Table of ContentsView AllTable of ContentsWhat Is Natural Hormone Replacement Therapy?The ResearchBalancing Your HormonesCommon Hormonal ImbalancesBenefits of NHRTSupplements for NHRTSide Effects and RisksSupportive Strategies

Table of ContentsView All

View All

Table of Contents

What Is Natural Hormone Replacement Therapy?

The Research

Balancing Your Hormones

Common Hormonal Imbalances

Benefits of NHRT

Supplements for NHRT

Side Effects and Risks

Supportive Strategies

Natural hormone replacement therapy (NHRT) is considered an alternative approach to conventional hormone replacement therapy (HRT). It may use natural or “bioidentical” treatments to restore hormonal balance and promote overall well-being.

The following article covers NHRT’s effects, benefits, and safety considerations.

Galina Zhigalova / Getty Images

Female healthcare provider in white sweater with omega 3, vitamin D capsules in one hand and a glass of water in the other.

Traditional HRTuses hormones likeestrogenorprogesteroneto counter the sharp decline in hormone levels that occurs duringperimenopauseandmenopause.The U.S. Food and Drug Administration (FDA) approves medications used in traditional HRT.

NHRT has gained traction in recent decades as traditional HRT has fallen out of favor.NHRT focuses on “natural” remedies to support hormone balance, such as:

What Are Bioidentical Hormones?The term “bioidentical hormones” can be confusing for a few reasons.First, the definition itself. According to the Endocrine Society, bioidentical hormones are chemically identical to hormones made in the body. However, many people use the term “bioidentical” to refer to hormones that are compounded, derived from plants, or not synthetic (made in a lab).Secondly, the FDA has approved several bioidentical hormones. These are available in tablets, patches, gels, creams, and sprays. Some of these prescription products include:Estradiolproducts like Estrace pill, Climara patch, and Estrace vaginal creamProgesterone products like Prometrium pill and Prochieve vaginal gelTestosteroneproducts like Testim gel and Androderm patch.Compounded bioidentical hormones are custom-made in compounding pharmacies, and the FDA has not approved them.This article refers to this kind of bioidentical hormone.

What Are Bioidentical Hormones?

The term “bioidentical hormones” can be confusing for a few reasons.First, the definition itself. According to the Endocrine Society, bioidentical hormones are chemically identical to hormones made in the body. However, many people use the term “bioidentical” to refer to hormones that are compounded, derived from plants, or not synthetic (made in a lab).Secondly, the FDA has approved several bioidentical hormones. These are available in tablets, patches, gels, creams, and sprays. Some of these prescription products include:Estradiolproducts like Estrace pill, Climara patch, and Estrace vaginal creamProgesterone products like Prometrium pill and Prochieve vaginal gelTestosteroneproducts like Testim gel and Androderm patch.Compounded bioidentical hormones are custom-made in compounding pharmacies, and the FDA has not approved them.This article refers to this kind of bioidentical hormone.

The term “bioidentical hormones” can be confusing for a few reasons.

First, the definition itself. According to the Endocrine Society, bioidentical hormones are chemically identical to hormones made in the body. However, many people use the term “bioidentical” to refer to hormones that are compounded, derived from plants, or not synthetic (made in a lab).

Secondly, the FDA has approved several bioidentical hormones. These are available in tablets, patches, gels, creams, and sprays. Some of these prescription products include:

Compounded bioidentical hormones are custom-made in compounding pharmacies, and the FDA has not approved them.This article refers to this kind of bioidentical hormone.

How to Increase Progesterone Levels Naturally

What the Research Says

Despite all the hype and advertising surrounding compounded bioidentical hormones, there isn’t enough evidence to determine if they’re safe or effective.More research is needed to know the long-term effects of these hormones on heart health and cancer risk.

There is also limited data to recommend supplements (e.g., herbs, vitamins, etc.) instead of traditional HRT. Some plant-based products have been shown to improve symptoms likehot flashesin up to 2 out of 3 postmenopausal women, but the same effects were seen with aplacebo(sugar pills).

On the other hand, physical activity (both aerobic exercise and resistance training) and eating abalanced, healthy diethave been shown to help maintain hormone levels throughout aging.Added benefits to these lifestyle changes include increased bone strength and mental function.

When people talk about HRT, they are usually referring to supplementing with prescription versions of the followingsex hormones:

These chemical messengers play a crucial role in various processes in the body, including:

Maintaininghormone balanceis crucial for overall health, vitality, and quality of life. But as with many things, finding this balance can be very tricky.

