Many of our patients ask about bio-identical hormones for treatment of menopausal symptoms, and it is easy to be confused with so much conflicting information available online and in product advertising. First of all, the term “bio-identical” is not a scientific or medical term but refers to hormones that look biologically identical to those produced by humans. Women produce three kinds of estrogen prior to menopause, the predominant one being estradiol. Any estrogen product that is called “estradiol” is bio-identical. We also produce a hormone called progesterone each month after ovulation and in pregnancy.

Any “progesterone” product is bio-identical. Our patients often tell us that they don’t want “synthetic hormones” and prefer something “natural”. Unfortunately, these terms are really marketing terms with no real meaning. All hormones including bio-identical hormones are synthetic, that is they are made in a lab to look exactly like human hormones. Some come from a plant source, hence the term “natural” that may be used in their advertising, but they are not taken out of the ground and put in a bottle, they are synthesized in a lab to be made useful to humans. The only truly “natural” human hormones would be taken out of one human and used in another, which is not the source of any hormones used for menopausal relief. Bio-identical hormones (estradiol and progesterone) are available from specialty pharmacies called compounding pharmacies that mix hormones to various specifications.

Estradiol and progesterone are also available under a variety of brand names from regular commercial pharmacies, and we use both commercial and compounding pharmacies according to patient preference. Another frequent misconception is that before one can take bio-identical hormones a lot of expensive lab testing is necessary to establish the correct dose and that those levels must be followed. In fact, levels of estrogen and progesterone can generally be evaluated as accurately by listening to the patient’s history as by lab testing. We rarely measure hormone levels to establish or follow dosing. We listen to the patient and dose accordingly using data from thousands of other patients in the past.

Your doctors at CWCC will almost always prescribe bio-identical hormones (estradiol and progesterone) to treat menopause symptoms if hormone therapy is indicated, and we believe that hormone replacement with estradiol and progesterone is a great option for reducing menopause symptoms in many women. But using a compounding pharmacy is an option, not a necessity, and beware of expensive lab tests that may be profitable to the provider ordering the test, and of terms like “natural” which suggest that a product is better or safer.