It must be remembered that hormone (HT) consists of either oestrogen-only therapy (ET) for women who have undergone a hysterectomy (removal of the womb), or oestrogen plus a progestogen (either cyclically or continuously) for women who still have their wombs. HT and ET are most commonly used either orally or transdermally. If it is taken orally, it has to pass through the stomach and liver and broken down into active ingredients. As transdermal applications, the hormones are directly absorbed into the bloodstream and available to the end organs
Transdermal routes of administration are available for oestrogen and for progestogen in the form of patches. They are more expensive than oral preparations. Implants are available as oestrogen and testosterone, but should be reserved for special indications in hysterectomised women. An oestrogen gel is also available for application to the skin and in some countries, as a nasal spray.
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