Menopause Hormone Therapy (HRT) in Pontiac, MI

Bioidentical hormones in Pontiac: what it means

"Bioidentical" is a word compounding pharmacies often use in marketing, but what it describes is real: a hormone built like the body's own. Estradiol and micronized progesterone are both bioidentical: their structure matches the hormones the ovaries make. Both come in FDA-approved prescription forms, from estradiol pills, patches, gels and vaginal forms to progesterone capsules.

Many products sold as "bioidentical hormones" or "BHRT" are compounded instead: mixed by a pharmacy for one prescription, often as a custom cream or a pellet. 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. The National Academies, reviewing them for the FDA in 2020, called their wide use a public health concern.

Pontiac is a center for OB-GYN care: the federal NPI registry lists 30 OB-GYNs with a primary practice address in the city, 48.5 per 100,000 residents, 2.7 times the US rate of 17.8 and above Michigan's 21.0. That is more per resident than 85% of the 924 cities VevaMD covers. That is about 250 women aged 45 to 64 for each OB-GYN in the city, a ratio rather than a count of open appointments.

Within 25 miles of Pontiac there are 890 OB-GYNs for 3,368,624 residents (26.4 per 100,000), well above the national rate; 232 are in the city or within 10 miles. None of this replaces your own OB-GYN or a menopause doctor you trust; VevaMD adds an online route, with a physician licensed in Michigan reviewing your answers from home in Pontiac.

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. Because the dispensing pharmacy also compounds, you can ask whether your estradiol or progesterone is an FDA-approved product. 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 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