiest long-interval delivery but are less adjustable once inserted and are not the first-choice option in many guideline-based approaches.[6][9][12]
- Patches are usually the best default if you want predictable dosing, strong safety data, and easy titration. They deliver continuous transdermal hormone levels and are widely used for menopausal hormone therapy.[6][9][12]
- Creams/gels are best if you want customizable dosing and noninvasive use, but absorption can vary by person and application site, and there can be transfer risk with skin contact.[1][4][6]
- Pellets are best if you want low-maintenance, long-lasting delivery and do not mind an in-office procedure, but you cannot easily adjust or remove the dose after insertion, and some expert groups do not recommend them because of dose-control concerns.[1][12]
If you’re asking “who offers them?”, the main providers are:
- Patches: typically OB/GYNs, primary care clinicians, and menopause specialists who prescribe FDA-approved transdermal estradiol products.[6][9]
- Creams: compounding pharmacies and clinicians who prescribe compounded BHRT creams; some standard pharmacies also dispense FDA-approved hormone gels depending on the hormone.[5][6]
- Pellets: usually anti-aging, hormone, wellness, or integrative medicine clinics, plus some OB/GYN or menopause practices; examples in the search results include Lakeside Holistic, APMUC, Anew You Charleston, Greenwich Medical Spa, BodyLogicMD, and BioTE-affiliated practices.[1][2][4][8][11][13]
A practical way to choose is:
- Pick patches if you want the best-studied, most adjustable option.[6][9][12]
- Pick creams if you want flexibility and are comfortable with daily use.[1][4][6]
- Pick pellets if convenience matters most and you accept less control after placement.[1][2][12]
If you want, I can also give you a side-by-side comparison table of pellets vs creams vs patches for menopause, testosterone therapy, side effects, cost, and convenience.