Bioidentical hormones have gained significant attention in recent years for their role managing hormone related problems. From menopause to testosterone deficiency, bioidentical hormone replacement therapy (BHRT) claims to offer a more personalised approach to restoring hormonal balance. However there still remains a lot of confusion and some controversy around what BHRT involves and its best uses. In this article, we explore what exactly are bioidentical hormones vs traditional hormone replacement therapy (HRT). We’ll review the benefits of bioidentical hormones, their uses, potential risks and key things to consider in order to make informed decisions about this treatment.
What are Bioidentical Hormones?
In simple terms, bioidentical hormones are synthetic compounds that replicate the molecular structure of the hormones naturally produced by the human body. Their near identical structure allows them to interact with hormone receptors in the same way as the body’s own hormones. This has made them a popular choice for managing hormonal imbalances. In comparison, traditional hormone replacement therapy often uses synthetic hormones or animal-derived compounds, such as oestrogens extracted from the urine of pregnant horses (e.g. Premarin). As these traditional hormones are not bioidentical in structure to human hormones, it may affect how they interact with the body.
The idea of using bioidentical hormones to treat hormonal imbalances emerged in the mid-20th century, when scientists began uncovering the molecular structures of natural hormones. By the 1980s, advances in synthesis enabled researchers to create bioidentical hormones from plant-derived sterols (compounds found in yams and soy), resulting in substances chemically identical to those produced by the human body. The final hormones are available in various forms including creams, gels, tablets, patches and injections. The popularity of biodentical hormones surged in the 1990s as concerns grew over the safety of traditional hormone replacement therapies (HRT), particularly synthetic and animal-derived hormones like conjugated equine oestrogens. To leverage this, bioidentical hormones were marketed as a more “natural” and thus effective as well as safer alternative vs traditional HRT.
Benefits Bioidentical Hormone Replacement Therapy
Bioidentical hormone replacement therapy is often seen as a more flexible option for those seeking relief from the effects of hormonal changes. Here are the main benefits of biodentical hormones therapy:
- Mimic Your Natural Hormones: Bioidentical hormones are chemically identical to the ones your body produces, so they interact with your hormone receptors in the same way. This compatibility means generally may have fewer side effects compared to synthetic or animal-derived hormones.
- Relieves a Variety of Symptoms: BHRT can help with a variety of symptoms caused by hormonal imbalances, including those due menopause, metabolic conditions and testosterone deficiency.
- Personalised Treatment: BHRT comes in many forms, such as creams, gels, patches, injections, and pellets. This variety means you can choose the option that fits best with your lifestyle and how your body absorbs the hormones. Furthermore, custom compounded bioidentical hormones can be further tailored to each individual patient’s needs.
Uses of Biodentical Hormones
Hormonal challenges that can arise due to aging, medical conditions or lifestyle factors can significantly impact physical health, emotional wellbeing and overall quality of life. BHRT offers a targeted approach to help restore hormone balance and manage symptoms effectively. The main uses of bioidentical hormone replacement therapy are:
- Menopause: Bioidentical hormones are popular for managing menopause symptoms including hot flushes, vaginal dryness, mood changes and poor sleep. Additionally, replacing oestrogen and progesterone can help protect against osteoporosis to reduce risk of fractures and maintain bone health.
- Andropause (Low Testosterone): BHRT can also help men with low testosterone. It’s effective at improving symptoms like fatigue, reduced muscle mass, low libido and even mental sharpness.
- Thyroid Issues: For those with hypothyroidism, bioidentical thyroid hormones such as T3 (triiodothyronine) and T4 (thyroxine) can restore balance. This helps improve metabolism, energy levels and mental clarity.
- Emotional & Cognitive Wellbeing: Hormonal imbalances and ageing often take a toll on mood and mental function, leading to anxiety, depression or brain fog. BHRT may be useful in helping to restore balance, supporting emotional stability and sharper thinking.
Safety, Risks or Side Effects?
Although bioidentical hormones are generally safe, they are not risk-free. Some of the key side effects include:
- Acne
- Bloating
- Weight changes
- Mood swings
- Breast tenderness
- Hair changes
- Headaches
- Cramps
In addition to the above bioidentical hormones carry the same serious risks as traditional HRT. These serious side effects include:
- Blood clots
- Stroke
- Heart disease
- Gall bladder disease
- Certain cancers including endometrial and breast
Licensing & Regulation of Bioidentical Hormone Replacement Therapy
Bioidentical hormones fall into two main categories; pharmaceutical bioidentical (or “body identical”) hormones and compounded bioidentical hormones. There are key differences in licensing and availability between the the two.
Pharmaceutical bioidentical hormones are standardised mass-produced medications that approved for specific uses in specific forms and doses by regulatory bodies like the FDA and MHRA. They undergo rigorous clinical trials for safety, efficacy and quality before getting their license. As such, they’re often referred to as body identical hormones to distinguish them from the unlicensed compounded BHRT and examples include:
- Estradiol patches (e.g. Evorel, Estraderm) and micronised progesterone capsules (e.g. Utrogestan) for menopause symptom relief and osteoporosis prevention.
- Thyroid hormones (e.g. Levothyroxine, Liothyronine) for treating hypothyroidism.
Pharmaceutical bioidentical hormones are licensed and available on the NHS in the for conditions like menopause management and thyroid disorders.
Compounded bioidentical hormones are custom-made formulas prepared by specialised pharmacies for individual patients. It allows healthcare providers to tailor dosages and formulations based on each patient’s hormone levels. This is often based on saliva or blood tests. The big advantage is the amount of personalisation and customisation they provide. However, compounded BHRT is not FDA- or MHRA-approved which means they lack the extensive rigorous testing for safety and effectiveness that licensed forms have. As such they are not available on the NHS and you can only access them through private clinics in the UK.
Bioidentical hormone therapy is valuable for managing hormonal imbalances and may carry fewer risks when compared vs traditional HRT. However, it’s not suitable for everyone. Always consult with a qualified healthcare provider to discuss your symptoms, medical history and all your treatment options. As with any treatment, it’s vital to weigh the benefits against potential risks. Your healthcare provider should be able to explore these in a way that fully centres on your specific problems. They should also take into account your needs and as much as possible your preferences.