Hormones can be taken in different ways. Some hormone therapy is considered “systemic” because the hormones are released into the bloodstream and travel to the appropriate organs and tissues. These hormones are usually taken through a pill, patch, gel, spray or vaginal ring. Other hormone therapy is considered to be “local.” An example of this is a low-dose vaginal ring, vaginal tablets or vaginal creams. These options help treat vaginal dryness or thinning of the vaginal lining, but the hormones are only released in the vaginal tissue. Estrogen-based hormone therapy provides the most effective relief for menopausal symptoms; however, it is not without risks. There are certain individuals who will not be candidates for hormone therapy because of their individual medical histories. For those women that are candidates, it is recommended that a woman uses the lowest dose of hormone therapy that works for her for the shortest possible time. In addition, women who choose hormone therapy should evaluate their dosage and use with their health care providers on an annual basis.