Key Principles of Bioidentical Hormone Replacement Therapy (BHRT)

Some are confused as to what exactly is meant by “bioidentical” hormone replacement, and rightly so, since this is basically a scientific term that describes the types of hormones used.  Honestly, it would be great if we had a name that was more readily understood by the general public, but unfortunately we don’t at the moment.  (If anyone has any ideas, please post them here!)

The way I see it, bioidentical hormone replacement therapy (BHRT) is a philosophy or approach to hormone replacement that satisfies 3 key principles:

1.  We use only hormones that are biologically identical to human hormones (this is where the “bioidentical” comes from).  This basically means is that if your body makes progesterone, which has a specific chemical structure, we will only give that specific hormone as a replacement.

provera-vs-progesterone-negThis image to the left provides an example of exactly what I mean by “biologically identical”.  The chemical at the top is Progesterone.  This is the hormone produced by the human ovaries in the second half of the menstrual cycle.  The chemical at the bottom is medroxyprogesterone.  It is a synthetic hormone that is similar to progesterone but not identical.  If we are giving bioidentical hormone replacement, we would only give the top hormone since it is exactly the same as the what the human body produces.

2.  The second key principle of BHRT is that we tailor each individual’s treatment to their specific hormone needs.  This requires testing to see where someone’s hormone baseline levels are and rigorous symptom evaluation to create a customized dosage based on that person’s particular hormone needs.

3.  The third key principle of BHRT is that the goal of treatment is to achieve a balance of activity of all the hormones.  We realize that all the hormones work together in concert in the body and optimizing the activity of one hormone will enhance the effects of others, and vice versa.  This is probably the most important concept in BHRT and one that can often be overlooked as we tend to focus on only one or two hormones or one or two organs in the body.  The human body is incredibly complex and intricate, and our purpose in treating with hormones is not to override the body’s innate intelligence but to facilitate it.  We want to restore balance and improve quality of life.

I hope this helps explain the key features of bioidentical hormone replacement.  As always, I welcome your questions and feedback.  In future posts, I will discuss how BHRT compares to HRT (or traditional hormone replacement), why I believe BHRT is worthy of consideration by any woman who suffers from menopausal symptoms, and what is the best way to test for hormones.

Thank you and live well!


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