What is bioidentical estrogen therapy?

Updated: Oct 16, 2018
  • Author: Janice L Bacon, MD; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Bioidentical hormones are plant-derived compounds that have the same chemical and molecular structure as those of hormones produced by the human body. Commercial preparations utilizing “natural compounds” are available– allowing patients the options of therapies biochemically related to a woman’s endogenous estrogen and progesterone. Pharmacy compounded regimens, while allowing some dosage adjustments and combinations not currently available by prescription have not undergone rigorous studies insuring therapeutic equivalence, safety and accuracy and reproducibility similar to commercial preparations. In addition, pharmacy compounded therapies are not usually covered by commercial insurance.

Monitoring of pharmacy compounded therapies are often monitored by saliva hormone levels and this route of testing and its assays have also not been subject to scientific trials and cannot be compared to serum hormone levels.

Only hormone therapies approved by the US FDA are recommended. This position has been supported and upheld by The Endocrine Society, the American College of Obstetricians and Gynecologists and the North American Menopause Society.

In 2017, an oral soft-gel capsule containing standardized doses of 17-beta- estradiol and natural progestins became available. This product has met FDA safety and efficacy standards. The study of this product was presented in a scientific session of The Endocrine Society at its annual meeting. This provides an option for women seeking a completely “natural” HT regimen to use a safe and carefully regulated medication instead of compounded therapy. [121]

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