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MEPS HC-248A + HC-FY · 2020–2023
HRT Method Usage — Female 45–69
Percentage of eligible women aged 45–69 filling ≥1 menopause HRT prescription, by delivery method.
Each bar = unique patients ÷ total eligible women in MEPS that year.
Systemic and Vaginal/Local are reported separately; rows are not mutually exclusive.
By Delivery Method
By Therapy Regimen
HRT identification: TC1S1_1 = 183 (estrogens) or 185 (progestins); excludes contraceptives (TC 102) and androgens (TC 182).
Systemic = ESTRADIOL (non-TOPICAL), CONJUGATED ESTROGENS, ESTROGENS, PROGESTERONE (oral / sublingual / troche / injectable / compounded).
Vaginal / Local = ESTRADIOL TOPICAL (any form) + CONJUGATED ESTROGENS TOPICAL (Premarin vaginal cream) + PROGESTERONE vaginal insert (Endometrin) — low systemic absorption, indicated for genitourinary syndrome of menopause (GSM).
* Progestogen-only (gray bars, systemic section): Micronized progesterone has no standalone FDA-approved menopause indication; it is approved only as the progestin component of combined estrogen + progestogen HRT for endometrial protection. Patients appearing in MEPS with systemic progestogen fills but no estrogen fills may be (1) using compounded bioidentical estrogen not captured in MEPS (no standard NDC), or (2) using progesterone for perimenopause-related indications such as abnormal uterine bleeding. These patients are retained in HRT Total with this caveat.
Local / Vaginal section — Estrogen Only only: Local vaginal estrogens (Estrace cream, Vagifem, Estring, Imvexxy) have minimal systemic absorption and do not meaningfully stimulate the endometrium. Progestogen co-administration is therefore not indicated for local-only therapy, and Combo / Progestogen-only categories are not shown for the local section.
Sample size: 2020: 4,854 eligible · 2021: 5,109 · 2022: 4,095 · 2023: 3,350. Compounded bioidentical HRT (no standard NDC) and pellet therapy are not captured — true prevalence is higher than shown.
Most Frequently Used Products
Unique patients per product type per year — a frequency ranking, not a volume measure.
Generics grouped by category; named brands kept individual. Arrows show rank change vs. prior year.
Key observations · 2020 → 2023
Generic E2 Oral + Generic Progesterone most frequent every year
together ~55–60% of all HRT patients; standard body-identical regimen
Premarin disappeared after 2020
21 patients in 2020 → zero in 2021–2023; post-WHI shift away from conjugated equine estrogens
Generic E2 Vaginal Cream climbing steadily
26 pts (2020) → 46 pts (2023), now #3–4; growing preference for low-dose local therapy
Generic Progesterone overtook E2 Oral in 2023
65 vs 49 patients — partly reflects women pairing P with transdermal E2 rather than oral
▲2rank improved (positions gained)
▼1rank dropped
—no change / new entry
–not in top 10 that year
| Product |
2020 |
2021 |
2022 |
2023 |
Patient counts overlap across rows.
A patient on combination E+P therapy is counted once in the estrogen row and once in the progesterone row.
True combo patients (E and P fills in the same year) number 25–33 per year; the remainder are E-only or P-only within MEPS records.
P-only patients (21–35/year) likely include women whose estrogen is compounded and absent from MEPS — not directly verifiable from the data.
Compounded HRT and pellet therapy lack standard NDC codes and are not captured.