Table of ContentsView AllTable of ContentsWhat Is BHRT?Bioidentical HormonesTreatmentsTraditional vs. BioidenticalBenefitsSide Effects and RisksFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What Is BHRT?
Bioidentical Hormones
Treatments
Traditional vs. Bioidentical
Benefits
Side Effects and Risks
Frequently Asked Questions
Hormone replacement therapy (HRT) is the use of artificial hormones to balance hormone levels and decrease symptoms. Bioidentical hormone replacement therapy (BHRT) is one version of this kind of treatment.
This article reviews what bioidentical hormones are, what BHRT treats, how it differs from other forms of HRT, its benefits and risks, and how to take it.
Anne Rippy / Getty Images
What Is Bioidentical Hormone Replacement Therapy?
Hormones control sexual health, mood, body temperature, growth,immunity(ability to fight infection), and more. Bioidentical hormone replacement therapy is a type of treatment used to reduce symptoms related tohormone imbalances.
What Are Bioidentical Hormones?
Bioidentical hormones are synthetic (artificial) versions of the hormones already made in the endocrine system. They are chemically and structurally identical to human hormones.
Bioidentical hormones are often confused with “natural” hormone therapy. “Natural hormones” is the term used to describe those extracted from plants such as yams and soybeans.
Are Bioidentical Hormones Natural?While parts of bioidentical hormones may be derived from natural sources, they are not considered natural because they are made in a lab.
Are Bioidentical Hormones Natural?
While parts of bioidentical hormones may be derived from natural sources, they are not considered natural because they are made in a lab.
What Can BHRT Treat?
BHRT can help with problems related to imbalanced hormones, such as:
BHRT is also an important treatment for those who aretransgenderand aretransitioning.
Estrogen Treatment for Transgender Women and Transfeminine People
Compounded Bioidentical Hormones vs. Standard BHRT
Standard BHRT is often confused with compounded bioidentical hormone replacement therapy (cBHRT). The following are the primary distinctions between standard BHRT and cBHRT:
How to Take BHRT
BHRT comes in various forms androutes, including:
Dosages and amounts vary based on the formulation and route of medication. It’s important to follow the prescriber’s directions to get the most benefit from BHRT.
Transdermal HRTThere is strong scientific evidence that transdermal estrogen (a patch placed on the skin) decreases many risks associated with taking oral hormone therapy. The absorption is better, and it is less likely to cause side effects such as nausea.
Transdermal HRT
There is strong scientific evidence that transdermal estrogen (a patch placed on the skin) decreases many risks associated with taking oral hormone therapy. The absorption is better, and it is less likely to cause side effects such as nausea.
Traditional HRT vs. BHRT
The goal of hormone replacement therapy is to replacelow levels of hormones. While levels may not be completely restored, treatment is usually enough to resolve symptoms. Differences between HRT and BHRT are:
Benefits of BHRT
New studies have found that the benefits of HRT outweigh the risks for younger women or those in the early stages of menopause.BHRT has become a popular form of HRT over the last couple of decades. The perceived benefits of BHRT include:
How Common Is Compounded BHRT?An estimated 1 million to 2.5 million women in the United States use cBHRT for menopausal symptoms.
How Common Is Compounded BHRT?
An estimated 1 million to 2.5 million women in the United States use cBHRT for menopausal symptoms.
Side Effects and Risks of BHRT
The side effects of BHRT vary depending on the type of hormone replacement used. Examples of side effects include:
As with any systemic (throughout the body) estrogen therapy, there is a slight risk of blood clots, breast cancer, andgallbladder disease. There is also a small risk of stroke and heart attack, especially for women over age 60.
For those who still have auterus, there is also an increased risk forendometrial cancer.
Is Compounded BHRT Safer or More Effective?While many people believe that cBHRT is safer or more effective than traditional HRT, this may not be true. According to the Endocrine Society, there is little to no scientific evidence to support these claims.There is concern that cBHRT does not have the FDA oversight needed to:Adequately test for safety and qualityEnsure doses are consistentRegulate effectivenessEnforce labeling and packaging regulations (which can lead to allergic reactions and incorrect or incomplete information)
Is Compounded BHRT Safer or More Effective?
While many people believe that cBHRT is safer or more effective than traditional HRT, this may not be true. According to the Endocrine Society, there is little to no scientific evidence to support these claims.There is concern that cBHRT does not have the FDA oversight needed to:Adequately test for safety and qualityEnsure doses are consistentRegulate effectivenessEnforce labeling and packaging regulations (which can lead to allergic reactions and incorrect or incomplete information)
While many people believe that cBHRT is safer or more effective than traditional HRT, this may not be true. According to the Endocrine Society, there is little to no scientific evidence to support these claims.
