Transcription
Are bioidentical hormones legit? This is the question, and wow, is this a polarizing one for Women's Health and all things that have to do with hormones. I mean, I've seen educators say that bioidentical hormones just straight up don't exist, which is not true. I've also seen educators say that bioidentical hormones are only pellets, which is not true. And I've seen educators say that bioidentical hormones are only compounded therapies, and that's not exclusively true.
So, we're going to get into it because this can be really confusing and overwhelming, and honestly, hurtful to women and Women's Health who are looking to go into hormones. So, if this is you, and you're on hormones and wondering about the whole term around bioidentical, or you're considering hormones and maybe want to talk to your doctor about the concept of bioidentical, then listen up because we're going to talk about what they are and what they aren't. Hi, my name is Dr. Carrie Jones, and you're going to want to hit that subscribe button because I know hormones can feel like hurting cats, and I am here to help.
Now, first, let's get into the definition. What is a bioidentical hormone? What does it even mean? There's kind of a consensus out there. So, I looked at the Mayo Clinic, the Cleveland Clinic, and WebMD to see what they said. In fact, I even looked at Wikipedia, you know, for better or worse, don't judge. And here's what they said. I'm going to read it directly so you have an understanding. The definition of a bioidentical hormone is a man-made hormone. I know, we're women, they still call it that. A man-made hormone that are identical on a molecular level to your own hormones that you make in your body. So, for example, if you are on bioidentical micronized progesterone, let's pretend you are on the pharmaceutical brand known as, um, Prometrium. When you swallow Prometrium and you're getting that progesterone, it should look like the progesterone in your own body. It should be identical. That is the concept around bioidentical.
The FDA doesn't recognize the term bioidentical as a scientific term. In fact, most everyone kind of calls it a marketing term. And I'm like, yeah, I get that. Bioidentical really isn't so much scientific, but you hear it all the time. What's interesting is that there are several commercially available hormones that are FDA approved and also bioidentical. So, I want to make sure we talk about those and we talk about like, maybe what isn't. So, some examples could be your estrogen patch, your progesterone capsule that I just mentioned, maybe you're using a form of an estradiol vaginal cream or an estriol cream. You are using a pellet, you're using some sort of injection estrogen or progesterone, you're doing an estradiol capsule. Um, you can see that there are a lot of options out there for the concept around bioidentical.
Now, what's really key, important, is that this is very different from synthetic. So, synthetic is a progestin or maybe even something called a conjugated equine estrogen. So, I don't want you to confuse the two. So, conjugated equine estrogen literally come from equines. They come from pregnant, uh, mare urine. That the Premarin is the name of it. So, pregnant mare urine. And then we have progestins such as medroxyprogesterone. Now, don't let that name fool you. I know it has progesterone in there, but medroxyprogesterone is synthetic. It's, it's not a progesterone. The progesterone in the birth control pill is also a progestin. Um, a progestin, I such as the Marina. None of those are bioidentical. So, I don't want you to confuse the two. And for research purposes, and outcome purposes, and side effect purposes, this is really important.
So, in the end, to answer the title question, are bioidentical hormones legit? Of course, they're legit. They are out there and available. If you have an estradiol patch and you're taking Prometrium, both of those are bioidentical.
Now, let's answer some other misconceptions around them. Does bioidentical hormone therapy only mean the pellet? Well, of course not. I just said if you have a patch, if you have, you're on Prometrium, if you are doing an oral estradiol capsule, if you're using vaginal estradiol or estriol cream, those are bioidentical and those are not pellets. Now, pellets are not FDA approved, but they are bioidentical. So, I can understand why there's confusion. And pellets themselves, which are little sort of rice-sized, um, uh, like they contain hormone and they get inserted into your hip, there's a lot of issues and controversy and things around pellets. But to blanketly say all bioidentical is pellets is is false. That's not true.
Another question that I commonly hear are around bioidentical hormones and compounding. I have heard educators say that bioidentical hormones only means compounding. But again, we've been talking, you know, if you have a patch that's estradiol, you know, if you're on Prometrium or some other progesterone capsule, you know, that if you're doing vaginal estradiol or estriol, you know, all of that's bioidentical. Now, it could be compounded. You can also get it compounded at a compounding pharmacy by a pharmacist. So, for example, Prometrium is the oral progesterone capsule that is commercially available and it is progesterone, bioidentical. But it has peanut oil in it. So, if you have a peanut allergy, it's possible your practitioner said, you know what, I need you to have this, but because of your allergy, we're going to get it made at a compounding pharmacy. In which case, it is still progesterone. It looks like the progesterone in your body. So, please, when you hear this out on social media around the education of, oh, bioidentical only means compounding, that's not true either. It's a mix. It can be commercially available, FDA approved, or it can be compounded.
Another question: Do I need a prescription for a bioidentical hormone therapy? And the answer is yes, usually. There are some progesterone creams that you've probably noticed over the counter or online in health food stores that are true progesterone when you read the label. But the large majority of bioidentical hormones, the patch, the pill, the vaginal, those are all prescription by your healthcare practitioner.
I've also had women say to me as feedback that their doctor says that bioidentical hormone therapy is not a real thing, and they want to know why they say that. And I'm like, I don't know. I understand that the FDA doesn't recognize it as a scientific term, and it's largely used as a marketing term. But to say that it doesn't exist at all, when I just gave you the definition of what bioidentical means in the beginning, and we know that a lot of these commercially available hormones fit the definition, they are bioidentical. I don't know why they would say it doesn't exist. So, honestly, I'm just as confused as you are.
I've actually also heard women say to me the opposite, that their healthcare providers said that all hormone replacement is synthetic. Is that true? Now, synthetic is often referred to as non-bioidentical, meaning like what's in the birth control pill or what's in the IUD, um, what's called a progestin, conjugated equine estrogen, CEE. Now, I understand to make hormones, no matter what, they're made in the lab. So, when you get the patch, when you get the progesterone pill, that has to be made in a lab. They're, they're using, uh, often plant-based, you know, material and converting them into the hormone. So, to say, I understand if you're like, technical, technical, like, well, it's everything's synthetic, it's made in the lab. True. But what we mean, it's semantics. Like, we have to get into the nuance of it. Of, I mean, yes, it's made in a lab, but it looks just like the kind in your body, which is different than made in a lab but pulled from mare urine. I think that's very different.
And lastly, because of the concept of bioidentical, and because the concept is it looks just like the hormone in your own body, I get asked, I've heard there are no side effects to bioidentical hormones. And that is not true. Of course, there are side effects, potentially. Just like your own hormones can cause symptoms in your own body. If you take hormones that look like your hormones, there's always the chance for side effects. It's not absolute, it's not guaranteed. I couldn't tell you what the side effects are going to be for you. Everybody's different. But if you have hormonal symptoms or had hormonal symptoms, then you know that hormones can cause side effects or symptoms. And unfortunately, the same can be true with the bioidentical version, whether you're doing estradiol or estriol or progesterone or whatever.
Now, of course, our goal in healthcare is always safety. Safety first. So, we work really hard to choose the right dose for you, the right way that you take it, how to like help coach you through it so that you don't get side effects, just like you wouldn't have them in your body with your own hormones. But that's not always guaranteed. So, we can't say that bioidentical means no side effects ever.
Hopefully, this helped answer some of your questions. And if you have more around bioidentical hormones, please pop them in the comment section below. I would be happy to make more videos around it. You're also going to want to hit that subscribe button because hormones feel like hurting cats, and I am here to help.