Forms of Compounded Hormone Replacement Therapy
An educational overview of the different forms in which compounded hormone preparations can be made — and how each works.
Compounded hormone preparations can be prepared in several different forms. Each has different properties — how absorption occurs, how the medication is used day to day, and what's most practical for a given patient. Your prescriber chooses the form that fits your clinical plan.
Note: Specific active ingredients, doses, and combinations are determined by your prescription. This is general educational content.
Topical Creams
Custom‑compounded topical creams are applied to the skin (inner forearm, inner thigh, abdomen). Hormones absorb through the skin into the bloodstream, bypassing the digestive tract and first pass through the liver. This may be associated with a different risk profile (e.g., lower VTE risk) compared to oral hormones.
Practical tips: Apply to clean, dry skin; rotate sites; wash hands after application; avoid skin‑to‑skin contact with others (especially children, pregnant individuals, pets) for several hours; use the calibrated syringe or pump — do not eyeball.
Oral Capsules
Capsules deliver hormones orally. The capsule dissolves in the GI tract, and active ingredients pass through the liver before entering general circulation (first‑pass metabolism). This affects bioavailability and how the medication is processed.
Tips: Take at the same time each day with or without food per prescription instructions. Do not open or chew capsules unless directed.
Sublingual Troches
Troches are small lozenges that dissolve under the tongue. Active ingredients are absorbed through the oral mucosa, partially bypassing first‑pass liver metabolism. Typical dissolution time is 10‑15 minutes. Do not chew or swallow whole. Avoid eating or drinking for 15 minutes before and after.
Vaginal Preparations
Vaginal creams, suppositories, or capsules deliver active ingredients directly to vaginal and urinary tract tissues, with low systemic absorption at typical doses. Indicated primarily for genitourinary syndrome of menopause (vaginal dryness, painful intercourse, recurrent UTIs). Use as directed (often bedtime application). Clean applicator after each use.
Combination Formulations
One advantage of compounding is the ability to combine multiple active ingredients in a single preparation, when clinically appropriate and stable. This simplifies regimens for conditions requiring multiple hormones or a hormone plus a non‑hormonal agent.
Quality and Safety at Our Pharmacy
All compounded hormone preparations from Humber Bay Compounding Pharmacy include: pharmaceutical‑grade ingredients from verified suppliers, documented batch records with lot numbers, validated procedures, beyond‑use dating, pharmacist verification, and patient counselling at dispense. We are a Level C non‑sterile compounding pharmacy certified by the Ontario College of Pharmacists.