Menopause Hormone Therapy (HRT) in Asheville, NC

Bioidentical hormones in Asheville: what it means

If you are one of the 11,849 women aged 45 to 64 in Asheville 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.

Compounded hormones are a different thing: a pharmacy prepares them for one patient, as a cream, a capsule or a pellet. None of these is FDA-approved, and the FDA has not reviewed them for safety, effectiveness or quality before sale. The FDA says it has no evidence that compounded "bioidentical hormones" are safe and effective, or more effective than FDA-approved hormone therapy. When the National Academies reviewed them in 2020, the evidence was mostly low quality, such as anecdotes and patient reports.

Asheville is a center for OB-GYN care: the federal NPI registry lists 97 OB-GYNs with a primary practice address in the city, 102.8 per 100,000 residents, 5.8 times the US rate of 17.8 and above North Carolina's 18.9. That is more per resident than 97% of the 924 cities VevaMD covers. Set against the city's 11,849 women aged 45 to 64, that is one OB-GYN for roughly every 120.

Within 25 miles of Asheville there are 126 OB-GYNs for 456,361 residents (27.6 per 100,000), well above the national rate; 100 are in the city or within 10 miles. Whether or not you have an OB-GYN, you can ask a physician licensed in North Carolina about menopause hormone therapy online from Asheville, with no waiting room.

You do not choose a "bioidentical" product from a menu: after a private intake, a physician licensed in North Carolina decides what, if anything, fits, and the form. Pellets are not part of it. The pharmacy that fills VevaMD prescriptions also compounds, so ask your physician whether yours is an FDA-approved product or compounded. Testosterone cream for women and Bi-Est are compounded and not FDA-approved.

Then there are pellets, implanted under the skin at a clinic; 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