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Is bioidentical hormone replacement therapy safe?

Marina Johnson
Endocrinology Diabetes & Metabolism
Many women have the mistaken notion that bioidentical hormone replacement is totally safe and synthetic pharmaceutical hormone replacement is dangerous.

Bioidentical hormones are identical in molecular structure to the hormones in a woman’s body, estradiol, progesterone and testosterone, so we often call them “natural” hormones. There’s a misperception that bioidentical hormones can only be obtained from compounding pharmacists. Yet pharmaceutical bioidentical hormones are readily available at any drug store! It’s much better to use pharmaceutical natural hormones because they have to meet stricter standards for quality control and efficacy. Regarding the issue about using “synthetic” hormones: ALL hormones are synthetic because they are made in a laboratory from plant estrogen. After all, we’re not plants, so they need to be modified to be identical to human estrogen.

Regarding the issue of safety, when ANY estrogen is given orally, it causes the liver to make harmful proteins that lead to blood clots and increased heart attacks, strokes, and gallbladder disease. It’s safer to give natural hormones topically to the skin as patches, creams or gels because it avoids these harmful proteins. 

The #1 fear women have of estrogen is breast cancer yet it’s a rare risk of less than 1 in 1000. In 10,000 women followed for 5 years on no estrogen, 30 develop breast cancer, considered the natural occurrence of breast cancer. In 10,000 women who take HRT for 5 years, the risk increases to only 38 so it’s only an increase of 8 women! There are more risks to NOT taking estrogen: heart attacks, strokes, Alzheimer’s, osteoporosis and a poor quality of life.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.