HRT Dosage: The Real Numbers by Patch, Pill, Gel, and Progesterone
Here is every FDA-approved HRT dose, by hormone and by how you take it. Patch, gel, pill, spray and progesterone are all covered, so you know what to expect at your next appointment.
Medically reviewed by Jill Garnier, MDThere is no single HRT dose. Each hormone and each route has its own range, and every plan starts low. Estradiol patches run from 0.025 to 0.1 mg a day. Pills run from 0.5 to 2 mg a day. Your progesterone dose depends on whether you still have periods.
On this page
- The HRT dosage chart: estrogen by route, plus progesterone
- Estrogen dosing by delivery method: patch, gel, pill and spray
- Progesterone dosing: cyclic vs. continuous, and why it's paired with estrogen at all
- How HRT titration works: why nobody gets "the" dose on day one
- Is there a real "HRT dose calculator"?
- What happens if you miss a dose of HRT
- Signs your HRT dose might be wrong
- Where dosing actually gets set
- Frequently asked questions
The HRT dosage chart: estrogen by route, plus progesterone
HRT dosage is not one number. Estradiol, the main estrogen used in HRT, comes as a patch, a gel, a pill or a spray. Each form has its own FDA-approved dose range. Progesterone has two usual schedules, depending on whether you still have periods. Here is the quick view. Brand details follow below.
Changed once or twice a week, depending on the brand
EstroGel gives 0.75 mg per pump. Divigel packets run from 0.25 to 1.25 mg.
Evamist, 1 to 3 sprays on the forearm each morning
Tablets come in 0.5, 1 and 2 mg
With estrogen, if you have a uterus and still have periods
Common once periods have stopped for good
Want to know what each form costs? HRT patch vs. pill cost compares patch, pill and cream prices by month. Not sure which form fits you? HRT pills vs. patches vs. injections walks through the trade-offs.
This page is about the numbers: what is typical, what the range looks like and how it gets adjusted. Is hormone therapy safe or right for you in the first place? That question has its own guide, hormone therapy in perimenopause.
Estrogen dosing by delivery method: patch, gel, pill and spray
The route matters as much as the milligram number. A patch, gel or spray is transdermal, which means the estradiol goes through your skin into your blood. A pill passes through your liver first. That is why a patch number and a pill number can't be compared directly.
Most patches come in several strengths. That lets a prescriber raise your dose in small steps. Vivelle-Dot, Alora and Minivelle are changed twice a week. Climara is changed once a week, which some women find easier to remember.
Range 0.025–0.1 mg/day. One patch a week.
Five strengths, 0.025–0.1 mg/day
Four strengths, 0.025–0.1 mg/day. The label starts at 0.025 mg for bone protection only.
Five strengths, 0.025–0.1 mg/day
The label sets one pump a day. There is one strength.
Packets go up to 1.25 mg/day
Can go up to 2 or 3 sprays a day
The label asks for the lowest dose that controls symptoms. A 0.5 mg tablet also exists.
Looking for a coupon for Climara or Minivelle? Estradiol coupons and savings cards shows which discounts work on brand and generic patches. For EstroGel and Divigel prices, see estradiol cream and gel cost.
There is also a vaginal ring that treats the whole body, called Femring. It is not the same as the low-dose rings used only for vaginal dryness. Femring starts at 0.05 mg a day. You replace it every 90 days.
Not every patch or cream sold online is one of these FDA-approved brands. Some telehealth providers sell compounded hormones instead. A licensed pharmacy mixes them, rather than a drug maker producing a fixed strength the FDA has approved. HRT patches: what's legit and what's a scam explains that difference and where to place a patch. To see how a patch works in your body, read hormone patches for menopause.
Progesterone dosing: cyclic vs. continuous, and why it's paired with estrogen at all
Progesterone does not relieve hot flashes. Estrogen does that work. Progesterone protects the lining of your uterus, called the endometrium. Estrogen alone can make that lining overgrow over time. If you have had a hysterectomy, you usually take estrogen alone.
The usual form is micronized progesterone, sold as Prometrium and as a generic. It is the same hormone your body makes.
The schedule on the Prometrium label, taken with daily estrogen
Widely used. It is also the progesterone dose in Bijuva, an FDA-approved daily capsule of estradiol and progesterone.
The two schedules lead to different bleeding patterns. That is often what decides which one you get. Cyclic dosing usually brings a period-like bleed each month. That can suit a woman in perimenopause whose body still expects a monthly rhythm. Continuous dosing aims for no bleeding at all. Some spotting in the first few months is common while your body adjusts.
Want the smallest doses that still work, from ultra-low patches to vaginal micro-doses? Our guide to the lowest HRT doses covers each form and what the trials found.
