Bioidentical vs Synthetic Hormone Replacement in Menopause

roses grunge © lynette sheppard

This guest post was written by Dr. Jo Ann Holoka, Jacksonville Bioidentical Hormones Expert and part of BodyLogicMD, a network of highly trained physicians across the country who use BHRT (bioidentical hormone therapy) to help anyone suffering from hormone related conditions such as adrenal fatigue, menopause, and andropause (the male menopause).

The difference between bioidentical and synthetic hormones:

Ever since the Women’s Health Initiative studies came to a screeching halt in 2002, hormone replacement therapy (HRT) has garnered a pretty bad rep. The number of women using HRT declined significantly after it was discovered that the combination of hormones that most women were taking (namely progestin and estrogen) increased the likelihood of heart disease, breast cancer, blood clots and stroke.

The main problem with these studies is that they were only focusing on women who used synthetic hormones, such as Premarin, Provera and Prempro. Nearly a decade later, hormone therapy has become more popular among menopausal women, thanks to natural HRT alternatives, like bioidentical hormone replacement therapy (BHRT).

Bioidentical hormones are molecularly identical to the hormones that the body produces naturally. Bioidentical hormones are derived from naturally occurring, plant-based sources, such as soy and yams. There are several advantages when using natural bioidentical hormones, when compared to their synthetic counterpart.

Being that bioidentical hormones are exact replicas of the hormones your body already produces, the body can’t distinguish the supplemented hormones from the ones your body is producing naturally. So when you take a blood test, your total estradiol level reflects both the bioidentical estradiol and the natural estradiol. This makes it easier for your doctor to closely monitor your total levels and adjust your treatment regimen accordingly. Most synthetic hormones are metabolized differently and aren’t visible using standard lab tests.

Another benefit of using bioidentical hormones is that they’re typically not taken orally. Most synthetic forms of HRT are administered orally, in the form of a pill. Instead, bioidentical hormones are compounded in a laboratory and come in the form of creams, gels, pellets or injection (though not common). It’s best to avoid taking hormones orally (bioidentical or not), because it can lead to high blood pressure, weight gain, elevated cholesterol levels and has even been found to bring on sudden bouts of depression in some women.

Perhaps the most alluring of benefits is the fact that each BHRT regimen is individually tailored to meet your specific needs. There is no such thing as a one-size-fits-all treatment when it comes to balancing hormones. Two women of the same age, who follow the same diet and workout routine, could have wildly different hormone levels. Bioidentical hormones are custom compounded based on your hormone levels and your specific set of symptoms. This makes them far more effective than the synthetic HRT drugs that are currently on the market.

Be it hormone therapy or anything else that may relate to your health or well-being, it’s always a good idea to do your homework and research all of your options before making a decision. It’s also important to remember that you know your body better than anyone else. If you feel like your body is trying to tell you something, don’t hesitate to talk with your doctor about further testing to take a closer look at what’s going on inside.

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17 Responses to Bioidentical vs Synthetic Hormone Replacement in Menopause

  1. Theresa June 3, 2011 at 5:47 pm #

    SUPERB ARTICLE (and awesome image.)

  2. jannie June 5, 2011 at 7:44 am #

    nice to hear from a doctor. mahalo

  3. Deb McBain June 5, 2011 at 9:41 am #

    Before you all jump on the BHT bandwagon I suggest checking out the North American Menopause Society website and look at their policy statement on BHT. There is no evidence that BHT is any safer. Any hormone has to be processed in order to be able to be used in the body, therefore no product is more “natural” than another. Once the body metabolizes any outside administered hormone it becomes identical to what the body makes or else it could not be used by the body. There is no evidence that checking hormone levels is helpful in determining dose. Not only do different women have wildly different levels but each woman may have “wildly different” levels from hour to hour, especially during perimenopause. Many of the people advocating BHT are making gobs of money off it. There are commercially made BHTs that work for most women and will be covered by insurance prescription benefits. Save your money and go to a spa. That will work as well as forking it over to hucksters, present company excluded, of course.

  4. Gia July 27, 2011 at 10:42 pm #

    I was on Divigel (gel) and Prometrium (capsuls). Both were covered at CVS). One day they just stopped working for me and all my severe symptoms came back like a hurricane. Now on a Bio-est cream, testosterone cream, and a different progesterone capsul (all compounds). It worked!!! So far it’s covered, but it’s still very expensive. If I didn’t have insurance, I couldn’t afford it – no way. I find it mind boggling that after all this time, women still have to any safe way to treat menopausal symptoms. I’m one of those people who needs to be on something in order keep my job. Safe or not safe. That is the question.

    Since the FDA approved Premarin and still dispenses it, they are the last source I’d ever listen to about what’s safe. They don’t have people in mind. Only money. They are glamorized drug dealers at best. Premarin gave my mom, and many others, breast cancer – twice! All I know is that what I’m taking now is working. Of course I don’t want to be on it forever – I don’t think that’s wise, but if it gets me to retirement , that’s what matters. Thanks for opening up the dialog. I really love this blog and appreciate all you do to keep it going.

  5. Lynette Sheppard July 28, 2011 at 6:20 pm #

    Good luck, Gia. It is such a bummer how a regimen can work for a time and then just stop all of a sudden. I’m almost off my estradiol – but I plan to stay on my natural progesterone cream, maybe forever. And I agree, we have to be careful about believing any company’s rhetoric when profit is at stake. Let us know how it goes.

