Are bioidentical hormones different from commercial ones?

What you get from the compounding pharmacy (where a compounding pharmacist custom mixes drugs to fit the unique needs of a patient) is not "more human-like" than what you get in a U.S. Food and Drug Administration (FDA)-approved product. In fact, you are actually getting the identical estradiol molecule whether you get your hormones from a compounding pharmacy or your mega-pharmacy.

How can that be? This is the interesting part. Compounding pharmacies don't manufacture hormones -- they just mix them. Manufacturing factories are the ones that extract estrogen from plants, synthesize it to a useable form, and then sell the same active ingredients to both commercial pharmaceutical companies and compounding pharmacies. It is then that the active ingredient is used to make lotions, pills, sprays or patches.

It's basically all the same stuff. In fact, many compounding pharmacies mass produce hormone preparations that are copies of those produced commercially.
Marina Johnson
Endocrinology Diabetes & Metabolism

Bioidentical hormones have the same identical molecular structure as the estradiol, progesterone and testosterone found in a woman’s body so another name for bioidentical hormones is natural hormones. On the other hand, Premarin, the most commonly used estrogen comes from pregnant horse urine so it’s only natural if you’re a horse! It makes a lot more sense to put back what’s actually missing from the body. ALL hormones are synthetic because even the bioidentical hormones are made in a laboratory from plant estrogen (soy, yam) and Premarin is made in a laboratory from horse urine. Many women mistakenly think that bioidentical hormones can only be obtained from compounding pharmacists. Bioidentical hormones are readily available from pharmaceutical companies in the form of patches, gels, creams and mist. The pharmaceutical products are preferable because they have to meet stricter standards of quality control and efficacy. When taking estrogen, choosing topical estrogen over estrogen pills avoids many of the side effects of oral estrogen.

Read more in my guidebook for women, “Outliving Your Ovaries: An Endocrinologists Reviews and Risks and Rewards of Treating Menopause with Hormone Replacement.”

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