What’s the Big Deal About Bioidentical Hormones?

Have you noticed that everyone seems to be talking about “bioidentical hormones” these days? The talk is everywhere: on talk shows, in books, in magazines, in the locker room, and at luncheons. What’s the big deal about bioidentical hormones?

Despite all the talk, few people really know what “bioidentical hormones” really are. And much of what they think they know about them isn’t really accurate. And typically, they lump together all sorts of different things into one big category that they label “bioidentical” when, in fact, they don’t all belong together.

The interesting thing to me is that most of the people who promote bioidentical hormones do so as if they are ideal hormones, or at least superior to other hormonal options. But they don’t usually know why that’s true or even if it’s true.

So let me give you the facts, all the facts, and nothing but the facts.

By definition, “Bioidentical Hormones” are hormones that are synthesized from substances that are identical to the molecules in the human body.

Now, the first thing an advocate for bioidentical hormones will tell you is that they’re “natural.” But are they?

Well, it depends on your definition of “natural.” They are “natural” in the sense that they’re identical to the molecules in your body, because your body recognizes things that resemble its own cells as “natural.” But they’re not natural with respect to their form, because they have been modified from the form in which they were found in nature. And they’re actually “synthetic” in the sense that they are created from other substances.

The second thing a bioidentical advocate will tell you is that they work better than other hormones and produce fewer side effects. But do they?

Theoretically, hormones that are identical to your own hormones should work better and should produce fewer side effects ... but they don’t always do as they should. The fact is that they work better for some people and not for others. Theory is not reality, so despite the logic of this concept, how well bioidentical hormones work varies from woman to woman.

The third thing an advocate for bioidential hormones will tell you is that all bioidentical hormones come from a compounding pharmacy, which is a pharmacy that custom makes them as designer hormones.

That’s the point at which I usually feel like rolling my eyes ... but I don’t.

A compounding pharmacy is different from a regular pharmacy. Instead of dispensing pharmaceutical drugs, a compounding pharmacy makes its own drugs (which is where the label “custom” comes into the picture). It uses bioidentical substances to create pills, creams, gels, suppositories, etc. And it does adjust the ingredients to conform to your specific needs (which is where the term “designer” comes up).

The problem with these labels is that they aren’t accurate. First, not all “custom compounded” hormones are bioidentical. Second, not all bioidentical hormones are “designed” specifically for you.

For instance, one of the facts about which many bioidentical hormone advocates are completely unaware is that many of the commercial pharmaceutical products for menopause are actually bioidentical! Yes, they’re produced by a pharmaceutical company. Yes, they come from a regular pharmacy. No, they’re not personally designed for you. But they are bioidentical! (That’s usually the most shocking thing of all. Most bioidentical hormone advocates get really quiet when I prove to them that this fact is true. It sort of takes the wind out of their sails for what they’re selling.)

If you’re thinking, “How can that be?” you just have to go back to the basic definition of “bioidentical hormone.” A “bioidentical hormone” is a hormone that is synthesized from molecules that are identical to the molecules in the human body. And some of the commercial pharmaceutical products for menopause consist of hormones identical to the molecules in the human body ... the exact same hormones that compounding pharmacies use to make bioidentical hormones.

What really makes advocates of bioidentical hormones squirm is the realization that these commercial pharmaceutical biodentical hormone products are actually FDA approved, whereas not all custom-compounded drugs are.

Now, I’m not a confrontational person. And I have nothing bad to say about either custom-compounded bioidentical or commercial pharmaceutical bioidentical hormones. So it is not my intention to denigrate either their stance on bioidentical hormones or their feelings.

So, I always make sure they know that it is possible to get bioidentical, custom-compounded hormones that are FDA approved and designed just for you.

The key is to understand that these issues are not all black and white. There are shades of gray. And it’s important to know and understand the distinctions that matter to you.

So, there are three different categories of these things that most people lump together in one big category when, in actuality, they don’t belong together. So here are the three categories:

Bioidentical Commercial Pharmaceutical Hormones

Bioidentical Custom-Compounded Hormones

Non-bioidentical Custom-Compounded Hormones

And here’s how they differ:


Product Bioidentical

Commercial Pharmaceutical


Custom Compounded


Custom Compounded

Identical to Human + - +
Perfect Fit + - +
FDA Tested & Approved + - +
Designed Just for You - + +
Fewer Side Effects + +/- +
“Natural” + +/- +
“Synthetic” + + +
From Plants +/- +/- +


Ahhh, now I feel better. And I hope you do, too. You have the facts, all the facts, and nothing but the facts. And now you really do know what the big deal is about bioidentical hormones.

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