Bioidentical hormone replacement therapy (BHRT) is one treatment option for addressing hormone deficiencies. Most often it is used to treat the hormone deficiencies associated with menopause. BHRT differs from traditional hormone therapy, in that bioidentical hormones are made to be chemically identical to the naturally occurring female hormones, whereas traditional hormone replacement therapy utilizes chemicals that have been derived from animal hormones, or otherwise created to be similar, but not identical to the ones in your body.Natural hormones include estrone (E1), estradiol (E2), progesterone, testosterone, dehydroepiandrosterone (DHEA), and pregnenolone. Of these, the most commonly used bioidentical hormones are estradiol, and progesterone. Both are available as stand alone FDA approved supplements, but are also widely prescribed in the form of pharmacy compounded preparations.

Pharmacy compounding is the act of changing a drug or preparation, to suit the specific needs of a patient. It can be done to remove a buffer, or inert ingredient to which the patient is allergic, or to change it from pill to liquid form. Or it can be as simple as adding a more palatable flavor to a cough syrup or other liquid medication.

In the case of bioidentical hormones, it is done to tailor them to your requirements, based on tests done by your health care provider. The resulting compound is usually delivered via a transdermal patch, or gel. The test involved, are usually blood tests which are done at specific intervals, but some BHRT doctors use a less dependable saliva test. The resulting compound is usually delivered via a transdermal patch, or gel.

How Bioidentical Hormones Are Derived

The majority of bioidentical hormones, as well as many non-bioidentical hormones, are derived from diosgenin. This is a cholesterol-like by-product found in many plants. In most cases, it is extracted from the tubers of the discorea, or wild yam.

A notable example of hormones that are not derived from diosgenin is premarin. This is a non-bioidentical hormone, and is synthesized from horse urine. Specifically, it is extracted from the urine of pregnant mares, and contains a compound of horse and human hormones.

Premarin came under fire in 2002, when a study pointed to an increased risk of breast cancer, stroke and heart attacks in older women undergoing traditional hormone replacement therapy. As a result, doctors became more reluctant to prescribe hormone replacement therapy. This in part, led to the growing popularity of BHRT.

Why You Might Need Them

During menopause, women experience lower levels of estradiol, which leads to some common symptoms such as: hot flashes, loss of memory, and depression. Estrogen replacement has been shown to relieve these symptoms. It is also used to slow, and in some cases partially reverse the effects of such diseases as osteoporosis, atherosclerosis, and dementia, which have also been linked to low estradiol levels.

BHRT practitioners believe that it is. They point to the fact that it is natural, and chemically identical to the hormones that your body produces. As such, it can function more safely and effectively within your system. They also believe it to be advantageous that, unlike non-bioidentical hormones, their levels can be precisely tracked with simple blood tests. Their claims were bolstered by a literature review in 2009. The review assessed the results of 200 studies, and stated that there was sufficient evidence to suggest that bioidentical hormones were safer, and more effective than synthetic hormones. A separate review, however, found little or no evidence to support these claims, where compounded hormones were concerned. The review went on to state that pharmacy-compounded hormones held no advantage what so ever, over their traditional counterparts.

According to the Mayo Clinic, and the North American Menopause Society, there are certain benefits to pharmacy-compounded hormones. Among these, is the ability to tailor the ingredients to a person’s specific needs. But they are quick to point out that there is no evidence that BHRT is safer, or more effective than traditional methods. While they have voiced confidence in the FDA approved bioidentical hormones that are available with a prescription, they believe that pharmacy compounded hormones may carry increased risk factors, due to the fact that these formulae are neither FDA approved, or regulated in the United States. With the human factor involved, they have said that there is also the possibility of mixing errors, or contamination.