Common hormonal imbalances that can affect both men and women include:

Signs and symptoms associated with hormonal imbalances include the following:

These can be vague and aren’t always associated with hormonal issues. Your healthcare provider can help you determine if your symptoms are related to a hormonal imbalance and develop a treatment plan if so.

Hormone Therapy for Menopause May Slow Down Biological Aging, Research Shows

Benefits of Natural Hormone Replacement Therapy

Some people use NHRT to address hormonal imbalances and promote well-being. NHRT is marketed for uses like the following:

Keep in mind that while traditional HRT has proven benefits for some menopausal symptoms, NHRT has not been proven effective.This doesn’t mean that NHRT can’t help, but it does mean that more research is needed before these alternative treatments can be routinely recommended.

Supplements for Natural Hormone Replacement Therapy

Dietary supplements that have been studied for hormone replacement therapy include

All supplements carry a risk of side effects and drug interactions. Discuss using these and other dietary supplements with your healthcare provider, pharmacist, or registered dietitian before adding them to your medicine cabinet.

Choosing a SupplementIn the United States, the FDA does not regulate supplements like prescription drugs. This means some supplement products may not contain what the label says.Whenchoosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RDN or RD), or pharmacist.

Choosing a Supplement

In the United States, the FDA does not regulate supplements like prescription drugs. This means some supplement products may not contain what the label says.Whenchoosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RDN or RD), or pharmacist.

In the United States, the FDA does not regulate supplements like prescription drugs. This means some supplement products may not contain what the label says.

Whenchoosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RDN or RD), or pharmacist.

Many people believe that NHRT is safer or more effective than traditional HRT because it is “natural.” But this is not the case.

In general, NHRT, which uses compounded hormones, is likely to have the same risks as traditional HRT. However, since these products aren’t standardized, additional risks are involved. Formulations with too much or not enough estrogen or progesterone, for instance, can cause side effects or limit effectiveness.

The FDA does not approve compounded bioidentical hormones. This means these products don’t have to be proven safe or effective. They also aren’t required to have aboxed warningabout their risks, like prescription hormone products.

Other risks associated with compounded bioidentical hormones include:

Keep in mind that people with a history of the following conditions should not use HRT of any kind:

Regular exercise and eating a healthy, balanced diet help the body continue to produce hormones, even during aging.

Some specific findings:

Other supportive strategies to complement traditional HRT or NHRT include:

Summary

NHRT is an alternative to traditional HRT to promote hormonal balance and overall health.

Common forms of NHRT include bioidentical hormones and dietary supplements. These have a reputation for being safe because they are considered “natural.”

The bottom line is that there’s insufficient evidence to know whether these products are safe or effective. Risks associated with NHRT are similar to those with conventional HRT and include cancer and heart disease, plus the unknowns associated with medications that the FDA hasn’t approved.

If you are experiencing signs of a hormonal imbalance, such as fatigue, mood swings, or libido changes, your healthcare provider can help determine the optimal treatment plan for you.

