Bioidentical hormone replacement therapy can help you get perimenopause and menopause symptoms relief. Here’s what you need to know.
Bioidentical hormone replacement therapy can help you get perimenopause and menopause symptoms relief. Here’s what you need to know.
For many people, the period of transition from reproductive years to menopause is plagued by symptoms ranging from mildly uncomfortable to absolutely unbearable.
Maybe you haven’t had any issues—it’s possible, and lucky! But if you’re one of the millions of people who experience perimenopause and menopause symptoms, you may be wondering how to get help.
Fortunately, there are lots of treatment strategies available to you.
Bioidentical hormone replacement therapy is one option among many to help you find relief from perimenopause and menopause symptoms. Here’s your guide on what bioidentical hormone replacement therapy is, and how it may help you.
What is bioidentical hormone replacement therapy?
As its name suggests, bioidentical hormone replacement therapy is a form of hormone replacement therapy (HRT). Like conventional HRT, bioidentical HRT helps treat menopause and perimenopause symptoms triggered by declining, unbalanced hormones.
During perimenopause, your body’s production of key reproductive hormones like estrogen and progesterone drops dramatically at uneven rates. This trifecta of fluctuation, decline, and imbalance leads to a number of physical and emotional perimenopause and menopause symptoms.
Bioidentical HRT seeks to offer symptom relief by supplementing and stabilizing your body’s declining hormone levels.
Today, bioidentical HRT is increasingly called “regulated body-identical hormone therapy” (rBHT). Many menopause specialists now prefer this term in order to distinguish bioidentical HRT from compounded bioidentical HRT, an unregulated treatment that is not government-approved.
How does bioidentical hormone replacement therapy work?
Bioidentical HRT aims to supplement your body’s hormone production in order to stabilize your hormone levels and ease hormone-driven symptoms of perimenopause and menopause, like:
- Hot flashes and night sweats (also called vasomotor symptoms)
- Sleep disturbances
- Mood swings
- Vaginal symptoms, like irritation, dryness, and pain during sex
Treatment with bioidentical HRT typically involves administering the hormones estrogen, progesterone, and testosterone. You can take bioidentical HRT in several forms, including:
- Oral pill
- Injection
- Patch
- Gel
- Spray
- Vaginal cream
- Vaginal ring
- Vaginal tablet
Is bioidentical hormone replacement therapy safe?
Bioidentical HRT is an FDA-approved, safe, and effective form of treatment for perimenopause and menopause symptoms.
Bioidentical HRT may be a helpful option for you if you’re dealing with frustrating, painful, or distressing symptoms, provided that you meet the following conditions:
- You’re 59 or younger
- You reached menopause less than ten years ago
- You’re not at high risk for breast cancer, blood clots, or stroke
Side effects of bioidentical HRT include:
- Bloating
- Acne
- Weight gain
- Mood swings
- Anxiety
- Irritability
- Increased facial hair
Like other forms of hormone therapy, including conventional HRT, bioidentical HRT has certain risks, including:
- Breast cancer
- Blood clots
- Stroke
Risk levels vary depending on your age and medical history. Your doctor can help you weigh the benefits and risks to decide if bioidentical HRT is right for you.
Hormone replacement therapy vs bioidentical hormone replacement therapy: what’s the difference?
Bioidentical HRT uses bioidentical hormones only. Bioidentical hormones come from plants. They have the same chemical and molecular structure as hormones produced by the body, and function in the same way.
Conventional HRT, on the other hand, uses bioidentical hormones combined with synthetic hormones and hormones derived from animals, neither of which are bioidentical to our hormones.
Synthetic and animal-derived hormones mimic the hormones our bodies make. They don’t impact the body in quite the same way as the hormones we make ourselves, but they work similarly to produce similar effects. Bioidentical hormones more closely match the hormones produced by our bodies.
Bioidentical hormones, animal-derived hormones, and synthetic hormones are all processed in labs. Though bioidentical hormones (like animal-derived hormones) come from natural sources, these plant-derived substances still need to be chemically processed before they’re ready for human use—like any medication!
Hormone replacement therapy vs. bioidentical hormone replacement therapy: which is better?
Research into the effectiveness of bioidentical HRT is ongoing.
According to a 2022 narrative review of existing scientific literature, there are no scientific studies comparing bioidentical HRT to conventional HRT. Instead, studies generally compare the effectiveness of bioidentical HRT to placebo.
Placebos are control substances that have no medical impact, used to test new drugs in comparison to no treatment. Other types of medical studies compare new drugs to existing forms of treatment, to see whether the new drug offers a benefit over available options.
