Hormone Replacement Therapy for Women in Westchester County, NY

Hormone replacement therapy for women in Westchester, in brief

Hormone replacement therapy (HRT), also called menopause hormone therapy, replaces the estrogen — and usually progesterone — the ovaries stop making around menopause. It is the most effective treatment for hot flashes and night sweats, and it also treats vaginal dryness and helps prevent bone loss.

Women come to Protocol Health's Scarsdale clinic from across Westchester County — White Plains, Yonkers, New Rochelle, Rye, Chappaqua, Bedford and every town in between. Eligible patients anywhere in New York can also start and continue HRT by telehealth.

HRT is not one prescription. The dose, the route (patch, gel, pill or vaginal) and whether progesterone is needed all depend on your age, your symptoms, whether you have a uterus and your personal and family history. Getting those choices right is what a menopause evaluation is for.

What changed in 2025: the FDA and the HRT boxed warning

For two decades, HRT carried a boxed warning that frightened many women — and many doctors — away from it. The warning followed the Women's Health Initiative (WHI) trial, whose participants averaged 63 years old, more than a decade past the typical age of menopause.

In November 2025, the FDA announced it was initiating removal of the broad boxed warnings on menopausal HRT, working with manufacturers to remove references to cardiovascular disease, breast cancer and probable dementia from the box. The FDA kept the boxed warning for endometrial cancer on systemic estrogen-alone products, because estrogen without progesterone can thicken the uterine lining.

A label change does not make HRT risk-free, and it does not make it right for everyone. What it does is move the conversation back to where it belongs: an individual risk review with a clinician, rather than a blanket warning.

Timing matters: age and years since menopause

The single most useful fact about HRT safety is that timing changes the balance of benefit and risk. The Menopause Society's 2022 position statement concludes that for healthy women younger than 60 or within 10 years of menopause with bothersome symptoms, the benefits of hormone therapy generally outweigh the risks.

Long-term follow-up of the WHI trials (JAMA 2013) found that absolute risks were low in women aged 50 to 59 and that the risk picture differed by age. Starting HRT for the first time after 60, or more than 10 years after the last period, needs a more careful review — which is why the evaluation asks when your periods stopped.

Perimenopause: why one blood test cannot diagnose it

Perimenopause — the years before the final period — often brings hot flashes, poor sleep, heavier or irregular periods, mood changes and brain fog, sometimes starting in the early 40s. Many women in Westchester are told their hormone levels are "normal" and sent home.

The reason is that estrogen and FSH swing widely from week to week during perimenopause. A single blood draw can land on a normal day. For women over 45 with typical symptoms, menopause and perimenopause are diagnosed clinically — from symptoms and cycle changes — not from one lab value.

Labs still matter at Protocol Health, for a different reason: thyroid problems, anemia and other conditions can mimic perimenopause, and a baseline panel makes follow-up safer. They rule things out rather than rule perimenopause in. Our menopause care page covers the symptoms in more detail.

HRT options for women: estradiol, progesterone and testosterone

Protocol Health providers in Westchester build HRT from a few well-studied parts. The combination depends mainly on whether you have a uterus and which symptoms matter most to you.

Patch, gel or pill: why the route of estrogen matters

Estrogen taken by mouth passes through the liver first, which raises clotting factors. Estrogen absorbed through the skin — a patch or gel — largely bypasses that step, and observational studies link it to a lower risk of blood clots than oral estrogen.

For that reason, Protocol Health providers often favor transdermal estradiol for women with migraine, higher body weight or other clot risk factors. Oral estrogen is still reasonable for many women; the point is that the choice of route is a safety decision, not just a preference.

Bioidentical hormones: what the term does and does not mean

"Bioidentical" means a hormone has the same chemical structure as the one your body makes. Estradiol and micronized progesterone are bioidentical — and both are available as FDA-approved products, including the patches, gels and capsules in the table above.

The term is also used to market custom-compounded hormone mixes and pellets. A 2020 National Academies review found insufficient evidence that compounded bioidentical hormone therapy is safer or more effective than FDA-approved hormone therapy, and raised concerns about dose consistency. Protocol Health uses FDA-approved bioidentical hormones where they fit, and explains clearly when a compounded product is being considered and why. Our guide to BHRT goes deeper.

Who should not take HRT

Systemic HRT is generally not used in women with a history of breast or endometrial cancer, a prior blood clot or stroke, active liver disease, or unexplained vaginal bleeding. Unexplained bleeding is always evaluated before treatment starts.

Women with a uterus who take systemic estrogen need progesterone as well, to protect against endometrial cancer. Women who have had a hysterectomy usually take estrogen alone. Low-dose vaginal estrogen has very little systemic absorption and is considered for many women who cannot take systemic HRT — a decision made with your provider and, where relevant, your oncologist.

How HRT works at Protocol Health

1. Evaluation. A provider reviews your symptoms, cycle history, personal and family history and goals, in person in Scarsdale or by telehealth.

2. A baseline. Blood pressure, relevant labs and, where due, a mammogram and other screening, so treatment starts from a known point.

3. A plan built around you. If HRT fits, your provider chooses the hormones, dose and route, and explains the tradeoffs. If it does not, you hear the non-hormonal options too.

4. Follow-up. A check-in after the first few months to adjust the dose, then at least yearly review of whether HRT still fits. See the Scarsdale women's HRT page for clinic details.

Hormone therapy for women across Westchester County

Protocol Health’s clinic at 700 White Plains Road in Scarsdale sits near the center of the county. Patients come from every town below, and eligible patients can continue care by telehealth. Each town has its own page with local details:

Women's HRT in Westchester — frequently asked questions

Where can I get hormone replacement therapy in Westchester?

Protocol Health's clinic is at 700 White Plains Road in Scarsdale, central to Westchester County. Our providers evaluate perimenopause and menopause symptoms and prescribe HRT when it fits. Eligible patients anywhere in New York can also be treated by telehealth.

Is HRT safe?

For healthy women under 60 or within 10 years of menopause with bothersome symptoms, the Menopause Society concludes the benefits generally outweigh the risks. In 2025 the FDA began removing the broad boxed warnings from menopausal HRT. Risk still depends on your age, history and the type of hormone, which is why an individual review comes first.

Can I start HRT during perimenopause?

Yes. Symptoms often start years before the final period, and HRT can treat them then. Perimenopause is diagnosed from symptoms and cycle changes, because hormone levels swing too much for one blood test to confirm it.

Are bioidentical hormones safer than regular HRT?

Estradiol and micronized progesterone are bioidentical and available as FDA-approved products. A 2020 National Academies review found insufficient evidence that custom-compounded bioidentical hormones are safer or more effective than FDA-approved hormone therapy.

Can I stop taking HRT at any time?

Yes, HRT can be stopped at any time, and it is not addictive. Hot flashes and other symptoms often return after stopping, so many women and their providers plan the timing and decide together whether to taper.

Do I need progesterone if I take estrogen?

If you have a uterus, yes. Estrogen alone thickens the uterine lining and raises the risk of endometrial cancer; progesterone protects against that. Women who have had a hysterectomy usually take estrogen alone.

Can I do menopause care by telehealth from Westchester?

Yes, if you are eligible. Many Westchester patients start with an in-person visit in Scarsdale and continue by telehealth.

Related

Important safety information

Systemic hormone therapy is not used in women with a history of breast or endometrial cancer, blood clots, stroke, active liver disease or unexplained vaginal bleeding. Estrogen without progesterone raises the risk of endometrial cancer in women with a uterus. Report new vaginal bleeding, leg swelling, chest pain or sudden headache promptly. Compounded medications are not FDA-approved.