36 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fishman JR, Flatt MA, Settersten RA Jr.Bioidentical hormones, menopausal women, and the lure of the “natural” in U.S. anti-aging medicine.Soc Sci Med. 2015;132:79-87. doi:10.1016/j.socscimed.2015.02.027National Cancer Institute.Menopausal hormone therapy and cancer.Stanczyk FZ, Matharu H, Winer SA.Bioidentical hormones.Climacteric. 2021;24(1):38-45. doi:10.1080/13697137.2020.1862079Bedell S, Nachtigall M, Naftolin F.The pros and cons of plant estrogens for menopause.J Steroid Biochem Mol Biol. 2014;139:225-236. doi:10.1016/j.jsbmb.2012.12.004Pataky MW, Young WF, Nair KS.Hormonal and metabolic changes of aging and the influence of lifestyle modifications.Mayo Clin Proc. 2021;96(3):788-814. doi:10.1016/j.mayocp.2020.07.033Files JA, Ko MG, Pruthi S.Bioidentical hormone therapy.Mayo Clin Proc. 2011;86(7):673-680. doi:10.4065/mcp.2010.0714National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on the Clinical Utility of Treating Patients with Compounded Bioidentical Hormone Replacement Therapy, Jackson LM, Parker RM, Mattison DR, eds.The Clinical Utility of Compounded Bioidentical Hormone Therapy: A Review of Safety, Effectiveness, and Use. Washington (DC): National Academies Press (US); 2020.Liu Y, Yuan Y, Day AJ, et al.Safety and efficacy of compounded bioidentical hormone therapy (cBHT) in perimenopausal and postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.Menopause. 2022;29(4):465-482. doi:10.1097/GME.0000000000001937Comhaire FH, Depypere HT.Hormones, herbal preparations and nutriceuticals for a better life after the menopause: part II.Climacteric. 2015;18(3):364-371. doi:10.3109/13697137.2014.985646Tao Z, Cheng Z.Hormonal regulation of metabolism-recent lessons learned from insulin and estrogen.Clin Sci (Lond). 2023;137(6):415-434. doi:10.1042/CS20210519Albert KM, Newhouse PA.Estrogen, stress, and depression: cognitive and biological interactions.Annu Rev Clin Psychol. 2019;15:399-423. doi:10.1146/annurev-clinpsy-050718-095557Celec P, Ostatníková D, Hodosy J.On the effects of testosterone on brain behavioral functions.Front Neurosci. 2015;9:12. doi:10.3389/fnins.2015.00012Stelzer IA, Arck PC.Immunity and the endocrine system.Encyclopedia of Immunobiology. 2016;73-85. doi:10.1016/B978-0-12-374279-7.19001-0Grub J, Süss H, Willi J, et al.Steroid hormone secretion over the course of the perimenopause: findings from the Swiss perimenopause study.Front Glob Womens Health. 2021;2:774308. Published 2021 Dec 14. doi:10.3389/fgwh.2021.774308Santoro N, Roeca C, Peters BA, et al.The menopause transition: signs, symptoms, and management options.J Clin Endocrinol Metab. 2021;106(1):1-15. doi:10.1210/clinem/dgaa764Gumussoy S, Gumussoy M, Hortu I, et al.The effect of surgical menopause after bilateral oophorectomy on hormonal changes, mucociliary clearance, and quality of life.Eur Arch Otorhinolaryngol. 2020;277(10):2793-2800. doi:10.1007/s00405-020-06164-8Brennan A, Hickey M.The use of menopausal hormone therapy after cancer.Best Pract Res Clin Obstet Gynaecol. 2022;81:22-30. doi:10.1016/j.bpobgyn.2021.11.005MacKendrick NA, Troxel H.Like a finely-oiled machine: self-help and the elusive goal of hormone balance.Soc Sci Med. 2022;309:115242. doi:10.1016/j.socscimed.2022.115242Patel S, Homaei A, Raju AB, et al.Estrogen: the necessary evil for human health, and ways to tame it.Biomed Pharmacother. 2018;102:403-411. doi:10.1016/j.biopha.2018.03.078Stefaniak M, Dmoch-Gajzlerska E, Jankowska K, et al.Progesterone and its metabolites play a beneficial role in affect regulation in the female brain.Pharmaceuticals (Basel). 2023;16(4):520. doi:10.3390/ph16040520Barone B, Napolitano L, Abate M, et al.The role of testosterone in the elderly: What do we know?Int J Mol Sci. 2022;23(7):3535. doi:10.3390/ijms23073535Vegunta S, Kling JM, Kapoor E.Androgen therapy in women.J Womens Health (Larchmt). 2020;29(1):57-64. doi:10.1089/jwh.2018.7494Green ME, Bernet V, Cheung J.Thyroid dysfunction and sleep disorders.Front Endocrinol (Lausanne). 2021;12:725829. doi:10.3389/fendo.2021.725829VandeVord PJ, Sajja VS, Ereifej E, et al.Chronic hormonal imbalance and adipose redistribution is associated with hypothalamic neuropathology following blast exposure.J Neurotrauma. 2016;33(1):82-88. doi:10.1089/neu.2014.3786Liu C, Kuang X, Li K, et al.Effects of combined calcium and vitamin D supplementation on osteoporosis in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.Food Funct. 2020;11(12):10817-10827. doi:10.1039/d0fo00787kMedlinePlus.DHEA.Chen LR, Ko NY, Chen KH.Isoflavone supplements for menopausal women: a systematic review.Nutrients. 2019;11(11):2649. doi:10.3390/nu11112649De Franciscis P, Colacurci N, Riemma G, et al.A nutraceutical approach to menopausal complaints.Medicina (Kaunas). 2019;55(9):544. doi:10.3390/medicina55090544Johnson A, Roberts L, Elkins G.Complementary and alternative medicine for menopause.J Evid Based Integr Med. 2019;24:2515690X19829380. doi:10.1177/2515690X19829380Rafieian-Kopaei M, Movahedi M.Systematic review of premenstrual, postmenstrual and infertility disorders of vitex agnus castus.Electron Physician. 2017;9(1):3685-3689. doi:10.19082/3685Mount Sinai.Wild yam.Flores VA, Pal L, Manson JE.Hormone therapy in menopause: concepts, controversies, and approach to treatment.Endocr Rev. 2021;42(6):720-752. doi:10.1210/endrev/bnab011Thompson JJ, Ritenbaugh C, Nichter M.Why women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-making.BMC Women’s Health;2017. doi:10.1186/s12905-017-0449-0Yelland S, Steenson S, Creedon A, et al.The role of diet in managing menopausal symptoms: a narrative review.Nutr Bull. 2023;48(1):43-65. doi:10.1111/nbu.12607Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society.Menopause. 2015;22(11):1155-1174. doi:10.1097/GME.0000000000000546Sandher RK, Aning J.Diagnosing and managing androgen deficiency in men.Practitioner. 2017;261(1803):19-22.

