Menopause Hormone Therapy (HRT) in Silver Spring, MD

Bioidentical hormones in Silver Spring: what it means

"Bioidentical" describes a hormone whose chemical structure matches one the body makes. Estradiol and micronized progesterone are both bioidentical: their structure matches the hormones the ovaries make. FDA-approved versions of both are sold by prescription at retail pharmacies.

"BHRT" often means compounded hormones, a cream, a blend such as Bi-Est or a pellet that a pharmacy mixes for one prescription. They are not FDA-approved, which means the FDA cannot assure their safety or effectiveness. The FDA also says it has no evidence that they are safe and effective, or more effective than approved hormone therapy. A 2020 National Academies review found no rigorous evidence of their safety and effectiveness.

For women in Silver Spring, a physician licensed in Maryland can prescribe estradiol (pill, patch, cream or vaginal) and progesterone when they fit your history. There are no pellets. Because the dispensing pharmacy also compounds, you can ask whether your estradiol or progesterone is an FDA-approved product. Two options are compounded for certain: testosterone cream for women and Bi-Est are not FDA-approved.

The NPI registry counts 90 OB-GYNs practicing in Silver Spring, about 109.6 for every 100,000 residents against 17.8 nationally and above Maryland's 22.0, a higher rate than 97% of the cities VevaMD covers. With about 9,223 women aged 45 to 64 living in Silver Spring, that is about 100 for each OB-GYN in the city, before counting any younger patients.

Counting the area around it, 571 OB-GYNs practice in Silver Spring or within 10 miles and 1,324 within 25 miles: 26.3 for every 100,000 of the 5,039,618 people who live within 25 miles, a dense supply. None of this replaces your own OB-GYN or a menopause doctor you trust; VevaMD adds an online route, with a physician licensed in Maryland reviewing your answers from home in Silver Spring.

Then there are pellets, implanted under the skin at a clinic; 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 advises FDA-approved hormone therapy over compounded preparations.

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