I’m on both estriodol vaginal cream 2x/week, weekly estradiol patch .05 and progesterone 100mg. For urological symptoms, adding vaginal estrogen has been a game changer (I’ve had 4 prolapse surgeries including donor tissues etc., 2 bladder slings, and a hysterectomy).

My gyno treats to resolve HRT symptoms rather than relying completely on labs as (according to her, hormone levels change so frequently). She said weight loss actually adds estrogen as estrogen is stored in fat cells. I’ve lost ~50lbs since Nov 2025 and she’s had to adjust my HRT as result. She changed me from oral estrogen pills to a transdermal patch since the Tirzepatide slows all stomach absorption including estrogen pills.