Understanding hormones: Bioidentical, Natural, Synthetic...
What does it really mean?

Bioidentical hormones are hormones synthesized from plants to be structurally identical to the hormones our body makes. They are often referred to as "natural", while other hormones are referred to as "synthetic". I have said before that the overuse of this word “natural” bothers me. The only thing, which is truly “natural” is not to take anything, and in reality all hormones are synthetic. They are all synthesized from something in order to put them in a form that it useful as a medication. Having said that let me also say that I think all hormones, when used correctly, are very safe and have many benefits.


Part of the current myth is that Bioidentical Hormones are a new alternative in hormone replacement therapy. Bioidentical hormones are not new. They have been available for over 60 years. They are made by pharmaceutical companies and are available at your neighborhood pharmacy, so you don’t have to go to a compounding pharmacy to get them.


Bioidentical hormones are not risk free. They are hormones, and it appears that they have the same benefits and risks as other hormone replacement therapy. There may be evidence of decreased risk with certain preparations of progesterone, and that is currently being investigated. They are a reasonable option for many women when prescribed by a doctor, prepared by a reputable pharmacy, and managed as a medication.

A benefit of bioidentical hormones is that it is sometimes easier to measure hormone levels on these medications. This is more useful in some patients than others.

A drawback to bioidentical hormones is that bioidentical progesterone is not absorbed well through the skin. Therefore, women who still have a uterus, and are taking estrogen, should be on an oral pill or sublingual form of progesterone (sublingual means that it is dissolved under the tongue) to insure that they are getting an adequate dose. New evidence shows that progesterone gels may be absorbed better than creams.

Compounded bioidentical hormones are not regulated by the FDA. This means that they are not tested for potency, efficacy or safety. There are many bioidentical hormones that are FDA approved. They are available as pills, patches creams and gels. It is important that you understand your medications. If you have questions, make an appointment with your doctor.