Bioidentical hormones
Also called BHRT, bioidentical hormone therapy, body-identical hormones, compounded bioidentical hormones
Bioidentical hormones are hormones made in a lab, usually from plant sources, to have the same chemical structure as the hormones the body produces. Estradiol, progesterone and testosterone are the most commonly used. The term describes the molecule, not how a product is made or regulated, and it covers two very different groups.
The first is FDA-approved bioidentical products, such as estradiol patches, gels and tablets and micronized progesterone capsules, which are regulated for purity and dose and come with a package insert. The second is compounded bioidentical hormones, custom-mixed by a pharmacy from a prescription, which are not FDA-approved.
The Menopause Society calls the term "bioidentical" misleading for this reason. Its position is that there is insufficient evidence to support the overall use of compounded bioidentical hormone therapy for menopause symptoms, that patient preference alone should not justify it, and that it can be considered for reasons such as an allergy to an ingredient in an approved product or a dose or form not available in one. It also considers saliva and urine testing to guide dosing unreliable.
Why it matters after 45
Estradiol and other estrogens fall after menopause, so the decade around it is when most women weigh hormone therapy and meet this term, often in marketing that blurs the two groups. Knowing which group a product belongs to tells you how it is regulated and what evidence sits behind it.
Where it comes up
- What bioidentical meansthe term unpacked, and where the marketing goes further than the evidence
- Compounded vs FDA-approved estradiol creamhow the two groups differ for one product
- Women's hormone therapyhow ACT 2 approaches menopausal hormone therapy
- HRT costwhat hormone therapy costs and what is included
References
- The North American Menopause Society (now The Menopause Society). The 2022 hormone therapy position statement. Menopause, 2022. https://menopause.org/wp-content/uploads/professional/nams-2022-hormone-therapy-position-statement.pdf
- Cleveland Clinic. Bioidentical Hormones. https://my.clevelandclinic.org/health/treatments/15660-bioidentical-hormones
- National Academies of Sciences, Engineering, and Medicine. The Clinical Utility of Compounded Bioidentical Hormone Therapy. 2020. https://nap.nationalacademies.org/catalog/25791/the-clinical-utility-of-compounded-bioidentical-hormone-therapy-a-review-of-safety-effectiveness-and-use
- MedlinePlus. Aging changes in hormone production. U.S. National Library of Medicine. https://medlineplus.gov/ency/article/004000.htm
Definitions here are educational and are not medical advice. They explain what a term means; the pages linked above cover what it means for you, and a clinician reviews your own results. Editorial & medical review policy · All glossary terms