There is concern that cBHRT does not have the FDA oversight needed to:
Summary
A Word From Verywell
Experiencing disruptions with your hormones can cause frustrating symptoms that interfere with your daily life. There are multiple options to help you combat these symptoms, including bioidentical hormone replacement therapy. Talk with your healthcare provider so they can help you decide on the best plan for your health and well-being.
No, according to the FDA and the Endocrine Society, research has not shown that bioidentical hormones are safer or more effective than traditional hormones.
How long you stay on bioidentical hormones varies based on the kind of hormone and your unique situation. For example, risk of adverse effects from systemic estrogen increases with age, especially for women over age 60, and with extended use (longer than 10 years). If your treatment stops working, you have severe side effects, or your risk increases, your healthcare provider may instruct you to discontinue hormone therapy.
11 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.Borda L, Wong L, Tosti A.Bioidentical hormone therapy in menopause: Relevance in dermatology.Dermatol Online J. 2019;25(1):13030/qt4c20m28z. PMID: 30710894.Dalton-Brewer, N.The role of complementary and alternative medicine for the management of fibroids and associated symptomatology.Curr Obstet Gynecol Rep5, 110–118 (2016). doi.org/10.1007/s13669-016-0156-0Stanczyk F, Matharu H, Winer S.Bioidentical hormones.Climacteric. 2021;24(1):38-45. doi: 10.1080/13697137.2020.1862079Endocrine Society.Compounded bioidentical hormone therapy.Files J, Kransdorf L, Ko M, et al.Bioidentical hormone therapy: An assessment of provider knowledge.Maturitas. 2016;94:46-51. doi: 10.1016/j.maturitas.2016.08.014National Academies of Sciences, Engineering, and Medicine.The clinical utility of compounded bioidentical hormone therapy: A review of safety, effectiveness, and use.Newson L, Lass A.Effectiveness of transdermal oestradiol and natural micronised progesterone for menopausal symptoms.British Journal of General Practice.2018;68(675):499-500. doi: 10.3399/bjgp18X699353Dubaut J, Dong F, Tjaden B, Grainger D, Duong J, Tatpati L.Prescribing bioidentical menopausal hormone therapy: A survey of physician views and practices.J Womens Health (Larchmt). 2018;27(7):859-866. doi: 10.1089/jwh.2017.6637Abou-Ismail MY, Citla Sridhar D, Nayak L.Estrogen and thrombosis: A bench to bedside review.Thromb Res. 2020;192:40-51. doi: 10.1016/j.thromres.2020.05.008United States (U.S.) Food & Drug Administration.Menopause & hormones: Common questions.Cagnacci A, Venier M.The controversial history of hormone replacement therapy.Medicina (Kaunas). 2019;55(9):602. doi:10.3390/medicina55090602
11 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.Borda L, Wong L, Tosti A.Bioidentical hormone therapy in menopause: Relevance in dermatology.Dermatol Online J. 2019;25(1):13030/qt4c20m28z. PMID: 30710894.Dalton-Brewer, N.The role of complementary and alternative medicine for the management of fibroids and associated symptomatology.Curr Obstet Gynecol Rep5, 110–118 (2016). doi.org/10.1007/s13669-016-0156-0Stanczyk F, Matharu H, Winer S.Bioidentical hormones.Climacteric. 2021;24(1):38-45. doi: 10.1080/13697137.2020.1862079Endocrine Society.Compounded bioidentical hormone therapy.Files J, Kransdorf L, Ko M, et al.Bioidentical hormone therapy: An assessment of provider knowledge.Maturitas. 2016;94:46-51. doi: 10.1016/j.maturitas.2016.08.014National Academies of Sciences, Engineering, and Medicine.The clinical utility of compounded bioidentical hormone therapy: A review of safety, effectiveness, and use.Newson L, Lass A.Effectiveness of transdermal oestradiol and natural micronised progesterone for menopausal symptoms.British Journal of General Practice.2018;68(675):499-500. doi: 10.3399/bjgp18X699353Dubaut J, Dong F, Tjaden B, Grainger D, Duong J, Tatpati L.Prescribing bioidentical menopausal hormone therapy: A survey of physician views and practices.J Womens Health (Larchmt). 2018;27(7):859-866. doi: 10.1089/jwh.2017.6637Abou-Ismail MY, Citla Sridhar D, Nayak L.Estrogen and thrombosis: A bench to bedside review.Thromb Res. 2020;192:40-51. doi: 10.1016/j.thromres.2020.05.008United States (U.S.) Food & Drug Administration.Menopause & hormones: Common questions.Cagnacci A, Venier M.The controversial history of hormone replacement therapy.Medicina (Kaunas). 2019;55(9):602. doi:10.3390/medicina55090602
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.