How HRT titration works: why nobody gets "the" dose on day one
Titration means adjusting a dose step by step until it works. Some drugs, like semaglutide, print a fixed weekly ladder on the label. HRT does not. Your right dose depends on how strong your symptoms are, your health history, your route and how your body responds.
Many women notice a first change within four to eight weeks of a new dose. Sleep evens out and hot flashes soften. Knowing whether the dose is enough can take about three months. That is the usual window before a prescriber holds, raises or changes it. You work this out together over time, not once and for good.
Before judging a dose, give it time. Our guide on how long HRT takes to work shows when each symptom usually responds.
Is there a real "HRT dose calculator"?
Not the way a BMI calculator works. Your dose depends on things no formula can weigh. Those include your symptoms, your personal and family history, your route and your body's response. An online quiz can help you start the conversation. The number on your prescription comes from a licensed prescriber who looks at your situation.
What happens if you miss a dose of HRT
It depends on the form. A skipped patch acts differently in your body than a skipped pill.
Missed patch
Put the patch on as soon as you remember. If your next change day is close, skip the missed one and stay on your usual schedule. Never wear two patches at once to catch up.
Missed pill: estrogen or progesterone
Take it as soon as you remember that day. If your next pill is almost due, skip the missed one and carry on. Don't take two to make up for it.
Missed gel or spray
Apply it as soon as you remember, the same day if you can. If the next day's dose is almost due, skip the missed one. Don't apply two doses close together.
Missed progesterone specifically
One missed night is handled like any other pill. Take it when you remember, or skip it if the next one is almost due. Did you miss several days in a row during a 12-day cyclic course? Call your prescriber rather than rebuilding the schedule yourself. The day count is what protects your uterine lining.
Signs your HRT dose might be wrong
Too much and too little both show up in fairly clear ways. That is what your prescriber listens for at a follow-up visit. For side effects in general, see our guide to HRT side effects.
Signs your estrogen dose may be too high
- Breast tenderness that is new or stronger than usual
- Bloating or fluid retention that wasn't there before you started
- Breakthrough bleeding outside what your schedule is meant to cause
- Headaches or mood swings that follow the timing of your dose
Signs your estrogen dose may be too low
- Hot flashes or night sweats that haven't improved much after several weeks
- Sleep still broken by temperature swings
- Vaginal dryness that hasn't responded
- No change at all since starting. That is worth reporting rather than waiting out.
Where dosing actually gets set
A prescriber reviews your symptoms and history. They pick a starting dose and a route. Then they adjust it based on how you respond over the next weeks.
Our guide on how to start HRT covers the first visit and the three-month review where doses get tuned.
Frequently asked questions
What is a normal starting dose of estrogen for HRT?+–
It depends on the route. Patches usually start at 0.025 to 0.05 mg a day, depending on the brand. Gels start at 0.25 to 0.75 mg a day. The pill label starts at 1 to 2 mg a day, and a 0.5 mg tablet also exists. Your prescriber picks a starting point from your symptoms and history, then adjusts.
What is the maximum dose of estradiol?+–
FDA-approved patches top out at 0.1 mg a day. Pills are labeled up to 2 mg a day. Gel and spray limits vary by product. Most women find relief well below the top of these ranges, and there is no reason to go higher than what controls your symptoms.
Do I need progesterone if I've had a hysterectomy?+–
Usually not. Progesterone protects the uterine lining from overgrowth caused by estrogen. Without a uterus, there is nothing to protect. So most women who have had a hysterectomy take estrogen alone. Your own history can change this.
How long before my HRT dose gets adjusted?+–
Many women notice a first change within four to eight weeks of a new dose. Knowing whether the dose is enough can take about three months. That is the usual window before a prescriber decides to hold, raise or change it.
What happens if I miss a dose of my estrogen patch?+–
Put it on as soon as you remember. If your next change day is close, skip the missed one and put on the next patch on schedule. Never wear two patches at the same time to make up for a missed one.
Is there an online HRT dose calculator I can use?+–
Not a real one. Your dose depends on your symptoms, your health history and your route, and a formula can't weigh those. A quiz can help you start the conversation. The number on your prescription comes from a licensed prescriber.
Is 100 mg or 200 mg the standard progesterone dose?+–
Both are standard. They are used for different schedules. The cyclic schedule is 200 mg at bedtime for 12 days of each 28-day cycle, usually while you still have periods. The continuous schedule is 100 mg every night, most common once periods have stopped for good.
Can I switch directly from a patch dose to a pill dose using the same milligram number?+–
No. A pill passes through your liver before it reaches your blood. A patch goes straight through your skin. So the two routes are not a one-to-one milligram swap. When you switch, your prescriber starts you on a new dose and adjusts from there.
This article is educational and not medical advice. Talk to a qualified clinician about your situation.