@raysecommunity's HRT routine, fact-checked

What did @raysecommunity actually say?

Rachel filmed herself applying her morning HRT stack, which includes Lenzetto estradiol spray, a testosterone gel in sachets, and Isogel (vaginal estrogen cream). She noted she takes progesterone at night because it makes her sleepy, and she admitted her testosterone came without instructions, saying she's "just been kind of figuring out along the way." She also disclosed she's using the vaginal cream topically rather than internally, calling it a "private experiment."

To her credit, she's transparent about the fact that she's sharing personal experience, not medical advice. She frames everything as anecdote. But 12,900 viewers are watching, and some will treat this as a how-to. That matters.

Her stack is consistent with post-surgical menopause management. A hysterectomy eliminates the need for progesterone to protect the uterine lining, but she's still taking it, which suggests either personal preference, ongoing symptom management, or a specific clinical reason her doctor hasn't communicated clearly to her.

Does the science back this up?

Mostly, yes. The clinical decisions she's describing are broadly evidence-based, even if her reasoning is sometimes off. The use of multiple estrogen delivery routes, adding testosterone for libido and energy post-surgical menopause, and taking micronised progesterone at night are all documented in current guidelines.

Testosterone for women with surgical menopause is supported by the 2019 Global Consensus Position Statement (Davis et al., 2019, Journal of Clinical Endocrinology and Metabolism), which found testosterone improved sexual function in postmenopausal women. The night-time progesterone strategy is backed by data showing oral micronised progesterone has sedative properties via GABA-A receptor activity (Baulieu et al., 2000, PNAS). Rotating testosterone gel application sites to reduce localised hair growth is consistent with prescribing guidance, though the evidence base for this specific practice is largely observational.

Her switch from gel to Lenzetto spray due to absorption issues is clinically plausible. Transdermal estrogen absorption varies between individuals based on skin hydration, body composition, and application technique (Kuhl, 2005, Gynecological Endocrinology).

What did they get wrong (or right)?

The biggest concern is the testosterone dosing. She says her sachets are "meant to last eight days" and that a "pea size lump" is the right amount. That is not standard prescribing language, and without knowing the concentration of her specific product, this is not reproducible advice. She openly admits the product came without instructions. That is a dispensing problem, not something viewers should normalise or replicate.

On the vaginal cream: she says she's applying it externally rather than inserting it, calling it a "private experiment" for sensitivity. Topical application of vaginal estrogen to the vulvar area is actually clinically recognised for vulvar atrophy and sensitivity, so this is not as rogue as she makes it sound. The Menopause Society (previously NAMS) acknowledges vulvar application in its 2023 position statement. She deserves partial credit here, even if the framing makes it sound improvised.

She also implies her body "stopped absorbing" the estrogen gel, which is a significant clinical claim. True tachyphylaxis to transdermal estrogen is not well-established in the literature. A more likely explanation is that her dose needed adjustment, or her estrogen levels were checked and found subtherapeutic. Without that context, the explanation she's passing on to followers could mislead people into thinking gel just stops working after a while.

What should you actually know?

If you are managing surgical menopause, the core principles Rachel is demonstrating are reasonable: use the formulations your prescriber has chosen, take progesterone at night if it causes sedation, rotate application sites, and stay consistent with timing. These are good habits.

But several things in this video should not be replicated without your own clinical guidance. First, testosterone dosing is highly individual. Sachets are not universally dosed to last eight days, and a visual cue like "pea size" is not a substitute for a properly labelled prescription. Second, if you think your transdermal gel has stopped working, get your estradiol levels checked rather than switching formulations based on that assumption alone. Third, off-label use of any hormone product, including applying vaginal cream externally, should be discussed with your prescriber, not decided as a solo experiment.

The broader issue is that HRT, especially post-surgical HRT, involves real pharmacology. Rachel is engaging with her treatment, which is genuinely positive. But the gaps in her information, and the gaps in how her prescriptions were communicated to her, are exactly the kind of thing a regulated telehealth consultation should catch before a patient is left figuring it out on TikTok.