36 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fishman JR, Flatt MA, Settersten RA Jr.Bioidentical hormones, menopausal women, and the lure of the “natural” in U.S. anti-aging medicine.Soc Sci Med. 2015;132:79-87. doi:10.1016/j.socscimed.2015.02.027National Cancer Institute.Menopausal hormone therapy and cancer.Stanczyk FZ, Matharu H, Winer SA.Bioidentical hormones.Climacteric. 2021;24(1):38-45. doi:10.1080/13697137.2020.1862079Bedell S, Nachtigall M, Naftolin F.The pros and cons of plant estrogens for menopause.J Steroid Biochem Mol Biol. 2014;139:225-236. doi:10.1016/j.jsbmb.2012.12.004Pataky MW, Young WF, Nair KS.Hormonal and metabolic changes of aging and the influence of lifestyle modifications.Mayo Clin Proc. 2021;96(3):788-814. doi:10.1016/j.mayocp.2020.07.033Files JA, Ko MG, Pruthi S.Bioidentical hormone therapy.Mayo Clin Proc. 2011;86(7):673-680. doi:10.4065/mcp.2010.0714National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on the Clinical Utility of Treating Patients with Compounded Bioidentical Hormone Replacement Therapy, Jackson LM, Parker RM, Mattison DR, eds.The Clinical Utility of Compounded Bioidentical Hormone Therapy: A Review of Safety, Effectiveness, and Use. Washington (DC): National Academies Press (US); 2020.Liu Y, Yuan Y, Day AJ, et al.Safety and efficacy of compounded bioidentical hormone therapy (cBHT) in perimenopausal and postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.Menopause. 2022;29(4):465-482. doi:10.1097/GME.0000000000001937Comhaire FH, Depypere HT.Hormones, herbal preparations and nutriceuticals for a better life after the menopause: part II.Climacteric. 2015;18(3):364-371. doi:10.3109/13697137.2014.985646Tao Z, Cheng Z.Hormonal regulation of metabolism-recent lessons learned from insulin and estrogen.Clin Sci (Lond). 2023;137(6):415-434. doi:10.1042/CS20210519Albert KM, Newhouse PA.Estrogen, stress, and depression: cognitive and biological interactions.Annu Rev Clin Psychol. 2019;15:399-423. doi:10.1146/annurev-clinpsy-050718-095557Celec P, Ostatníková D, Hodosy J.On the effects of testosterone on brain behavioral functions.Front Neurosci. 2015;9:12. doi:10.3389/fnins.2015.00012Stelzer IA, Arck PC.Immunity and the endocrine system.Encyclopedia of Immunobiology. 2016;73-85. doi:10.1016/B978-0-12-374279-7.19001-0Grub J, Süss H, Willi J, et al.Steroid hormone secretion over the course of the perimenopause: findings from the Swiss perimenopause study.Front Glob Womens Health. 2021;2:774308. Published 2021 Dec 14. doi:10.3389/fgwh.2021.774308Santoro N, Roeca C, Peters BA, et al.The menopause transition: signs, symptoms, and management options.J Clin Endocrinol Metab. 2021;106(1):1-15. doi:10.1210/clinem/dgaa764Gumussoy S, Gumussoy M, Hortu I, et al.The effect of surgical menopause after bilateral oophorectomy on hormonal changes, mucociliary clearance, and quality of life.Eur Arch Otorhinolaryngol. 2020;277(10):2793-2800. doi:10.1007/s00405-020-06164-8Brennan A, Hickey M.The use of menopausal hormone therapy after cancer.Best Pract Res Clin Obstet Gynaecol. 2022;81:22-30. doi:10.1016/j.bpobgyn.2021.11.005MacKendrick NA, Troxel H.Like a finely-oiled machine: self-help and the elusive goal of hormone balance.Soc Sci Med. 2022;309:115242. doi:10.1016/j.socscimed.2022.115242Patel S, Homaei A, Raju AB, et al.Estrogen: the necessary evil for human health, and ways to tame it.Biomed Pharmacother. 2018;102:403-411. doi:10.1016/j.biopha.2018.03.078Stefaniak M, Dmoch-Gajzlerska E, Jankowska K, et al.Progesterone and its metabolites play a beneficial role in affect regulation in the female brain.Pharmaceuticals (Basel). 2023;16(4):520. doi:10.3390/ph16040520Barone B, Napolitano L, Abate M, et al.The role of testosterone in the elderly: What do we know?Int J Mol Sci. 2022;23(7):3535. doi:10.3390/ijms23073535Vegunta S, Kling JM, Kapoor E.Androgen therapy in women.J Womens Health (Larchmt). 