HRT for Vegans, Vegetarians and Animal‑free Choices

Article written by Dr Mari Walling, British Menopause Society Registered Specialist, GP, Co-founder of Lemala Health, January 2026

This information is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider for personal guidance. 

The aim of this guide is to help women make an informed choice. Some HRT products contain animal-derived ingredients.


Many modern HRT options are plant-based or fully synthetic, making them suitable for vegans, vegetarians and people avoiding certain animal products for religious reasons.

Do you need both hormones?

If you have a womb, you need both oestrogen and progesterone. Progesterone protects the womb lining.

If you’ve had a hysterectomy, you usually only need oestrogen.

Progesterone can be taken as natural micronised progesterone or a synthetic progestogen.

Oestrogen

Vegan/vegetarian-friendly options (transdermal):

  • Gels: Oestrogel, Sandrena

  • Patches: Estradot, Evorel, Progynova TS, Estraderm MX

  • Spray: Lenzetto

Not suitable for vegans:

  1. Tablets such as Premarin (derived from pregnant mares).

    1. There are currently no oestrogen-only tablets fully suitable for vegans; some are vegetarian-friendly.

Progesterone/ Progestogens

Vegan/vegetarian-friendly options:

  • Cyclogest (vaginal pessary)

  • Crinone (vaginal gel)

Notes:

  • Oral micronised progesterone capsules (Utrogestan) contain gelatin, so are not suitable.

  • Mirena coil: hormone device contains no animal products, but the inserter does.

  • Alternative coils (Levosert, Benilexa) are fully plant-based.

  • Synthetic progestogens (e.g. norethisterone, medroxyprogesterone) are fully synthetic and suitable for vegans/vegetarians.

Combined HRT

Vegan/vegetarian-friendly patches:

  • Evorel Sequi, Evorel Conti, FemSeven Sequi, FemSeven Conti

Not suitable (contains gelatin or animal oestrogen):

  • Tablets: Indivina, Tridestra, Bijuve

  • Tablets with equine oestrogen: Prempak C, Premique


Vaginal Oestrogen

Suitable for vegans/vegetarians:

  • Ovestin cream, Blissel gel, Imvaggis pessaries, Estring ring

  • Intrarosa (DHEA-based, no animal products)

Testosterone

All commonly prescribed testosterone gels are vegan/vegetarian-friendly:

  • Testogel, Testim, Tostran, and Androfeme

Vegetarian-only options

Some HRT tablets contain lactose, so they are suitable for vegetarians but not vegans:

  • Oestrogen-only tablets: Elleste Solo, Zumenon, Progynova

  • Combined tablets: Femoston, Femoston Conti, Elleste Duet, Elleste Duet Conti, Kliofem, Kliovance, Trisequens, Tibolone

  • Progesterone pessaries: Lutigest

  • Local vaginal oestrogen: Vagifem, Vagirux

  • Other separate progestogen tablets for vegetarians: Provera, Norethisterone

Religious considerations

Some HRT capsules, like Gepretix, contain bovine-derived gelatin. The manufacturer has certified the gelatin as halal and kosher, but the product still contains animal-derived ingredients.

Patients who avoid all animal products for religious reasons may prefer gelatin-free alternatives.

Others who follow halal or kosher rules may consider it acceptable.

Always check with your healthcare professional if you are concerned about religious dietary rules when choosing HRT.

Extra options and tips

Some women accept animal-derived HRT if no alternatives exist or for health reasons.

Changing the route of administration may make a product more acceptable. For example, oral Utrogestan can be used vaginally (off-label), avoiding the digestive system. Evidence shows it still protects the womb lining.

Always discuss your priorities and choices with your clinician.

Next steps

If you’d like to explore HRT options based on your dietary or religious choices, speak to your healthcare professional. They can guide you on which HRT products are suitable for you.


References:

Annie Hawkins. 2022. Dietary restrictions – ingredients and excipients in hormone replacement therapy (HRT) products.

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What to Expect After Starting HRT?