  6. Stephanie Setaro September 25, 2011 at 12:21 pm #

    I have been doing research on HRT for school and I found 2 intersting articles that you all may find beneficial.
    “Conclusion: Physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal- derived counterparts. Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT. Further randomized controlled trials are needed to delineate these differences more clearly.” Review_Safety_ Efficacy_ Bioidentical_Hormones_Management_Menopause_Deborah_Moskowitz.pdf

  7. Lisa October 24, 2011 at 9:57 pm #

    I am wondering, if you have heard about Amberen? Thank you for the great article!

  8. Bio Identical Hormones April 22, 2012 at 10:52 pm #

    Total Life Medical Center offers fantastic anti aging services for all your needs such as botox, fillers, testosterone therapy, Bioidentical hormone therapy, HGH therapy and many more. Call us today to make an appointment!

  9. Anar December 17, 2012 at 10:37 pm #

    Just started on my estradiol last month and my period was so heavy. My Doc says that’s normal but it took everything out of me, has anybody gone thru this?

  10. Jane January 22, 2013 at 5:07 pm #

    There is an amazing man in Southfield, MI who has turned my life around with bioidentical hormone therapy. Sam was a pharmacist who became disillusioned with traditional medicine and has become what I like to call “The Wizard of Oz”. His contention is hormone balance promotes healthy organs and systems within the body. I am living proof and time will tell how long well-being is mine, but I would (and am) betting my life on Sam.

    As the above post mentioned, it is very difficult when you’re the sole wage earner in your household. You HAVE to get up every day (hopefully you slept!!!!!!!!!!!!!!!!!) I am single with one son. Our lives have depended on me putting one foot in front of the other and making the show go on. I can’t properly express my gratitude for the BHT and vitamin program I am on that is not only getting me out of bed and on my way, but brought back my soul, my happiness and my enthusiasm for life. I would trade 10 years of my life for the way I am feeling now and who knows, maybe that’s exactly what I’m doing.

    After the menningitis scare people got worried about the compounding pharmacies. I spent some time yesterday at Sam’s pharmacy in Southfield and actually watched them make the creams and capsules (thank you to his incredible staff for allowing me this privilege!). I can tell you they are made with impeccable sanitation, precise measurement and a system that at least triple checks each individual measurement and ingredient, and total compound at the end (as well as many other checks and balances including name, etc).

    Before I got on the bandwagon I wanted to do my homework and today I can say that I stand behind Sam and his BHT 100%. I have been using his products for approximately 2 years. I was a bit of a “worst case scenario” and it took some manipulation to get this right. Once things fell into place my thyroid, pancreas, gall bladder and sleep (sweet, sweet sleep) balanced themselves back to normal and all systems are go.

    I have so much to tell but no time. Off to my night job which is now a breeze for me thanks to BHT.

    Thank you for making this beautiful site where we can share and learn from each other.

  11. LynetteSh February 3, 2013 at 6:44 pm #

    Thank you so much for sharing your story with us. This is how we really learn – women sharing wisdom with one another.

  12. Anna Bolton April 10, 2013 at 12:13 pm #

    Im trying to learn about the treatmeants with bioidentical hormones, are safe or note? are natural or what? I have a lot of question about it. Your article is very useful for me. Maybe soon I will be on this kind of therapy

  13. LynetteSh April 10, 2013 at 6:57 pm #

    Good luck! The decision whether or not to use bioidentical hormones is individual for each woman – based on your risk profile measured against potential help and benefit. Find a trusted health care professional to help you assess risk/benefit ratio – preferably a holistic physician or nurse practitioner. Let us know if we can be of assistance with more info.

  14. Lorri Jenkins September 17, 2016 at 6:38 am #

    Do all the natural HRT have risk associated with them? I am getting ready to try Divigel .1% and this has a lot of side affects showing in the brochure that came with it.

  15. LynetteSh September 17, 2016 at 4:01 pm #

    Yes, Lorri, all HRT comes with some risk. However, if you do not have reproductive cancer, breast cancer, or blood clots in your family history – the latest research suggests that short term HRT use does not increase risk over women who take none for 3-5 years. Best to discuss your personal risk factors with your trusted health care practitioner. Hope this helps.

  16. Nicole Beal November 24, 2017 at 8:38 pm #

    I am planning to book an appointment with a doctor specializing in BHRT. I don’t really suffer with the hot flashes or the night sweats but the 4 years of low to mid-grade nausea most days and the pure exhaustion is horrid (not to mention the desert that has now become of my labia). I was put on HRT but the progesterone made my nausea unbearable so I took myself off as I also wasn’t really getting any relief. After 4 years and three separate gynos (one specializing in menopause) all dismissing the nausea as hormone related (yes I did all the gastro tests with nothing abnormal) I am ready to give up and just accept that this is my lot in later life. The BHRT is the last attempt. All this to say, does anyone have any suggested questions I should be inquiring about?

  17. LynetteSh December 23, 2017 at 1:09 pm #

    Make sure they test your hormones via saliva as well as blood – question? was your progesterone oral or topical? Topical is less likely to cause nausea since it does not go through the GI tract. Good luck and keep us posted.