2020;29(1):57-64. doi:10.1089/jwh.2018.7494Green ME, Bernet V, Cheung J.Thyroid dysfunction and sleep disorders.Front Endocrinol (Lausanne). 2021;12:725829. doi:10.3389/fendo.2021.725829VandeVord PJ, Sajja VS, Ereifej E, et al.Chronic hormonal imbalance and adipose redistribution is associated with hypothalamic neuropathology following blast exposure.J Neurotrauma. 2016;33(1):82-88. doi:10.1089/neu.2014.3786Liu C, Kuang X, Li K, et al.Effects of combined calcium and vitamin D supplementation on osteoporosis in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.Food Funct. 2020;11(12):10817-10827. doi:10.1039/d0fo00787kMedlinePlus.DHEA.Chen LR, Ko NY, Chen KH.Isoflavone supplements for menopausal women: a systematic review.Nutrients. 2019;11(11):2649. doi:10.3390/nu11112649De Franciscis P, Colacurci N, Riemma G, et al.A nutraceutical approach to menopausal complaints.Medicina (Kaunas). 2019;55(9):544. doi:10.3390/medicina55090544Johnson A, Roberts L, Elkins G.Complementary and alternative medicine for menopause.J Evid Based Integr Med. 2019;24:2515690X19829380. doi:10.1177/2515690X19829380Rafieian-Kopaei M, Movahedi M.Systematic review of premenstrual, postmenstrual and infertility disorders of vitex agnus castus.Electron Physician. 2017;9(1):3685-3689. doi:10.19082/3685Mount Sinai.Wild yam.Flores VA, Pal L, Manson JE.Hormone therapy in menopause: concepts, controversies, and approach to treatment.Endocr Rev. 2021;42(6):720-752. doi:10.1210/endrev/bnab011Thompson JJ, Ritenbaugh C, Nichter M.Why women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-making.BMC Women’s Health;2017. doi:10.1186/s12905-017-0449-0Yelland S, Steenson S, Creedon A, et al.The role of diet in managing menopausal symptoms: a narrative review.Nutr Bull. 2023;48(1):43-65. doi:10.1111/nbu.12607Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society.Menopause. 2015;22(11):1155-1174. doi:10.1097/GME.0000000000000546Sandher RK, Aning J.Diagnosing and managing androgen deficiency in men.Practitioner. 2017;261(1803):19-22.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Fishman JR, Flatt MA, Settersten RA Jr.Bioidentical hormones, menopausal women, and the lure of the “natural” in U.S. anti-aging medicine.Soc Sci Med. 2015;132:79-87. doi:10.1016/j.socscimed.2015.02.027National Cancer Institute.Menopausal hormone therapy and cancer.Stanczyk FZ, Matharu H, Winer SA.Bioidentical hormones.Climacteric. 2021;24(1):38-45. doi:10.1080/13697137.2020.1862079Bedell S, Nachtigall M, Naftolin F.The pros and cons of plant estrogens for menopause.J Steroid Biochem Mol Biol. 2014;139:225-236. doi:10.1016/j.jsbmb.2012.12.004Pataky MW, Young WF, Nair KS.Hormonal and metabolic changes of aging and the influence of lifestyle modifications.Mayo Clin Proc. 2021;96(3):788-814. doi:10.1016/j.mayocp.2020.07.033Files JA, Ko MG, Pruthi S.Bioidentical hormone therapy.Mayo Clin Proc. 2011;86(7):673-680. doi:10.4065/mcp.2010.0714National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on the Clinical Utility of Treating Patients with Compounded Bioidentical Hormone Replacement Therapy, Jackson LM, Parker RM, Mattison DR, eds.The Clinical Utility of Compounded Bioidentical Hormone Therapy: A Review of Safety, Effectiveness, and Use. Washington (DC): National Academies Press (US); 2020.Liu Y, Yuan Y, Day AJ, et al.Safety and efficacy of compounded bioidentical hormone therapy (cBHT) in perimenopausal and postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.Menopause. 2022;29(4):465-482. doi:10.1097/GME.0000000000001937Comhaire FH, Depypere HT.Hormones, herbal preparations and nutriceuticals for a better life after the menopause: part II.Climacteric. 2015;18(3):364-371. doi:10.3109/13697137.2014.985646Tao Z, Cheng Z.Hormonal regulation of metabolism-recent lessons learned from insulin and estrogen.Clin Sci (Lond). 2023;137(6):415-434. doi:10.1042/CS20210519Albert KM, Newhouse PA.Estrogen, stress, and depression: cognitive and biological interactions.Annu Rev Clin Psychol. 