Are biodentical hormones the same as synthetic HRT?

Bioidentical hormones are plant based, creating molecules that mimic our natural hormones. They are the most natural approach not only because they are plant based in their source, but because they so closely resemble what our own bodies produce.  This is very important because synthetically altered hormones are different in molecular structure than what our bodies produce, and have different and often opposite effects compared to bioidentical hormones.

This topic can get very confusing because oftentimes doctors will tell patients, “all hormones are the same” whether bioidentical or not, but this is not accurate,  and there are plenty of studies to support that they are different both in molecular structure and actions on the body.   The synthetic hormones are those such as Premarin and Provera.  Obviously, we don’t recommend or use Premarin or Provera, because we know there are more risks with synthetically altered hormones.

Fatigue, depression, hot flashes, night sweats, mood swings, weight gain, bad cramping and heavy bleeding, insomnia and irritability (to name just a few) can come from hormonal deficiencies or imbalances related to menopause, perimenopause (starts as early as 35 in some women!), PCOS (polycystic ovarian syndrome), or PMS.   And in men, we can see the effects of hormone imbalances and deficiencies in low testosterone (andropause) causing fatigue, depression, low libdo, erectile dysfunction, abdominal fat and muscle atrophy.


2325-207x300We’ve all heard “ hormone replacement is bad and causes cancer”, right?   Well, not exactly.  Where does that notion come from?  Let’s explore that more…

The Women’s Health Initiative trial nearly 15 years ago found a link between breast cancer, stroke and heart disease with the use of Premarin and Provera, the synthethic hormones.  The link was specifically related to using progestin (Provera), and found that Premarin, or synthetic estrogen, used alone had minimal complications.  Once the medical media got ahold of and sensationalized the results, it was all over the news that “hormone replacement is bad and causes cancer”.   But we cannot extrapolate the results of that one study to mean that all hormone replacement must be bad, and that natural bioidentical hormone replacement is the same as those synthetics and therefor, bad too.   This is not an accurate conclusion to come to from that one study and actually not an accurate conclusion of what the study actually showed.

Many practitioners and patients simply do not understand the difference between these synthetic hormones that showed risk and feel afraid of hormones as a result, which is really a shame. The unsafe synthetic HRT negative studies gives bioidentical hormone replacement a bad name!


“Fear of breast cancer is the strongest factor limiting postmenopausal hormone use. The most powerful study to date definitively demonstrated that estrogen does not cause an increase risk for cancer. The increased risk was associated only with taking the progestin (Provera®) and not estrogen.” JAMA 2004;291(24): 2947-2958.

In the Danish Trial from 2012. it looked at the use of bioidentical estradiol and concluded there was no increased risk of heart disease, and actually showed a decrease in the risk, along with a decreased risk of stroke and breast cancer. It was the exact opposite result of the WHI trial which looked at synthetics.

Thus far there are no negative studies in the medical literature on biodentical progesterone.  Progesterone does not equal medroxyprogesterone acetate (Provera) but even in some medical texts and literature you will see them used interchangeably, but this is very much inaccurate, as many studies have proven.


But my doctor told me if I don’t have a uterus, I don’t need progesterone…

There are progesterone receptors in the brain, uterus, heart, breast, vagina, bones and blood vessels. There is no reason NOT to give progesterone to all perimenopausal or menopausal women, uterus or no uterus.

There was a medical trial called the PEPI trial which showed that bioidentical progesterone is safe, reduces cholesterol, and reduces coronary artery disease.  In the EPIC trial it showed progesterone protects against breast cancer and that Provera (synthetic progestin) causes breast cancer. Obviously, we know which one we want to use.   Avoid the synthetic hormones.

Prevention is the BEST kind of medicine!

A preventive medicine approach to health of course focuses on interventions that will prevent disease.  That goal is at the forefront of my practice.  Of course it can be difficult to measure what didn’t happen as a result of health interventions, but that’s okay, we’ll go with it and enjoy our healthy lives into ripe old age knowing we were proactive and did ALL we could to stay healthy!

Maturo-Medical-Bioidentical-HormonesAfter doing a lot of research on “anti-aging medicine” and age management medicine, I came to realize that we all have an incredible power within ourselves to promote good health if we tap into the knowledge, habits and interventions that can slow down the aging process and create happier, healthier lives as we age. And while there is no magic pill, I do think there are some VERY specific things we can do to age gracefully, healthfully, and with avoiding the age related diseases like osteoporosis, cognitive decline, cardiovascular disease and cancers.  In my view, the most powerful way to prevent those types of age related diseases, and it’s well documented in studies, is to optimize ALL our hormones as we age. That means taking a look at every single one and not letting it fall into a deficiency.

When you combine hormone optimizing with healthy diet, restorative sleep and regular exercise….you have tapped into the most powerful ways to stay healthy as you age and reduce the likelihood of any kind of debilitating disease coming along.

hormone testing for women

Call our office today to talk more about preventive wellness through hormone optimizing!  480-730-2755