Menopause Hormone Therapy (HRT) in Livonia, MI

Bioidentical hormones in Livonia: what it means

If you are one of the 13,431 women aged 45 to 64 in Livonia and have searched for "bioidentical" hormones: the word means a hormone whose structure matches one the body makes. Two hormones used in menopause care fit it exactly, estradiol and micronized progesterone. 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. Compounded drugs are not FDA-approved, so the FDA cannot assure their safety, effectiveness or dose. The FDA also says it has no evidence that they are safe and effective, or more effective than approved hormone therapy. The National Academies, reviewing them for the FDA in 2020, called their wide use a public health concern.

41 OB-GYNs in the federal NPI registry give a primary practice address in Livonia: 43.6 per 100,000 residents, above the US rate of 17.8 and above Michigan's 21.0, and more per resident than 82% of the 924 cities VevaMD covers. With about 13,431 women aged 45 to 64 living in Livonia, that is about 330 for each OB-GYN in the city, before counting any younger patients.

Within 25 miles of Livonia there are 1,160 OB-GYNs for 3,656,549 residents (31.7 per 100,000), well above the national rate; 305 are in the city or within 10 miles. VevaMD is an online option alongside them: a physician licensed in Michigan reviews your intake from Livonia without an office visit, and an OB-GYN you already see stays your doctor.

Through VevaMD, a physician licensed in Michigan decides whether hormone therapy fits you and, if so, the form: an estradiol pill, patch, cream or vaginal cream, with progesterone if you have a uterus. There are no pellets. Since the pharmacy that fills these prescriptions also compounds, ask whether yours is an FDA-approved product or compounded. Testosterone cream for women and Bi-Est are compounded and not FDA-approved.

BHRT pellet clinics work differently: they place a hormone pellet under the skin in the office, and compounded pellets are not FDA-approved. The Endocrine Society cites blood levels well above the expected range in women using compounded pellets. ACOG's guidance is to prefer FDA-approved menopause hormone therapy to 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