So, is bioidentical hormone replacement therapy better than conventional hormone replacement therapy? No, there’s currently no scientific evidence that bioidentical HRT is more effective or better than conventional HRT.
Which is safer?
What about treatment safety? Is bioidentical hormone replacement therapy safer than conventional hormone replacement therapy? No, the hormones used in bioidentical HRT aren’t safer than those used in conventional HRT, and current research doesn’t indicate that one form of treatment is safer than the other. Both bioidentical HRT and conventional HRT are safe.
In fact, many conventional HRTs contain bioidentical hormones, too (in addition to synthetic and animal-derived hormones). In other words, many of the same hormones may be used in both bioidentical HRT and conventional HRT.
More rigorous scientific research, including large-scale and long-term clinical studies, is needed to better understand the use, effectiveness, and impact of bioidentical HRT.
Bioidentical HRT vs. compounded bioidentical HRT
Bioidentical hormone replacement therapy is not the same treatment as compounded bioidentical hormone replacement therapy.
Compounded bioidentical HRT relies on pharmacists mixing custom-made hormone combinations based on a doctor’s prescription. The resulting formulations may not be safe or effective, and they may use untested methods to administer treatment.
While compounded bioidentical HRT is often marketed as a personalized and natural perimenopause and menopause treatment approach, it’s crucial to understand that compounded bioidentical HRT isn’t FDA-approved and isn’t regulated by any government agencies.
This means that compounded bioidentical HRT has no federal oversight regarding quality, sterility, quantity, purity, and safety standards.
Major health organizations, including the North American Society for Menopause and the American College of Obstetricians and Gynecologists, strongly advise against using compounded bioidentical HRT. Instead, health experts recommend using safe, FDA-approved options like bioidentical HRT and conventional HRT for perimenopause and menopause treatment.
Health experts specify that exceptions for compounded bioidentical HRT may be made under particular circumstances, like if you have an allergy that prevents you from taking an FDA-approved hormone therapy. This would be a serious discussion to have with your doctor.
Is bioidentical hormone replacement therapy right for me?
Talk with your doctor if you’re interested in learning more about whether bioidentical HRT can help you manage perimenopause and menopause symptoms.
Bioidentical HRT may not be the right treatment for you if:
- You’re 60 or older
- You reached menopause more than ten years ago
- You’re at high risk for breast cancer, blood clots, or stroke
Other perimenopause and menopause treatment options
Bioidentical HRT and conventional HRT aren’t the only ways to get perimenopause and menopause relief.
>>MORE: Perimenopause Treatment: 9 Ways to Find Relief (And How to Know It’s Working)
Other options include:
- Diet changes
- Regular exercise, like swimming, walking, yoga, biking, or jogging
- Improved sleep hygiene
- Mindfulness practices, like meditation
- Perimenopause vitamins and supplements
- Certain over-the-counter painkillers
- Some prescription medications, including certain antidepressants
These options for managing perimenopause and menopause symptoms may be used on their own or in combination with bioidentical HRT or conventional HRT (with your doctor’s OK, of course).
Bioidentical hormone replacement therapy: the takeaway
For many people, transitioning into menopause can be a frustrating, uncomfortable, or even painful process. But it doesn’t need to be—there are ways to get relief, including with hormone therapies like bioidentical hormone replacement therapy.
Bioidentical HRT uses bioidentical, plant-derived hormones to supplement and stabilize your hormones, helping to ease symptoms triggered by hormone changes. This treatment may help you get relief from perimenopause and menopause symptoms like hot flashes, night sweats, and sleep disturbances.
If you’re dealing with difficult symptoms, talk with your doctor about your treatment options. Your course of action will depend on your unique perimenopause journey, your health and medical history, your symptom severity, and your treatment priorities.
Your health, wellbeing, and comfort matter at every age. Your body may be changing, but that doesn’t mean you have to suffer.
About the author
Sources
- American College of Obstetricians and Gynecologists. (2023). Compounded Bioidentical Menopausal Hormone Therapy.
- British Menopause Society. (2024). Bioidentical HRT.
- Burnett T, Mayo Clinic. (2022). Bioidentical hormones: Are they safer?
- Donnelly L & Balneaves LG. (2022). Fact or Fiction? The Role of Regulated Body-Identical Hormone Therapy for Menopausal Women.
- Gina Harper-Harrison G & Shanahan MM. (2023). Hormone Replacement Therapy.
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- North American Menopause Society. (n.d.). Hormone Therapy & Menopause FAQs.
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