What You Need to Know about the Differences Between Bioidentical and Conventional Hormone Therapies
14 Jul 2015

What You Need to Know about the Differences Between Bioidentical and Conventional Hormone Therapies

What You Need to Know about the Differences Between Bioidentical and Conventional Hormone TherapiesWhen I speak to groups of women, the topic of hormone replacement therapy often comes up. And what I’ve discovered is that there’s a lot of confusion, misinformation and fear out there.

There are important differences between the two and it’s important to understand them, especially if you are considering hormone replacement therapy.

Let’s start with bioidentical hormone replacement therapy (BHRT). There are 2 key points to understand about BHRT:

  1. All hormones used are chemically identical to human hormones.
  2. The dosage can be individualized to a patient’s specific hormonal needs.

These products are commercially available or in compounded dosage forms. Compounded products are made at specialty pharmacies in doses that are customized for each client.

Bioidentical estrogens include estrone, estradiol, estriol, 17 β-estradiol, and estradiol hemihydrate.

Progesterone is also bioidentical, as are testosterone and DHEA.

Commercially-available products come in specific strengths that cannot be customized.

Conventional Hormone Replacement Therapy

The best known examples of conventional HRT are Premarin and the combination drug, Prempro. Prempro is a combination of synthetic estrogen and a synthetic progestin and is the product that was involved in the Women’s Health Initiative study that showed increased risk of breast cancer, blood clots and stroke with HRT.

The estrogens in the product are derived from the urine from pregnant mares, and the progestin is medroxyprogesterone, a synthetic hormone not found in nature. Other products that contain synthetic hormones include oral contraceptives and some IUDs. Some names of other synthetic progestins are norethindrone, drosperinone and levonorgestrel.

Take Note!!

An extremely important takeaway point is that PROGESTERONE and PROGESTINS are NOT the same thing. The medical community tends to lump progesterone into the progestin category, but they work very differently in the body. Progesterone is calming and affects your brain in addition to protecting your uterus from the effects of estrogen. Synthetics have no calming effects and are associated with a number of side effects. Progesterone DOES NOT raise cancer risk, and has not been associated with an increased risk of blood clots or stroke. You can read more about that here.

Many nay-sayers suggest there is little scientific evidence to support the use of bioidentical hormones, when this couldn’t be further from the truth. Progesterone has been available for almost 80 years now and there are reams of clinical trials that have looked at its efficacy and safety in a number of ways. Also, estradiol, progesterone and testosterone are available as mass-produced pharmaceuticals and have passed the current FDA safety and efficacy standards.

Critics of BHRT would have you believe that pharmacists are in the back room mixing up potions without regard to quality or safety. While it IS true that compounded bioidentical hormones are not regulated by the FDA, they ARE regulated by state Boards of Pharmacy in many states. A compounding pharmacy that is using the top of the line equipment and has the proper quality assurance procedures in place will consistently exceed any standards the FDA might have for a mass-produced medication.

If you’re in perimenopause or menopause and are looking for support and good information, I invite you to join the Hormone Harmony Club on Facebook. We’re talking over there, night and day!


About Dr. Anna

Dr. Anna Garrett is a pharmacist and menopause expert who helps women who are struggling with symptoms of perimenopause and menopause find natural hormone balancing solutions so they can rock their mojo through midlife and beyond. But her clients would tell you that her real gift is helping them reclaim pieces of themselves they thought were gone forever.

Dr. Anna offers a complimentary 30-minute Get Acquainted Call to anyone who’d like to learn more about working 1-1 with her. You can schedule that at your convenience by clicking here

Please contact her at dranna@drannagarrett.com.

Dr. Anna Garrett


  1. jen camillo Says: July 27, 2018 at 12:21 pm

    Dr., i have been perimenopausal for over 4 yrs. only sx is hairloss. only labs off were low estrsdiol (under 10) & low progesterone (.30) i am now 48. i had been on bcp for most of my adult life. i begged 11 dr’s to switch me from bcp to bio hrt. i finally got a dr to rx me divigel & oral progesterone. i have to pay cash for both. ins wont cover. i ordered divigel from a canada pharmacy & got sadrena. foreign equiv to divigel. it is estradiol hemihydrate tho. is this still ok?

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Information on this web site is provided for informational purposes only. This information is not intended as a substitute for the advice provided by your physician or other healthcare professional or any information contained on or in any product label or packaging. Do not use the information on this web site for diagnosing or treating a health problem or disease. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or using any treatment for a health problem. If you have or suspect that you have a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read on this web site. Information provided on this web site and the use of any products or services purchased from our web site by you DOES NOT create a doctor-patient relationship between you and any of the physicians affiliated with our web site. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.