What are bioidentical hormones?
Bioidentical hormones are processed hormones created to closely match the hormones naturally made by your body's glands. They are used to alleviate symptoms caused by low or imbalanced hormone levels, which women often experience during perimenopause or menopause. Hormones are chemical messengers your endocrine glands produce that regulate various bodily functions. Even a slight hormonal imbalance can cause disruptive symptoms that affect your daily life. Healthcare professionals may recommend hormone replacement therapy to alleviate these symptoms.
Bioidentical hormone therapy (BHRT) involves the use of hormones derived from plants. The hormones most frequently used in BHRT are estrogen, progesterone, and testosterone. Drug companies manufacture some prescription forms approved by the Food and Drug Administration (FDA). Other bioidentical hormones are compounded (or mixed) by a pharmacist based on a healthcare physician's prescription.
It is important to note that compounded forms of hormones have yet to undergo FDA testing and approval. Despite being marketed as "natural" choices due to their plant-based origins, experts modify them in a laboratory, which renders them no longer natural. On the other hand, FDA-approved hormones come in different doses and forms, such as pills, creams, gels, sprays, and vaginal inserts. Consult a healthcare provider offering bioidentical hormone therapy near you to determine which bioidentical hormone replacement therapy suits you.
Why are bioidentical hormones used?
As people age, key hormones such as estrogen, progesterone, and testosterone levels naturally decline. This hormonal drop can lead to a range of symptoms, including night sweats, vaginal dryness, reduced interest in sex or painful intercourse, hot flashes, difficulty sleeping, fatigue, weight gain, mood swings, and even memory issues or confusion. Hormone replacement therapies—either bioidentical or conventional—can restore hormone levels.
When therapy brings a person's hormone levels to a more balanced state, many individuals experience significant relief from these symptoms. While some experts project bioidentical hormone therapy as a natural alternative, there is limited scientific evidence proving it is more effective or safer than conventional hormone therapy. Your doctor can help you choose the best treatment for your symptoms and overall health history.
Types of Bioidentical Hormone Replacement Therapy
Bioidentical hormone replacement therapy (BHRT) is available in various forms, and the ideal option for you depends on your healthcare provider's recommendation. You should experiment with different forms to find the most effective one for your needs.
- Pills- Estradiol pills, available in doses of 0.5 mg, 1 mg, or 2 mg, are commonly used to relieve menopause symptoms, including mood swings, hot flashes, and sleep disturbances. This option suits individuals without a history of smoking, high blood pressure, clotting issues, or heart and liver diseases. If you have a uterus, combining estradiol with progesterone is necessary to protect the uterine lining.
- Patches- Estradiol patches are another popular choice for those undergoing perimenopause or menopause. They offer convenience by requiring only twice-weekly changes, unlike daily pills. Patches are particularly recommended for women who smoke, are overweight, suffer from hypertension or migraines, or have a family history of stroke or heart disease.
- Gels- Transdermal BHRT gels are absorbed through the skin, similar to patches. These gels can effectively reduce symptoms such as hot flashes, night sweats, mood fluctuations, and vaginal discomfort. Your doctor will help you choose the appropriate gel based on your symptoms.
- Vaginal creams- Estradiol vaginal creams specifically target genitourinary symptoms of menopause, including painful intercourse, vaginal dryness, itching, burning, and recurrent urinary tract infections. These creams deliver a low dose of estrogen directly to the specific area for targeted relief rather than treating systemic symptoms like hot flashes. The application involves using an applicator to insert the cream into the vagina and apply it externally to the vulva. Initially, using the cream every other day is recommended, gradually decreasing frequency after the first few months.
How long do bioidentical hormones take to work?
Your doctor will recommend the appropriate method for using bioidentical hormones, and it may take trying more than one type to find the most effective option. Doses are carefully selected and adjusted to relieve symptoms using the lowest effective amount for the shortest duration. While some providers may use blood, urine, or saliva tests to monitor hormone levels, the FDA advises against relying on hormone level testing, particularly saliva tests, since hormone levels naturally fluctuate and may not correlate with symptoms. As for results, some individuals notice mild improvement within a few weeks. However, it typically takes around three months to gain the full benefits of bioidentical hormone therapy.
Bioidentical hormone therapy vs. conventional hormone therapy
Manufacturers often market compounded bioidentical hormones as a safer, more effective, and personalized alternative to traditional hormone therapy. However, scientific evidence does not support these claims, and the FDA's lack of oversight exacerbates the potential risks associated with these hormones.
Some custom hormone combinations inculcate the same ingredients found in FDA-approved bioidentical hormones. In contrast, others incorporate additional hormones that have yet to undergo sufficient testing and are absent from any FDA-approved products. Consequently, the purity and safety of compounded bioidentical hormones may become compromised.