Borda L, Wong L, Tosti A.Bioidentical hormone therapy in menopause: Relevance in dermatology.Dermatol Online J. 2019;25(1):13030/qt4c20m28z. PMID: 30710894.Dalton-Brewer, N.The role of complementary and alternative medicine for the management of fibroids and associated symptomatology.Curr Obstet Gynecol Rep5, 110–118 (2016). doi.org/10.1007/s13669-016-0156-0Stanczyk F, Matharu H, Winer S.Bioidentical hormones.Climacteric. 2021;24(1):38-45. doi: 10.1080/13697137.2020.1862079Endocrine Society.Compounded bioidentical hormone therapy.Files J, Kransdorf L, Ko M, et al.Bioidentical hormone therapy: An assessment of provider knowledge.Maturitas. 2016;94:46-51. doi: 10.1016/j.maturitas.2016.08.014National Academies of Sciences, Engineering, and Medicine.The clinical utility of compounded bioidentical hormone therapy: A review of safety, effectiveness, and use.Newson L, Lass A.Effectiveness of transdermal oestradiol and natural micronised progesterone for menopausal symptoms.British Journal of General Practice.2018;68(675):499-500. doi: 10.3399/bjgp18X699353Dubaut J, Dong F, Tjaden B, Grainger D, Duong J, Tatpati L.Prescribing bioidentical menopausal hormone therapy: A survey of physician views and practices.J Womens Health (Larchmt). 2018;27(7):859-866. doi: 10.1089/jwh.2017.6637Abou-Ismail MY, Citla Sridhar D, Nayak L.Estrogen and thrombosis: A bench to bedside review.Thromb Res. 2020;192:40-51. doi: 10.1016/j.thromres.2020.05.008United States (U.S.) Food & Drug Administration.Menopause & hormones: Common questions.Cagnacci A, Venier M.The controversial history of hormone replacement therapy.Medicina (Kaunas). 2019;55(9):602. doi:10.3390/medicina55090602
Borda L, Wong L, Tosti A.Bioidentical hormone therapy in menopause: Relevance in dermatology.Dermatol Online J. 2019;25(1):13030/qt4c20m28z. PMID: 30710894.
Dalton-Brewer, N.The role of complementary and alternative medicine for the management of fibroids and associated symptomatology.Curr Obstet Gynecol Rep5, 110–118 (2016). doi.org/10.1007/s13669-016-0156-0
Stanczyk F, Matharu H, Winer S.Bioidentical hormones.Climacteric. 2021;24(1):38-45. doi: 10.1080/13697137.2020.1862079
Endocrine Society.Compounded bioidentical hormone therapy.
Files J, Kransdorf L, Ko M, et al.Bioidentical hormone therapy: An assessment of provider knowledge.Maturitas. 2016;94:46-51. doi: 10.1016/j.maturitas.2016.08.014
National Academies of Sciences, Engineering, and Medicine.The clinical utility of compounded bioidentical hormone therapy: A review of safety, effectiveness, and use.
Newson L, Lass A.Effectiveness of transdermal oestradiol and natural micronised progesterone for menopausal symptoms.British Journal of General Practice.2018;68(675):499-500. doi: 10.3399/bjgp18X699353
Dubaut J, Dong F, Tjaden B, Grainger D, Duong J, Tatpati L.Prescribing bioidentical menopausal hormone therapy: A survey of physician views and practices.J Womens Health (Larchmt). 2018;27(7):859-866. doi: 10.1089/jwh.2017.6637
Abou-Ismail MY, Citla Sridhar D, Nayak L.Estrogen and thrombosis: A bench to bedside review.Thromb Res. 2020;192:40-51. doi: 10.1016/j.thromres.2020.05.008
United States (U.S.) Food & Drug Administration.Menopause & hormones: Common questions.
Cagnacci A, Venier M.The controversial history of hormone replacement therapy.Medicina (Kaunas). 2019;55(9):602. doi:10.3390/medicina55090602
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