Menopause Hormone Therapy (HRT) in Palo Alto, CA

Bioidentical hormones in Palo Alto: what it means

"Bioidentical" describes a hormone whose chemical structure matches one the body makes. Two hormones used in menopause care fit it exactly, estradiol and micronized progesterone. Both come in FDA-approved prescription forms, from estradiol pills, patches, gels and vaginal forms to progesterone capsules.

Compounded hormones are a different thing: a pharmacy prepares them for one patient, as a cream, a capsule or a pellet. Compounded drugs are not FDA-approved, so the FDA cannot assure their safety, effectiveness or dose. The FDA says it has no evidence that compounded "bioidentical hormones" are safe and effective, or more effective than FDA-approved hormone therapy. The National Academies, reviewing them for the FDA in 2020, called their wide use a public health concern.

You do not choose a "bioidentical" product from a menu: after a private intake, a physician licensed in California decides what, if anything, fits, and the form. VevaMD does not offer pellets. The pharmacy that fills VevaMD prescriptions also compounds, so ask your physician whether yours is an FDA-approved product or compounded. Two options are compounded for certain: testosterone cream for women and Bi-Est are not FDA-approved.

The NPI registry counts 84 OB-GYNs practicing in Palo Alto, about 124.9 for every 100,000 residents against 17.8 nationally and above California's 16.9, a higher rate than 98% of the cities VevaMD covers. Set against the city's 9,405 women aged 45 to 64, that is one OB-GYN for roughly every 110.

Counting the area around it, 388 OB-GYNs practice in Palo Alto or within 10 miles and 818 within 25 miles: 24.8 for every 100,000 of the 3,299,941 people who live within 25 miles, a dense supply. VevaMD is an online option alongside them: a physician licensed in California reviews your intake from Palo Alto without an office visit, and an OB-GYN you already see stays your doctor.

A pellet clinic is a different model: it implants a hormone pellet under the skin during a visit, and compounded pellets are not FDA-approved. The Endocrine Society points to a study that found hormone levels well above the expected range in women using them. ACOG recommends FDA-approved menopause hormone therapy over compounded hormones.

Sources: FDA: Menopause · FDA: National Academies study of compounded bioidentical hormones (2020) · Endocrine Society position statement on compounded bioidentical hormones (2019) · ACOG Clinical Consensus No. 6, compounded bioidentical menopausal hormone therapy (2023) · CMS NPPES NPI full file, 2026-10-11