Menopause Hormone Therapy (HRT) in Manchester, NH

Bioidentical hormones in Manchester: what it means

If you are one of the 14,358 women aged 45 to 64 in Manchester and have searched for "bioidentical" hormones: the word means a hormone whose structure matches one the body makes. Estradiol and micronized progesterone are both bioidentical: their structure matches the hormones the ovaries make. Neither has to be compounded: FDA-approved estradiol comes as pills, patches, gels, sprays, vaginal creams and rings, and progesterone as capsules.

"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.

24 OB-GYNs in the federal NPI registry give a primary practice address in Manchester: 20.8 per 100,000 residents, above the US rate of 17.8 and about level with New Hampshire's 21.0, and more per resident than 52% of the 924 cities VevaMD covers. That is about 600 women aged 45 to 64 for each OB-GYN in the city, a ratio rather than a count of open appointments.

Within 10 miles of the city there are 70 OB-GYNs, and within 25 miles 171, about 15.9 per 100,000 of the 1,076,004 residents in that radius. None of this replaces your own OB-GYN or a menopause doctor you trust; VevaMD adds an online route, with a physician licensed in New Hampshire reviewing your answers from home in Manchester.

Through VevaMD, a physician licensed in New Hampshire 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.

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 cites blood levels well above the expected range in women using compounded pellets. 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