What type of hormone therapy is considered physiologically better for treating POI symptoms?

Transdermal hormone replacement therapy (HRT) is considered physiologically better for treating the symptoms of primary ovarian insufficiency (POI) due to its method of delivery and absorption properties. Transdermal systems, such as patches or gels, allow hormones to be absorbed directly into the bloodstream through the skin. This bypasses first-pass metabolism in the liver, which can lead to a more stable serum hormone level and potentially fewer side effects.

Transdermal HRT can closely mimic the body's natural hormone release patterns, thereby improving the efficacy of treatment while minimizing risks associated with oral formulations, such as increased risk of thrombosis or gastrointestinal side effects. This route is particularly beneficial for individuals experiencing specific symptoms of POI such as hot flashes, mood swings, and vaginal dryness, offering a more effective symptom relief while adhering to safety considerations.

In contrast, continuous hormonal contraception and oral contraceptive pills are beneficial in certain contexts but may not provide the same level of symptom management for POI due to the ongoing suppression of ovarian function rather than the restoration of hormone levels. Intramuscular injections might also offer hormone delivery but can lead to inconsistent hormone levels depending on timing and frequency of injections, which may not effectively alleviate symptoms in a way that mimics the body's natural