Updated:11-09-2025 ;
We are all familiar with hormones, those tiny chemical messengers that send signals throughout our bodies.
What are bioidentical hormones?
These plant-derived hormones can resemble and function similarly to those our body naturally produces.
As such, they may have benefits in conditions like perimenopause and menopause, making them a popular therapeutic option for women.
Let’s deep dive into exactly what bioidentical hormones are, how they may help, and some of the potential risks associated with therapy.
What are hormones?
Chances are, you’ve probably heard a thing or two about hormones, but what exactly are they?
Hormones are often referred to as the chemical messengers of the body because they help transfer signals to your tissues, organs, muscles, and skin.
These signals are important because they tell your body how to function and when to turn things “on” and “off”.
Your endocrine system is comprised of both hormones and the tissues (usually glands) that produce them.
Some glands in your endocrine system include the thyroid, ovaries, testes, pancreas, hypothalamus, pituitary gland, and more.
These are accompanied by over 50 different types of hormones, all produced by different glands that control an array of functions throughout the body.
For example, hormones can regulate things like sleep, metabolism, growth and development, mood, reproduction, sexual function, and homeostasis.
There are two forms of communication involving hormones in the body. The first kind involves communication between two endocrine glands.
With this process, one gland produces a hormone, which then activates a different gland to alter the levels of hormone it is producing.
For example, the pituitary gland creates a hormone known as thyroid-stimulating hormone (TSH). This then activates the thyroid gland to produce its hormones. The second form of communication involves the endocrine gland and the target organ.
For example, the pancreas produces insulin, which causes the liver and muscles to release glucose (1).
What are bioidentical hormones?
Let’s take it one step further from just hormones and discuss bioidentical hormones.
Bioidentical hormones are not naturally found in the body; they are hormones derived from plants. Chemically, they are very similar to the hormones in the body. Structurally, they are practically identical to the hormones in the body.
The US Food and Drug Administration (FDA) has approved several different types of bioidentical hormones for a variety of use cases.
Some of these include estradiol, micronised progesterone, and dehydroepiandrosterone (DHEA). Other bioidentical hormones are available via compounded preparations that are not overseen by the FDA.
These include things like compounded bioidentical menopausal hormone therapy, which includes estradiol cypionate, testosterone, and more (2).
It is important to note that the phrase “bioidentical hormones” is a broad term. It doesn’t necessarily describe the manufacturing, delivery, or source of the hormones, as these can vary.
Additionally, it can encompass both FDA-approved and non-FDA-approved formulations (3).
How are bioidentical hormones used?
Menopause occurs as women age, and it is defined as the permanent stopping of menstruation due to loss of ovarian function.
Perimenopause can also occur before menopause, and it is the period before menopause when women may start to experience irregular periods (4).
Both perimenopause and menopause are associated with changes to hormone levels that can lead to an array of uncomfortable symptoms.
These symptoms include things like hot flashes, mood swings, night sweats, difficulty concentrating, sleep disruptions, and more.
The frequency and severity of these symptoms can range from mild to severe (3). In the US, the FDA has approved a few different hormone preparations to help treat women experiencing menopausal symptoms.
While perimenopause and menopause are the most common reasons to use bioidentical hormones, there are other potential use cases as well.
Bioidentical hormones may be used to treat symptoms associated with cancer treatment. They can also potentially help with adrenal and thyroid disorders, fibromyalgia, insulin resistance, and osteoporosis (5).
Different forms of bioidentical hormones
Bioidentical hormones can come in many different forms.
For example, bioidentical estrogen can be provided as a pill, cream, gel, patch, spray, or vaginal tablet.
Having different formulations and routes of administration allows patients to select a therapy that best fits their needs and preferences.
As aforementioned, both FDA-approved bioidentical hormones and non-FDA-approved bioidentical hormones exist.
At present, the FDA has approved products that have bioidentical progesterone and bioidentical estrogen.
FDA-approved formulations such as these are manufactured under tight regulations and have been backed by scientific studies that demonstrate their safety and effectiveness.
For example, several publications in medical journals report on the potential benefits of FDA-approved estrogen products.
