Women’s health conversations often start with symptoms: hot flashes, night sweats, brain fog, irregular cycles, low libido, sleep disruption. That’s a reasonable entry point, but it’s not where most clinical decisions are actually made.
What matters more is how those symptoms are interpreted. Not just what’s being reported, but the pattern it may represent, the assumptions shaping the starting point, and which decisions are being made too quickly.
In this Strive Sessions webinar, Megan Kilkeary, PharmD, approaches BHRT from a different angle. Instead of starting with a list of hormones, the session focuses on how providers think through perimenopause, menopause, and hormone regimen when the picture is anything but straightforward.
Watch the Replay: See These Decisions in Practice
This session walks through how these patterns are interpreted in real patient scenarios, including how sequencing, route of administration, and monitoring considerations shape decisions.
Where the Conversation Has Changed since the Women’s Health Initiative (WHI)
The Women’s Health Initiative (WHI) still shapes how hormone regimen is discussed. Even when patients don’t reference it directly, the hesitation often carries through. What’s less clear is how much of that hesitation comes from timing, formulation, and assumptions that haven't kept pace with the evidence.
The webinar revisits the WHI in the context of modern hormone formulation conversations—not to dismiss concerns, but to examine where clinical decision-making may still be catching up.
Perimenopause Symptoms and Hormone Patterns: Why Early Changes Are Often Missed
Perimenopause is where the signal gets noisy. Patients may still be cycling, labs may not tell the full story, and symptoms often overlap with stress, sleep issues, or lifestyle factors. In practice, hormone transition is not always the first place providers look.
But certain hormone patterns tend to emerge earlier than expected. Recognizing those patterns can change how perimenopause is identified and how providers begin structuring hormone formulation discussions.
Progesterone vs Estrogen in Perimenopause: Rethinking Hormone Formulation Starting Points
When hormone formulations enter the conversation, estrogen often becomes the focal point quickly. That starting point isn’t neutral. Hormone patterns in perimenopause are not always linear, and not all signals are pointing in the same direction at the same time. This webinar explores how progesterone and estrogen considerations may be sequenced differently depending on cycle patterns, symptoms, and hormone variability.
“Progesterone deficiency is often the first hormone that we see start to decline in the perimenopause phase.” - Megan Kilkeary, PharmD
See how Megan sequences progesterone and estrogen across real patient scenarios in the full Strive Sessions webinar.
How Hormone Formulation Route of Administration May Affect Clinical Decisions
Cream, capsule, troche, vaginal preparation—it’s easy to think of route of administration as a preference. But that framing breaks down when you consider how route may influence metabolism, absorption, duration, and timing.
Once those factors are in play, the same hormone can carry very different clinical considerations. That's often where the decision-making gets oversimplified.
“Formulation does matter… when we're taking oral medication, we do have to be cognizant of those potential metabolites that we are creating.” - Megan Kilkeary, PharmD
Watch the full session to see how the route of administration plays out across real clinical decision-making.
Compounded Hormone Formulations and Monitoring: How Follow-Up Shapes BHRT Decisions
Compounded hormone formulations are often described as individualized preparations, but the more practical question is what that individualization allows providers to observe and respond to over time.
Patient-reported experiences, tolerability signals, and even subtle changes in response shape how formulation is adjusted. In that sense, monitoring and follow-up are not just checkpoints but part of how decisions continue to evolve.
BHRT in Perimenopause and Menopause: Why Clinical Decision-Making Still Feels Unclear
A provider can review BHRT in a few minutes and come away with a list of hormones and options. That’s not what this session is designed to do.
The focus is on how individualized hormone formulation decisions are structured when patterns are unclear, variables are shifting, and the path forward is not immediately obvious.
The blog introduces the questions. The webinar walks through how those questions are approached in practice.
Watch the full Strive Sessions webinar with Megan Kilkeary to see how perimenopause patterns, hormone sequencing, route of administration, and monitoring considerations may come together in real clinical decision-making.
For unanswered questions after viewing, reach out to your Strive rep.
Ongoing Education Across Personalized Medicine
Stay current with upcoming Strive Sessions as we continue exploring clinical decision-making across personalized medicine, compounding, and emerging areas of care. Visit the site here to view upcoming webinars and register for the sessions ahead.
Disclaimer:
Compounded medications are specially prepared for individual patient needs based on a valid prescription from a licensed healthcare provider and, as such, are not reviewed or approved by the U.S. Food and Drug Administration (FDA) for safety or efficacy. The information presented in this webinar and associated materials is intended for licensed healthcare providers for educational purposes only and does not constitute medical advice or a recommendation regarding any specific compounded preparation. Individual patient presentations vary; prescriber clinical judgment should guide all decisions. These statements have not been evaluated by the FDA.
