Oral hormones should never be used, particularly the synthetic ones or the equine ones.

 The oral route for hormone delivery maximizes risk & side-effects while minimizing the benefits for HRT. One useful message out of the WHIMS is that oral horse estrogen's increase clot-driven stroke & pulmonary embolism risks, while failing to reduce heart disease risk. Even oral estradiol, the natural human estrogen is inadvisable, because during its passage through the liver, about two thirds of it is converted into a different estrogen, called estrone. In contrast non-oral estradiol shares none of these nasty qualities & when administered expertly, it greatly reduces heart disease events & risks, in the process making natural, non-oral, physiologic forms of HRT a powerful force in the service of preventive health.