The HRT preparations using PMU are the older types although many women get on well with these. This the list of HRT preparations from the menu at the top of the screen
https://www.menopausematters.co.uk/treatafter.php The estrogen in Vagifem is synthetic so you don't have to worry on that score. This is from their site
"DESCRIPTION
Vagifem 10 mcg (estradiol vaginal inserts) are small, white, film-coated tablets containing 10.3 mcg of estradiol hemihydrate equivalent to 10 mcg of estradiol. Vagifem 25 mcg (estradiol vaginal inserts) are small, white, film-coated tablets containing 25.8 mcg of estradiol hemihydrate equivalent to 25 mcg of estradiol. Each tablet of Vagifem 10 mcg and 25 mcg contains the following excipients: hypromellose, lactose monohydrate, maize starch and magnesium stearate. The film coating contains hypromellose and polyethylene glycol. Each Vagifem tablet is 6 mm in diameter and is placed in a disposable applicator. Each tablet-filled applicator is packaged separately in a blister pack. Vagifem tablets are used intravaginally. When the tablet comes in contact with the vaginal mucosa, estradiol is released into the vagina.
Estradiol hemihydrate is a white, almost white or colorless crystalline solid, chemically described as estra-1,3,5 (10)-triene-3,17β-diol. The chemical formula is C18H24O •½ H2O with a molecular weight of 281.4."
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