Large-scale, well-controlled clinical trials have been conducted that demonstrate reductions in hot flashes, vasomotor symptoms, and urogenital atrophy and improvements in bone density and fracture risk.
It is important to note that non-FDA-approved products are not regulated by the FDA. Thus, they have not been subject to the same scientific scrutiny as those approved by the FDA.
These are typically bioidentical hormones provided in compounded preparations. Compounded preparations are usually created and dispensed by select pharmacies.
They sometimes claim to have increased efficacy and safety due to their individualised preparations (3).
Potential benefits of bioidentical hormones
As aforementioned, the most common use case for bioidentical hormones is to treat symptoms of menopause. Women may experience a reduction in menopause symptoms, including things like hot flashes, mood swings, difficulty sleeping, and impaired concentration.
Other benefits that individuals may or may not experience include:
✅ Reduced risk of osteoporosis (bone thinning)
✅ Improved cognitive functioning
✅ Healthy skin and nails
✅ Improved sexual function (6)
Risks and controversies surrounding bioidentical hormones
It is important to note that while there are several potential benefits of bioidentical hormones, there are some inherent risks and controversy associated with their use.
Much of the controversy surrounding bioidentical hormones is with regard to the compounded formulations. These are created by compounding pharmacies, which are subject to Section 503A of the Federal Food, Drug and Cosmetic Act.
As such, the pharmacies and the drugs they create are exempt from the Federal Food, Drug, and Cosmetic Act.
This means that they do not need FDA approval before marketing, and they are not required to maintain good manufacturing practice or certain labelling requirements (3). Thus, there is some concern around the quality of compounded formulations of bioidentical hormones.
In addition to the potential quality issues, experts and patients have some concerns about the safety of hormonal therapy, such as these.
Although they can provide relief from troublesome symptoms in the short term, studies have shown they carry some long-term risks.
For example, one study conducted in 2002, known as the Women’s Health Initiative (WHI) had some concerning findings.
In this study, individuals who received medroxyprogesterone acetate (MPA) and conjugated equine estrogen (CEE) were shown to have an elevated risk of cardiovascular disease, breast cancer, stroke, and thromboembolic events versus those taking a placebo.
As such, many women opted to stop hormone therapy altogether or pursue an alternative therapy for their menopausal symptoms that was considered safer.
While some advocates for bioidentical hormone therapy claim that compounded preparations are safer than FDA-approved products.
However, no published studies in peer-reviewed journals have substantiated these claims. Thus, there is an inherent risk of adverse effects with bioidentical hormone therapy as well (3).
It is also important to note the common misconception that natural automatically means safe.
Although bioidentical hormones are plant-derived, they are still structurally identical to normal hormones.
Thus, if an individual decides to pursue bioidentical hormone therapy, it should be done so under the supervision of a trusted healthcare professional.
How to safely start bioidentical hormones
To get started on bioidentical hormones, you’ll want to start with a consultation with a healthcare provider. This can be an endocrinologist, gynaecologist, or functional medicine doctor.
Usually, your provider will do some lab tests to get measurements of your baseline hormone levels. Based on these results, they’ll be able to determine if you’d be a good candidate for bioidentical hormone therapy.
If bioidentical hormone therapy is right for you, your healthcare provider will help select the hormone, dose, and formulation that best suits your needs and preferences.
Careful monitoring and follow-up will be required not just to ensure the therapy is efficacious, but also that it is safe.
When considering how to use bioidentical hormones safely, know that both the FDA-approved and non-FDA-approved products carry inherent risks.
Keep in mind, however, that FDA-approved products undergo rigorous review and approval that others don’t, and thus some may consider these hormones “safer”.
Conclusion
So, it turns out that bioidentical hormones are not so different from the hormones found naturally within our bodies. But that’s not to say they are totally safe!
Now that you know a little bit about bioidentical hormones, are they right for you? To answer this question, you’ll need to work with a provider to understand how bioidentical hormones can support your treatment goals while also balancing their potential risks.
If you’re interested in potentially beginning therapy, reach out to a qualified provider or visit us at Weight Loss and Vitality to get started.
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