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Hormone replacement has been around for over 100 years.  Drug companies cannot patent a naturally occurring chemical or hormone.  Therefore, companies developed synthetic hormones.  These synthetic hormones were often marketed as "better than the real thing" when in truth they were much worse.  These synthetics did not have natural metabolic pathways.  In some cases these synthetics suppressed or over activated natural hormone receptors.  This led to unexpected adverse effects and outcomes

The route of administration depends upon the hormone.  Depending upon the type of hormone it may be delivered via pills, injection, creams, subcutaneous pellets

Oral administration of medication seems easy but is actually one of the more highly variable methods of taking a medications.  Absorption in the gut may be variable depending upon  food intake, stomach acid levels, or other medications.  Also, medications absorbed through the stomach or intestines may be metabolized immediately by the liver in what is known as "first-pass effect"

In addition to pain, many may not want to inject themselves or deal with the hassle of drawing up medication and disposing of needles.  Plus, this often requires multiple injections a week.

Creams or topicals must be applied carefully to avoid spread to other household members