What is bioidentical hormone replacement therapy?

What bioidentical actually means

It refers to molecular structure. A bioidentical hormone has the same chemical structure as the hormone your body makes, whereas some conventional preparations use molecules that are similar but not identical, or hormones derived from other species.

It does not mean natural in the sense of unprocessed — bioidentical hormones are manufactured in a laboratory, typically from plant-derived starting material. It also does not automatically mean safer; that depends on the hormone, the dose, the route, and your individual history.

Commercial versus compounded

Several bioidentical hormones are available as FDA-approved commercial products, including estradiol patches and gels and oral micronized progesterone. Compounded preparations are made by a pharmacy to an individual prescription and allow more flexibility in dose and combination, but they are not FDA-approved and are not subject to the same standardized testing.

Both have a legitimate place. Which is appropriate depends on your needs and should be an explicit part of the conversation rather than an assumption.

What treatment usually involves

A symptom history, a review of personal and family medical history, and baseline laboratory testing come first. From there, a starting dose and delivery route are chosen, with follow-up testing and symptom review to adjust over time.

Hormone needs change, so this is a therapy that is monitored and adjusted rather than set once. Ongoing supervision by a licensed provider is part of doing it properly.