2019;15:399-423. doi:10.1146/annurev-clinpsy-050718-095557Celec P, Ostatníková D, Hodosy J.On the effects of testosterone on brain behavioral functions.Front Neurosci. 2015;9:12. doi:10.3389/fnins.2015.00012Stelzer IA, Arck PC.Immunity and the endocrine system.Encyclopedia of Immunobiology. 2016;73-85. doi:10.1016/B978-0-12-374279-7.19001-0Grub J, Süss H, Willi J, et al.Steroid hormone secretion over the course of the perimenopause: findings from the Swiss perimenopause study.Front Glob Womens Health. 2021;2:774308. Published 2021 Dec 14. doi:10.3389/fgwh.2021.774308Santoro N, Roeca C, Peters BA, et al.The menopause transition: signs, symptoms, and management options.J Clin Endocrinol Metab. 2021;106(1):1-15. doi:10.1210/clinem/dgaa764Gumussoy S, Gumussoy M, Hortu I, et al.The effect of surgical menopause after bilateral oophorectomy on hormonal changes, mucociliary clearance, and quality of life.Eur Arch Otorhinolaryngol. 2020;277(10):2793-2800. doi:10.1007/s00405-020-06164-8Brennan A, Hickey M.The use of menopausal hormone therapy after cancer.Best Pract Res Clin Obstet Gynaecol. 2022;81:22-30. doi:10.1016/j.bpobgyn.2021.11.005MacKendrick NA, Troxel H.Like a finely-oiled machine: self-help and the elusive goal of hormone balance.Soc Sci Med. 2022;309:115242. doi:10.1016/j.socscimed.2022.115242Patel S, Homaei A, Raju AB, et al.Estrogen: the necessary evil for human health, and ways to tame it.Biomed Pharmacother. 2018;102:403-411. doi:10.1016/j.biopha.2018.03.078Stefaniak M, Dmoch-Gajzlerska E, Jankowska K, et al.Progesterone and its metabolites play a beneficial role in affect regulation in the female brain.Pharmaceuticals (Basel). 2023;16(4):520. doi:10.3390/ph16040520Barone B, Napolitano L, Abate M, et al.The role of testosterone in the elderly: What do we know?Int J Mol Sci. 2022;23(7):3535. doi:10.3390/ijms23073535Vegunta S, Kling JM, Kapoor E.Androgen therapy in women.J Womens Health (Larchmt). 2020;29(1):57-64. doi:10.1089/jwh.2018.7494Green ME, Bernet V, Cheung J.Thyroid dysfunction and sleep disorders.Front Endocrinol (Lausanne). 2021;12:725829. doi:10.3389/fendo.2021.725829VandeVord PJ, Sajja VS, Ereifej E, et al.Chronic hormonal imbalance and adipose redistribution is associated with hypothalamic neuropathology following blast exposure.J Neurotrauma. 2016;33(1):82-88. doi:10.1089/neu.2014.3786Liu C, Kuang X, Li K, et al.Effects of combined calcium and vitamin D supplementation on osteoporosis in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.Food Funct. 2020;11(12):10817-10827. doi:10.1039/d0fo00787kMedlinePlus.DHEA.Chen LR, Ko NY, Chen KH.Isoflavone supplements for menopausal women: a systematic review.Nutrients. 2019;11(11):2649. doi:10.3390/nu11112649De Franciscis P, Colacurci N, Riemma G, et al.A nutraceutical approach to menopausal complaints.Medicina (Kaunas). 2019;55(9):544. doi:10.3390/medicina55090544Johnson A, Roberts L, Elkins G.Complementary and alternative medicine for menopause.J Evid Based Integr Med. 2019;24:2515690X19829380. doi:10.1177/2515690X19829380Rafieian-Kopaei M, Movahedi M.Systematic review of premenstrual, postmenstrual and infertility disorders of vitex agnus castus.Electron Physician. 2017;9(1):3685-3689. doi:10.19082/3685Mount Sinai.Wild yam.Flores VA, Pal L, Manson JE.Hormone therapy in menopause: concepts, controversies, and approach to treatment.Endocr Rev. 2021;42(6):720-752. doi:10.1210/endrev/bnab011Thompson JJ, Ritenbaugh C, Nichter M.Why women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-making.BMC Women’s Health;2017. doi:10.1186/s12905-017-0449-0Yelland S, Steenson S, Creedon A, et al.The role of diet in managing menopausal symptoms: a narrative review.Nutr Bull. 2023;48(1):43-65. doi:10.1111/nbu.12607Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society.Menopause. 2015;22(11):1155-1174. doi:10.1097/GME.0000000000000546Sandher RK, Aning J.Diagnosing and managing androgen deficiency in men.Practitioner. 2017;261(1803):19-22.

