- What are bioidentical hormones and how do they differ from traditional, natural, synthetic, and compounded hormones?
- What is the Difference between Traditional vs. Bioidentical Hormones?
- Why Should I Take Bioidentical Hormones?
- What Are the Benefits of Bioidentical Hormones?
- Do bioidentical hormones help with weight loss?
- Do Bioidentical Hormones Have Risks or Side Effects?
- With all the controversy over cancer, heart attack, and blood clot risks, are bioidentical hormones safe to use?
- Bioidentical Hormones for Menopause
- FDA-Approved Bioidentical Hormones for Menopausal Symptoms
- Can I Buy Bioidentical Hormones Online?
- Are bioidentical hormones covered by insurance?
It is easy to get confused by the terms “bioidentical,” “traditional,” “natural,” “synthetic,” and “compounded” when talking about hormone replacement therapy. It often seems as though one must have a medical degree to understand their differences. Although we are here to explain the benefits of bioidentical hormones, we will also touch on what the other terms mean.
What are bioidentical hormones and how do they differ from traditional, natural, synthetic, and compounded hormones?
have the same chemical structure as the hormones in the body they correspond to and replace or increase. Although they are synthesized in a laboratory, the body recognizes them as identical matches to the ones naturally secreted. Bioidentical hormones are carefully tested for purity, quality, and safety.
Traditional (conventional) hormones are the ones that have been in use for many years. They might include bioidentical, natural, and synthetic hormones in their categories. These are the “tried and true” methods of hormone replacement – which does not always mean they are the best options. It is just that many doctors have been prescribing them for decades.
Natural hormones are those which come from animal or plant sources. They must still be prepared in commercial laboratories to make them bioidentical to the body’s hormones. We often see natural progesterone derived from yams or soy. Also, natural does not always mean safe, as the properties in some products, such as progesterone derived from soy, may slightly increase breast cancer risk for some women.
Synthetic hormones are laboratory-manufactured medications that do not have the same structure as naturally secreted hormones. Upon administration to the body, a synthesis must occur before they can have any benefit. Synthetic hormones also carry the most significant risk of side effects.
are custom-made in special compounding pharmacies. These are not the same as your local neighborhood pharmacies. A compounding pharmacy prepares the hormone medication to the exact specifications of the prescribing doctor. They are made in small batches and must follow the same manufacturing guidelines and standards as the large pharmaceutical companies.
Here is a list of bioidentical hormones most commonly prescribed to adults:
- Human growth hormone
- Progesterone (not progestin which is synthetic)
Bioidentical hormones have the same chemical structure as the hormones secreted by your body.
What is the Difference between Traditional vs. Bioidentical Hormones?
There are both differences and similarities between traditional and bioidentical hormones. Some traditional therapies are bioidentical in nature. Doctors have prescribed estradiol (estrogen) medications for years that are bioidentical. Unfortunately, they have also given women combination estrogen/progestin treatments that are not bioidentical. Progestin is a synthetic form of progesterone that the body must synthesize before use. That causes an increased risk of dangerous side effects, such as heart attack, blood clots, and breast cancer. Natural, does not carry that concern.
Many traditional hormone therapies use treatments derived from plants or animals, such as Premarin which comes from the urine of pregnant mares. While it is a “natural” treatment, it is not bioidentical to human estrogen. Synthetic hormones do not match the body’s molecular structure. They are viewed as a foreign entity and require some form of synthesis before they can enact their functions.
The main takeaway about bioidentical hormones is that the body cannot distinguish them from those naturally secreted by the glands. Human growth hormone (HGH) injections have the same molecular structure as pituitary somatotropin. The body immediately recognizes the bio-similarity and puts HGH right to work binding with growth hormone receptors.
Why Should I Take Bioidentical Hormones?
As you age, or in response to other situations in your life, your natural hormone levels can decline. When that occurs, the functions corresponding to those hormones also suffer. By taking bioidentical hormones, you give back to your body what it is missing. Increasing hormone levels allows you the opportunity to restore balance to your body’s delicate chemical structure.
Hormones are the body’s chemical messengers. They carry out functions such as metabolism, digestion, circulation, cell regeneration, reproduction, thought processes, and more. Without hormonal balance, your body will not perform at its best. By taking bioidentical hormones, you improve your body’s physiological, physical, and mental functions.
What Are the Benefits of Bioidentical Hormones?
The whole purpose of taking bioidentical hormones is to improve how your body performs. Depending on the hormone in question, any number of impaired functions could occur with a hormone deficiency. Immunity, fertility, blood cell production, heart health, libido, and mood all require hormonal balance.
Do bioidentical hormones help with weight loss?
Some people do gain weight when they suffer from a hormone deficiency. Testosterone, estrogen, and growth hormone all impact metabolism – albeit in different ways.
Elevated levels of estrogen will lead to weight gain. Estrogen causes the body to increase fat storage, particularly in the abdominal region. Belly fat produces aromatase, an enzyme that converts free testosterone into estradiol (the most abundant form of estrogen). As the conversion occurs, estrogen levels increase and stimulate further fat storage, and the cycle continues. The other aspect of this process is that testosterone levels decline as a result. Since testosterone plays a significant role in metabolism, the body becomes inefficient at processing food for energy. Instead, it turns to fat.
Human growth hormone also plays a significant role in metabolism, and when it declines, you will likely gain weight. Since HGH also stimulates testosterone secretion, you have twice the risk of fat retention. Treatment with both HGH and testosterone therapy often lead to a decrease in belly fat and an increase in lean muscle mass.
