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Bioidentical hormones (also called bioidenticals) are made in a laboratory. They are made from compounds found in plants (usually soybeans or wild yams).
After the plant-based hormone is processed, its structure is said to be identical to the estrogen, progesterone, or androgen hormone your body makes. Some estrogens and progesterones that are bioidenticals are commonly prescribed by a doctor and commercially available. This means they’re made by a drug company and you can get them from any pharmacy. Estrace (estradiol) and Prometrium (micronized progesterone) are examples of commercial products.
Your doctor may also prescribe a custom-made bioidentical. This means that a special pharmacy (a compounding pharmacy) will make the product so it’s only meant for you. It may come in many forms, such as a capsule, a cream or gel, a tablet to dissolve under your tongue, a suppository, or a nose spray. There's a big difference between custom-made bioidenticals and commercial products. Both of these can be prescribed by a doctor. But custom-made bioidenticals aren't regulated and tested for purity and potency, like commercial products. This means that custom-made bioidenticals could have other ingredients in them or that the strength may not be the same each time they're made. There also isn't scientific evidence to show that custom-made bioidenticals have any effect on the body (good or bad). For these reasons, the Society of Obstetricians and Gynaecologists of Canada doesn't support the use of custom-made bioidenticals.
Just like non-bioidentical hormone therapy, bioidentical hormones are prescribed to increase or stabilize a woman's hormone levels. This is most often done during perimenopause, when hormone levels change unpredictably. It's also done after menopause, when the hormones drop to low levels.
The most important fact to remember about taking bioidentical hormones is that the risks are not yet well understood. They may have the same breast cancer, stroke, blood clot, heart disease, and dementia risks that non-bioidentical hormone therapy has.
Adaptation Date: 8/17/2021
Adapted By: Alberta Health Services
Adaptation Reviewed By: Alberta Health Services
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