If you've been feeling a bit confused about what types of hormones you should or shouldn’t be using, you're not alone. Hormone management and hormone replacement therapy (HRT) have become some of the most misunderstood areas of health care today. It’s no surprise—there’s so much misinformation floating around on the internet. As a healthcare professional, I find it frustrating to see false information ranking highly in search results, especially when it’s confusing patients who are just looking for answers.

So, today, let’s pull back the curtain on hormones and hormone replacement therapy and break down what you need to know. But first, let’s answer the question: Why is hormone management so confusing?

The simple answer is that pharmaceutical companies have worked hard to blur the line between bioidentical hormones and synthetic hormones. This confusion serves their interests because they stand to profit more from synthetic, altered hormones. They want you to think you need these medications, despite the fact that natural, bioidentical alternatives are often safer, more effective, and cheaper.

Now, let's dive in and clear up the confusion about hormones. Here's what you'll learn:

• What bioidentical hormones are, and how they differ from pharmaceutical hormones

• Examples of bioidentical hormones

• Whether bioidentical hormones are safe (and why we don’t need studies to "prove" it)

• The difference between birth control and bioidentical hormones

• Much more

What Are Bioidentical Hormones?

At the core, bioidentical hormones are simply hormones that are chemically identical to the ones your body naturally produces. These hormones are often referred to interchangeably as bioidentical or body-identical.

Think of it like this: Your body produces essential hormones like testosterone, estradiol (the most potent form of estrogen), progesterone, and thyroid hormone. But, certain medical conditions can cause your body to produce less of these hormones. The solution? Supplementing with hormones that are identical to the ones your body is supposed to make. These are bioidentical hormones.

Now, here’s where things can get confusing: Rather than prescribing actual bioidentical hormones, many doctors give patients medications that mimic those hormones. These are what I call Frankenstein hormones—they look somewhat similar and activate the same hormone receptors, but they are not the same. Birth control pills are a prime example of these synthetic hormones.

Why Do Pharmaceutical Companies Push Synthetic Hormones?

Pharmaceutical companies are all about profit. Bioidentical hormones are natural compounds, which means they can’t be patented by drug companies. Without the ability to patent them, these companies can’t monopolize the market. So, they take bioidentical hormones and tweak them slightly, creating a hormone that’s just different enough to be patented. The result? A synthetic version of the hormone that doesn’t work as well and may not be as safe.

To further confuse matters, these companies lump bioidentical hormones and their synthetic alternatives together in research studies. They’ll refer to both bioidentical and synthetic hormones as simply “hormones.” The problem? When studies claim that certain hormones are unsafe, they might only be referring to the synthetic versions, leaving people confused about whether all hormones are dangerous.

Examples of Bioidentical Hormones

It’s essential to know the specific hormones that are bioidentical, so you can make informed decisions about your treatment. Here are some examples:

• Thyroid hormones (T3 and T4): All thyroid medications, such as levothyroxine (Synthroid), are considered bioidentical.

• Progesterone: To ensure you’re getting bioidentical progesterone, look for Progesterone USP (United States Pharmacopeia) as the active ingredient. Prometrium is one example of a bioidentical progesterone medication.

• Testosterone: Many testosterone preparations are bioidentical, though they are often prescribed to men more than women. For women, getting testosterone through a compounding pharmacy may be the only way to ensure you’re receiving a bioidentical version.

• Estrogens: Bioidentical estrogens include estradiol, estrone, and estriol. These are found in medications like Biest and Triest, as well as in prescriptions like 17-beta estradiol.

Synthetic vs. Bioidentical Hormones: What’s the Difference?

You may hear the terms “synthetic” and “natural” tossed around when it comes to hormones, but here’s the important distinction: Synthetic hormones are created in a lab, but that doesn’t automatically mean they aren’t bioidentical. For example, medications like Synthroid or Estrace are synthetic, but they’re still bioidentical because they exactly match the hormones your body produces naturally.

On the other hand, non-bioidentical hormones, like those found in birth control pills or some forms of hormone replacement therapy (HRT), are altered in ways that make them behave differently in your body.

It’s crucial to focus on whether a hormone is bioidentical rather than whether it’s labeled as “natural” or “synthetic.”

Are Bioidentical Hormones Safe?

You’ve probably heard doctors claim that bioidentical hormones are unsafe, or that they haven’t been proven to be safe. But let’s pause for a moment: Why would the very hormones your body produces naturally be dangerous? If your body is designed to use them, how could they cause harm?

The standard that we apply to other pharmaceutical medications—proving safety before use—exists because those medications are foreign to the body. Bioidentical hormones, however, are not foreign. They are identical to the ones your body already produces, so the risk isn’t the hormone itself but the dose.

In short, bioidentical hormones are very safe when used correctly. Problems arise when doses are too high or incorrect, which is why it’s crucial to start low and increase gradually.

Birth Control vs. Bioidentical Hormones: What’s the Difference?

Here’s where the confusion often peaks. Birth control pills contain synthetic hormones that mimic estrogen and progesterone, but they are not bioidentical. These synthetic hormones can have high doses that completely shut down your body’s natural hormone production.

Interestingly, doctors are often comfortable prescribing these synthetic hormones, even though they come with significant side effects, like an increased risk of breast cancer. But when it comes to prescribing bioidentical hormones—especially to women going through menopause—doctors may hesitate, citing vague concerns about safety. This creates a double standard.

Wrapping It Up

Bioidentical hormones are the same as the hormones your body naturally produces, and they are the safer option when compared to synthetic hormones. Unfortunately, the pharmaceutical industry’s influence often clouds the truth, and many doctors don’t have the education needed to make informed recommendations.

The key takeaway here is that bioidentical hormones are safe, effective, and preferable to synthetic alternatives. But remember: it’s not about whether a hormone is “natural” or “synthetic”—it’s about whether it’s bioidentical.

If you’re currently using hormone therapy, check with your doctor to ensure you’re using bioidentical hormones, especially if you’re concerned about safety or effectiveness. There are plenty of options available, and you deserve the best treatment for your body.

Now, I’d love to hear from you:

• Are you currently using hormones as part of your treatment?

• Do you know if your hormones are bioidentical?

• Have you been told that bioidentical hormones are unsafe?

Feel free to leave any questions or comments below!

*Disclaimer, I am not a doctor or have the ability to prescribe or deprescribe any form of medication. The information above is from my own research and are my views. If you have any concerns related to medications you are on, please speak with your GP.