It means the same exact molecule as your body makes. Most types of bioidentical HRT now prescribed are from yams, the root vegetable, or from soy.

While synthetic hormones such as conjugated equine estrogens and progestins may seem similar to natural progesterone and estrogen, the molecular structure is completely different. Synthetic hormones were popular in the 1960s when birth control pills and products like Premarin and PremPro were widely used for treating osteoporosis and to help relieve menopausal symptoms in a “one size fits all” approach. However, this became controversial after the results of the Women’s Health Initiative showed that synthetic hormones were doing more harm than good.

While menopause is not an illness or a medical condition, the effects of menopause often have a negative impact on a woman’s wellbeing and quality of life. Low estrogen levels and other biological changes of menopause are also associated with increased risk of heart disease, osteoporosis, type 2 diabetes, depression, and dementia.

There is new evidence demonstrating that transdermal estrogen together with natural micronized progesterone represents an optimal HRT regimen. Transdermal estrogen is the preferred route of administration because, in contrast with pills, estrogen as a cream, gel, or patch is not associated with an increased risk of blood clots, heart attack, or stroke.

While pellets provide a form of bioidentical HRT, a recent study published in the Journal of the North American Menopause Society (NAMS) observed that women who used hormone pellets were much more likely to experience side effects like mood swings, anxiety, hair pattern change, acne, and weight gain.

Bioidentical hormone replacement therapy, given in physiologic (natural) doses, does NOT increase a woman’s risk for breast cancer. In contrast, the study on synthetic hormone replacement therapy showed a 26% increased risk for breast cancer.

Bioidentical progesterone (but NOT synthetic progestin) has a protective effect on breast tissue. The E3N Cohort study in France (more than 80,000 women) reported the use of estrogen and progesterone together was much safer than estrogen therapy alone. In fact, all studies have shown that the use of bioidentical progesterone is associated with a diminished risk for breast cancer. Oher important functions of natural progesterone include cardiovascular protection, balancing estrogen, a positive effect on sleep, decreased anxiety, irritability, and mood swings.

Once you have begun hormone replacement therapy, we ask you to perform follow-up testing twice per year. This helps ensure that your hormones are optimally balanced and personalized for you. At least once per year we will also look at your body’s metabolism of estrogen and other hormones to ensure we are doing everything to not only optimize your hormone levels but also minimize your risk for hormonally related breast cancers.

Saliva testing is the preferred method of hormone testing for transdermally applied BHRT. Hormone levels in saliva represent the bioavailable fraction of hormones that are active at the level of the cell. Blood testing measures the “protein-bound” biologically inactive hormone levels in the body. Therefore, serum testing cannot reliably be used to monitor topical hormone therapy.

Urine testing measures the downstream metabolites or breakdown products of the sex hormones. This helps make sure the hormones are broken down into safe metabolites that decrease the risk of breast cancer and other pathological processes.

The 2022 HT (Hormone Therapy) Position Statement of The Menopause Society states there is no general rule for stopping HT in women based on age alone.

A new large-scale study based on the records of 10 million senior Medicare women from 2007 to 2020 concluded that compared with never use or discontinuation of HT before the age of 65 years, the use of estrogen beyond age 65 years was associated with significant risk reductions in mortality, breast cancer, multiple other cancers, blood clots, heart disease, and dementia.