When a woman goes through menopause, her ovaries stop producing hormones. The two main female hormones are estrogen and progesterone. Many symptoms can occur as a result of low hormone levels. One of the ways of decreasing these symptoms is to give back some of the hormones that the body doesn’t make any more through hormone replacement.
The term “bioidentical hormones” is used to describe a type of hormone replacement where the hormone given has the same molecular structure as the hormones your body used to produce prior to menopause. A woman’s body makes various estrogens (estradiol, estrone, and estriol) as well as progesterone and testosterone. Bioidentical hormone therapy can mean a medication that provides one or more of these hormones as the active ingredient. These hormones are plant-derived then altered in a lab to a form that humans can use.
The term bioidentical is also used to refer to compounded hormone therapy (HT) that is not manufactured by a commercial pharmaceutical company but is custom made for a particular patient by a compounding pharmacy. This treatment is often based on salivary hormone testing with the goal of maintaining hormone levels in a physiologic range. Compounded bioidentical HT is not FDA approved and thus not subject to FDA monitoring and regulation.
There are many FDA-approved bioidentical HT formulations that are readily available in many forms such as pills, skin patches, skin cream, gels, and topical sprays. FDA-approved HT formulations are tested for purity, potency, and safety in clinical trials before being released onto the market.
Compounded bioidentical HT formulations are not required to go through this testing. The quality of the hormone therapy is very dependent on the quality of the compounding pharmacy which can be extremely variable.
We are fortunate to have a few reputable compounding pharmacies in the SE Wisconsin area. The decision to go on hormone replacement therapy and which type is a personal one that can only be decided by the individual woman in consultation with her health care provider.