Bioidentical hormone therapy vs. synthetic hormone therapy

You might hear about “bioidentical” hormone therapy as an alternative to synthetic hormone therapy for menopause symptom relief.

Bioidentical hormones (such as estradiol, estriol and progesterone) have the same molecular structure as the hormones made by your body. Synthetic hormones (such as Premarin and Provera) do not have the same molecular structure as the hormones in your body, but your body converts them to a usable form.

Bioidentical hormones have developed a reputation as being “natural,” and therefore presumed to be safer than synthetic hormones. However, there is no evidence to support this claim. Both bioidentical and synthetic hormones are made in a laboratory — the main difference is the raw ingredient.  Bioidentical hormones are made from plant sources; synthetic hormones are made from man-made chemical compounds. There is no evidence to show that bioidentical hormones are any safer or more effective than synthetic hormone therapy.

Bioidentical hormones can be produced by a pharmaceutical company or a compounding pharmacy. When bioidentical hormones are made for you by a compounding pharmacy, these hormones are called compounded hormones.  Compounding pharmacies are not regulated by the Food & Drug Administration, unlike the pharmaceutical companies who can also make bioidentical hormone therapies.  Without regulation, there is no way to ensure the safety of compounded hormones. Thus, there have been serious concerns about the consistency of these medications from batch to batch and pharmacy to pharmacy.