Fishman JR, Flatt MA, Settersten RA Jr.Bioidentical hormones, menopausal women, and the lure of the “natural” in U.S. anti-aging medicine.Soc Sci Med. 2015;132:79-87. doi:10.1016/j.socscimed.2015.02.027

National Cancer Institute.Menopausal hormone therapy and cancer.

Stanczyk FZ, Matharu H, Winer SA.Bioidentical hormones.Climacteric. 2021;24(1):38-45. doi:10.1080/13697137.2020.1862079

Bedell S, Nachtigall M, Naftolin F.The pros and cons of plant estrogens for menopause.J Steroid Biochem Mol Biol. 2014;139:225-236. doi:10.1016/j.jsbmb.2012.12.004

Pataky MW, Young WF, Nair KS.Hormonal and metabolic changes of aging and the influence of lifestyle modifications.Mayo Clin Proc. 2021;96(3):788-814. doi:10.1016/j.mayocp.2020.07.033

Files JA, Ko MG, Pruthi S.Bioidentical hormone therapy.Mayo Clin Proc. 2011;86(7):673-680. doi:10.4065/mcp.2010.0714

National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on the Clinical Utility of Treating Patients with Compounded Bioidentical Hormone Replacement Therapy, Jackson LM, Parker RM, Mattison DR, eds.The Clinical Utility of Compounded Bioidentical Hormone Therapy: A Review of Safety, Effectiveness, and Use. Washington (DC): National Academies Press (US); 2020.

Liu Y, Yuan Y, Day AJ, et al.Safety and efficacy of compounded bioidentical hormone therapy (cBHT) in perimenopausal and postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.Menopause. 2022;29(4):465-482. doi:10.1097/GME.0000000000001937

Comhaire FH, Depypere HT.Hormones, herbal preparations and nutriceuticals for a better life after the menopause: part II.Climacteric. 2015;18(3):364-371. doi:10.3109/13697137.2014.985646

Tao Z, Cheng Z.Hormonal regulation of metabolism-recent lessons learned from insulin and estrogen.Clin Sci (Lond). 2023;137(6):415-434. doi:10.1042/CS20210519

Albert KM, Newhouse PA.Estrogen, stress, and depression: cognitive and biological interactions.Annu Rev Clin Psychol. 2019;15:399-423. doi:10.1146/annurev-clinpsy-050718-095557

Celec P, Ostatníková D, Hodosy J.On the effects of testosterone on brain behavioral functions.Front Neurosci. 2015;9:12. doi:10.3389/fnins.2015.00012

Stelzer IA, Arck PC.Immunity and the endocrine system.Encyclopedia of Immunobiology. 2016;73-85. doi:10.1016/B978-0-12-374279-7.19001-0