What are the advantages of bioidentical hormones?
BHRT, called bioidentical hormone replacement therapy, is commonly used by people experiencing decreased hormone levels due to perimenopause or menopause. The treatment aims to increase hormone levels that have dropped, thereby improving moderate to severe menopause signs such as night sweats, mood changes, memory problems, hot flashes, weight gain, sleep issues, reduced interest in sex, or pain during sex.
Hormone replacement therapy may also help minimize the risk of diabetes, tooth loss, and cataracts by restoring hormonal balance. Additionally, some anecdotal evidence suggests that it can improve skin thickness, hydration, and elasticity and even reduce wrinkles.
Are bioidentical hormones safe, and what about compounded versions?
FDA-approved bioidentical hormones are thoroughly tested for safety and meet strict regulatory standards, making them generally safe under medical supervision. However, like all hormone therapies, they carry certain risks, so it’s necessary to discuss the benefits and potential side effects with your doctor.
Compounded bioidentical hormones, on the other hand, are custom-made and not FDA-approved. Not tested for safety or effectiveness, many medical organizations caution against their use due to the lack of data on long-term safety and potential side effects. Sometimes, they may be necessary, but you should carefully evaluate them with your doctor.
What are the side effects of bioidentical hormones?
Hormone replacement therapies may cause side effects, especially at the beginning when your body is adjusting to the hormones. The probable side effects can vary depending on the type of hormone therapy you are taking, so it is best to consult your doctor to know what to expect.
Some common side effects of BHRT may include acne, bloating, weight gain, fatigue, and mood swings. It is important to note that some people cannot take BHRT or any form of hormone replacement due to the risks and potential for side effects that may vary depending on their health history. Therefore, discussing the pros and cons with your healthcare provider before using any form of hormone replacement therapy is advisable.
Are there groups of people for whom bioidentical hormones are not recommended?
After thoroughly considering the risks and benefits, you and your healthcare provider should jointly decide whether to use hormone therapy or not. Bioidentical hormones have been controversial, and the FDA has not approved many of them; however, your healthcare provider may still consider them a treatment option.
If you have a history of or are at high risk for any of the following conditions, hormone therapy may not be a safe option for you:
- Blood clotting disorders
- Gallbladder disorders
- Heart or cardiovascular disease
- Breast cancer
- Stroke
Finding the best specialist for bioidentical hormone therapy near you
Choosing the right doctor can be a task. But don't worry; you can find some of the country's best hormone therapy specialists through Zocdoc. It is a platform that lets you look up the top physicians through its easy-to-navigate website. Enter your health issue or type of medical practitioner, preferred date and time of appointment, area and zip code, and medical insurance plan in the search bar. If you cannot see your insurance plan listed on Zocdoc, you can upload a photo of your medical insurance card (note: this service doesn't support vision or dental cards). We will scan the card and display your likely plan. Zocdoc’s service team can assist you if you encounter difficulties uploading the image. If you have any insurance-related questions, please visit Zocdoc's patient help center.
Zocdoc will immediately curate a list of the best available consultants from its extensive database to align with your requirements. You can refine these results based on gender, location, availability, fluent languages, etc.
Every practitioner has a unique professional profile with essential information about the doctor, such as their educational qualifications, years of practice, licenses, and hospital affiliations. You can also make a note of the kind of insurance they accept. Further, you can read authentic ratings and reviews from previous patients to assist you in making the right decision.
Once you've chosen the best physician for bioidentical hormone therapy near you, you can make an online or in-person appointment. The best part is that all bookings on Zocdoc are simple, secure, and 100% free!
BHRT statistics
After the Women's Health Initiative released its findings in 2017 about the potential harms of hormone replacement therapy (HRT) after five years of daily oral conjugated equine estrogen combined with medroxyprogesterone in women ages 50 to 79, the popularity of compounded bioidentical hormones has steadily increased as an alternative. These findings revealed that the risks outweighed the anticipated benefits in preventing chronic diseases.
According to several surveys in 2017, out of the 3,725 women surveyed, about 9% used hormone therapy. Additionally, one-third of these women used a compounded bioidentical hormone formulation, meaning that approximately 1 to 2.5 million women in the country, 40 years or older, have used cBHT. Half of the women taking cBHT were under the impression that the formulation was FDA-approved. However, that was not the case.
In the Women's Health Initiative (WHI), a combination hormone therapy using non-bioidentical estrogen CEE with synthetic progestin MPA increased the risk of heart attack and stroke due to cardiovascular disease. According to the data amalgamated by the Atlas Health Medical Group, experts have reported this in multiple publications.
Sources
Atlas Health Medical Group
Cleveland Clinic
MedCentral
Healthline
Alloy
