Menopause Hormone Therapy (HRT) in Vancouver, WA

Bioidentical hormones in Vancouver: what it means

Behind the label "bioidentical hormone replacement therapy" is a plain idea: a hormone whose structure matches the body's own. 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.

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. None of these is FDA-approved, and the FDA has not reviewed them for safety, effectiveness or quality before sale. The FDA also says it has no evidence that they are safe and effective, or more effective than approved hormone therapy. A 2020 National Academies review found no rigorous evidence of their safety and effectiveness.

You do not choose a "bioidentical" product from a menu: after a private intake, a physician licensed in Washington decides what, if anything, fits, and the form. VevaMD does not offer pellets. Since the pharmacy that fills these prescriptions also compounds, ask whether yours is an FDA-approved product or compounded. Two options are compounded for certain: testosterone cream for women and Bi-Est are not FDA-approved.

The NPI registry counts 110 OB-GYNs practicing in Vancouver, about 57.1 for every 100,000 residents against 17.8 nationally and above Washington's 17.0, a higher rate than 89% of the cities VevaMD covers. With about 23,113 women aged 45 to 64 living in Vancouver, that is about 210 for each OB-GYN in the city, before counting any younger patients.

Counting the area around it, 264 OB-GYNs practice in Vancouver or within 10 miles and 608 within 25 miles: 26.9 for every 100,000 of the 2,256,380 people who live within 25 miles, a dense supply. None of this replaces your own OB-GYN or a menopause doctor you trust; VevaMD adds an online route, with a physician licensed in Washington reviewing your answers from home in Vancouver.

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 points to a study that found hormone levels well above the expected range in women using them. 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