Grub J, Süss H, Willi J, et al.Steroid hormone secretion over the course of the perimenopause: findings from the Swiss perimenopause study.Front Glob Womens Health. 2021;2:774308. Published 2021 Dec 14. doi:10.3389/fgwh.2021.774308

Santoro N, Roeca C, Peters BA, et al.The menopause transition: signs, symptoms, and management options.J Clin Endocrinol Metab. 2021;106(1):1-15. doi:10.1210/clinem/dgaa764

Gumussoy S, Gumussoy M, Hortu I, et al.The effect of surgical menopause after bilateral oophorectomy on hormonal changes, mucociliary clearance, and quality of life.Eur Arch Otorhinolaryngol. 2020;277(10):2793-2800. doi:10.1007/s00405-020-06164-8

Brennan A, Hickey M.The use of menopausal hormone therapy after cancer.Best Pract Res Clin Obstet Gynaecol. 2022;81:22-30. doi:10.1016/j.bpobgyn.2021.11.005

MacKendrick NA, Troxel H.Like a finely-oiled machine: self-help and the elusive goal of hormone balance.Soc Sci Med. 2022;309:115242. doi:10.1016/j.socscimed.2022.115242

Patel S, Homaei A, Raju AB, et al.Estrogen: the necessary evil for human health, and ways to tame it.Biomed Pharmacother. 2018;102:403-411. doi:10.1016/j.biopha.2018.03.078

Stefaniak M, Dmoch-Gajzlerska E, Jankowska K, et al.Progesterone and its metabolites play a beneficial role in affect regulation in the female brain.Pharmaceuticals (Basel). 2023;16(4):520. doi:10.3390/ph16040520

Barone B, Napolitano L, Abate M, et al.The role of testosterone in the elderly: What do we know?Int J Mol Sci. 2022;23(7):3535. doi:10.3390/ijms23073535

Vegunta S, Kling JM, Kapoor E.Androgen therapy in women.J Womens Health (Larchmt). 2020;29(1):57-64. doi:10.1089/jwh.2018.7494

Green ME, Bernet V, Cheung J.Thyroid dysfunction and sleep disorders.Front Endocrinol (Lausanne). 2021;12:725829. doi:10.3389/fendo.2021.725829

VandeVord PJ, Sajja VS, Ereifej E, et al.Chronic hormonal imbalance and adipose redistribution is associated with hypothalamic neuropathology following blast exposure.J Neurotrauma. 2016;33(1):82-88. doi:10.1089/neu.2014.3786

Liu C, Kuang X, Li K, et al.Effects of combined calcium and vitamin D supplementation on osteoporosis in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.Food Funct. 2020;11(12):10817-10827. doi:10.1039/d0fo00787k

MedlinePlus.DHEA.

Chen LR, Ko NY, Chen KH.Isoflavone supplements for menopausal women: a systematic review.Nutrients. 2019;11(11):2649. doi:10.3390/nu11112649

De Franciscis P, Colacurci N, Riemma G, et al.A nutraceutical approach to menopausal complaints.Medicina (Kaunas). 2019;55(9):544. doi:10.3390/medicina55090544

Johnson A, Roberts L, Elkins G.Complementary and alternative medicine for menopause.J Evid Based Integr Med. 2019;24:2515690X19829380. doi:10.1177/2515690X19829380

Rafieian-Kopaei M, Movahedi M.Systematic review of premenstrual, postmenstrual and infertility disorders of vitex agnus castus.Electron Physician. 2017;9(1):3685-3689. doi:10.19082/3685

Mount Sinai.Wild yam.

Flores VA, Pal L, Manson JE.Hormone therapy in menopause: concepts, controversies, and approach to treatment.Endocr Rev. 2021;42(6):720-752. doi:10.1210/endrev/bnab011

Thompson JJ, Ritenbaugh C, Nichter M.Why women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-making.BMC Women’s Health;2017. doi:10.1186/s12905-017-0449-0

Yelland S, Steenson S, Creedon A, et al.The role of diet in managing menopausal symptoms: a narrative review.Nutr Bull. 2023;48(1):43-65. doi:10.1111/nbu.12607

Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society.Menopause. 2015;22(11):1155-1174. doi:10.1097/GME.0000000000000546

Sandher RK, Aning J.Diagnosing and managing androgen deficiency in men.Practitioner. 2017;261(1803):19-22.

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