Other benefits of bioidentical hormones include:
- Reduction or cessation of menopausal symptoms such as hot flashes and night sweats
- Sharper memory and cognitive functions
- Improved muscular strength and bone density
- More youthful looking skin
- Better nail and hair growth
- Stronger immune system
- Deeper, more restful sleep
- Improved emotional state with reduced depression and anxiety
- Reduced risk of osteoporosis, diabetes, heart disease, and obesity
- Increased energy and endurance
- Enhanced sex drive and sexual functions
Bioidentical hormones offer many positive benefits for the entire body.
Do Bioidentical Hormones Have Risks or Side Effects?
Due to reports of potential side effects from hormone replacement therapy, people have every right to express concern. There is a significant difference between bioidentical hormones side effects and those from synthetic medications. Anytime the body has to alter the chemical structure of medication before it can be assimilated for use, you have an increased risk.
With all the controversy over cancer, heart attack, and blood clot risks, are bioidentical hormones safe to use?
When properly prescribed and administered, bioidentical hormones are extremely safe. There will always be inherent risks from any medication. Even over-the-counter preparations. Some women and men have a higher risk factor due to underlying medical conditions or genetic concerns. If you have an immediate family member who had cancer, some hormone therapies may not be recommended for you to use. Breast cancer often eliminates estrogen and progestin therapies from use. However, many women and men can still use testosterone and progesterone if they have a deficiency in those hormone levels. An aromatase blocker is typically used with testosterone to prevent the conversion into estradiol, making testosterone safe even if there is a history of breast cancer.
Both women and men must adhere to the following guidelines for the use of bioidentical hormone therapy:
- Always be completely honest with the hormone specialist about your current and past medical history, including all medications and supplements you take
- Undergo a comprehensive physical examination and blood test to verify candidacy for hormone therapy
- Follow all instructions as directed for the use of bioidentical hormone replacement therapy
- Report any adverse reactions or side effects to the doctor
- Never alter dosage or treatment frequency without doctor authorization
Bioidentical hormones are extremely safe to use under the care and supervision of a hormone specialist.
Bioidentical Hormones for Menopause
In 2002, when the Women’s Health Initiative trial was stopped, many women and their doctors turned away from hormone replacement therapy. The concerns over heart disease, blood clots, stroke, and breast cancer were too high to justify the use of HRT. However, further study of the trial results showed that the issue was isolated mostly to the use of synthetic progestin.
Estrogen therapy using bioidentical hormones is safe for many women. Those who have concerns can often use testosterone or progesterone therapy safely.
Thee are many reasons to use a safe form of HRT other than to stop night sweats and hot flashes. Unbalanced or deficient hormone levels can increase a woman’s risk of osteoporosis and debilitating bone fractures as she ages. Hormones also protect and strengthen brain functions and immunity. You need both these areas to keep you healthy in mind and body.
Since bioidentical hormones such as HGH ensure that your body is manufacturing enough new cells to replace the ones that die off each day, this hormone is vital to your very existence. HGH protects your internal organs from shrinkage, supports testosterone production (and, therefore estradiol), keeps your brain functions sharp, and strengthens your immune system. Without enough HGH, every part of your body is subject to some form of decline.
For many women, HGH takes care of the symptoms of menopause, improving overall health and quality of life.
Many safe options exist for menopausal women to receive bioidentical hormones.
FDA-Approved Bioidentical Hormones for Menopausal Symptoms
Doctors who prescribe bioidentical hormones for the treatment of menopause symptoms have many options available. The chart below shows only those brands of estrogen that are bioidentical:
|Type of Estrogen||Brand Name||Preparation|
|17 beta-estradiol plants (micronized)||Estrace||Pills**|
|Alora, Climara, Esclim, Estraderm, Vivelle, others||Patch|
|Estrace||Vaginal cream +|
|Estradiol acetate||Femring||Vaginal ring|
|Estradiol hemihydrate||Vagifem||Vaginal tablet+|
|*Smaller particles for improved absorption|
**Estradiol only bioidentical until ingested, then converts to estrone in the liver
+Only for vaginal symptom use
The following forms of progesterone are approved bioidentical hormones:
|Type of Progesterone||Brand Name||Preparation|
|Micronized * progesterone USP||Prometrium||Pill|
|Prochieve 4%||Vaginal gel|
|*Smaller particles for improved|
No combined estrogen/progestin preparations are bioidentical. However, a hormone specialist can prescribe bioidentical progesterone along with estrogen therapy if necessary.
Can I Buy Bioidentical Hormones Online?
Do not buy bioidentical hormones online from unregulated sources. An unregulated source is anything other than a legitimate, licensed US pharmacy.
Per US law, you must have a doctor’s prescription to purchase hormones. The body is a complicated machine that requires hormone levels to be in balance for optimal health. Blindly raising or lowering hormone levels can lead to widespread system breakdown. That is why only a hormone specialist should prescribe HRT.
Also, many hormone medications purchase online come from overseas sources that often ship counterfeit or dangerous products. Do not take a chance with your health.
Are bioidentical hormones covered by insurance?
Some forms of HRT are covered by insurance while others are not. Please contact our hormone clinic for a free consultation to discuss your needs.
- Amanda Rosenthal, MD, Ted Jacoby, Rachel Israilevich, Dr. Ronald Moy, MD
- Luis J. Borda, MD, Dr. Antonella Tosti, MD, Lulu L Wong
- Julia A. Files, MD, Marcia G. Ko, MD, Sandhya Pruthi, MD
- Tatnai Burnett, M.D.
- Dr. Deborah Moskowitz
The role of bioidentical hormone replacement therapy in anti‐aging medicine: a review of the literature
Bioidentical hormone therapy in menopause: relevance in dermatology
Bioidentical hormone therapy
Bioidentical hormones: Are they safer?
A comprehensive review of the safety and efficacy of bioidentical hormones for the management of menopause and related health risks.