Bioidentical vs Synthetic Hormone Therapy

There’s a lot of buzz around bioidentical hormones—and for good reason. When it comes to HRT, structure matters.

What Are Bioidentical Hormones?

Bioidentical hormones are chemically identical to those your body naturally produces. They’re often derived from plant sources and processed to match human hormones.

Examples:

• Estradiol (E2)

• Micronized progesterone

• Testosterone (compounded)

These forms are better recognized by your receptors, metabolized more efficiently, and associated with lower risks.

What Are Synthetic Hormones?

Synthetic hormones have a different structure and often act differently in the body. Common examples include:

• Conjugated equine estrogens (Premarin)

• Medroxyprogesterone acetate (Provera)

These forms have been linked to higher risks of breast cancer, cardiovascular events, and mood disturbances.

Delivery Methods Matter

Hormones can be taken in different forms:

• Transdermal estrogen (patches, gels, sprays) avoids first-pass liver metabolism and lowers clot risk.

• Oral estrogen is convenient but slightly increases clot risk.

• Oral micronized progesterone is the safest option for uterine protection.

• Topical testosterone allows individualized dosing, especially in women.

• Vaginal estrogen is used locally with minimal systemic absorption—great for vaginal dryness or UTIs.

An individualized plan should consider symptoms, safety profile, and preferences.