Menopause Hormone Therapy (HRT) in Charleston, SC

Bioidentical hormones in Charleston: what it means

If you are one of the 17,654 women aged 45 to 64 in Charleston 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.

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.

Charleston is a center for OB-GYN care: the federal NPI registry lists 148 OB-GYNs with a primary practice address in the city, 97.4 per 100,000 residents, 5.5 times the US rate of 17.8 and above South Carolina's 18.0. That is more per resident than 96% of the 924 cities VevaMD covers. With about 17,654 women aged 45 to 64 living in Charleston, that is about 120 for each OB-GYN in the city, before counting any younger patients.

Within 25 miles of Charleston there are 233 OB-GYNs for 768,242 residents (30.3 per 100,000), well above the national rate; 194 are in the city or within 10 miles. VevaMD is an online option alongside them: a physician licensed in South Carolina reviews your intake from Charleston without an office visit, and an OB-GYN you already see stays your doctor.

You do not choose a "bioidentical" product from a menu: after a private intake, a physician licensed in South 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.

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