Synthetic hormones vs. bioidentical: who wins?

synthetic hormones vs bioidentical- pharmacist pulling med from shelf

Making the decision to try hormone replacement therapy (HRT)? It can be a little nerve-wracking. You may worry if it’ll work. Or if the benefits outweigh the risks. And you also might be wondering which to use: synthetic hormones vs. bioidentical.

What are the differences between synthetic hormones vs. bioidentical?

If you and your physician decide to replace or supplement the sex hormones your body produces, you’re going through HRT. Even though two main types of HRT exist, not all women are presented with both options. However, you do have the choice to take synthetic hormones vs. bioidentical hormones.

Synthetic hormones

Synthetic hormones are derived from animals (usually equines, or horses). What’s most important to know is: the chemical structure of synthetic hormones differs from the structure of your natural hormones (by as much as 70%.) This means that, your body doesn’t synthetic hormones as natural. Therefore, they cannot work exactly like your own hormones. Instead, they act similarly to estrogen and progesterone. Many HRT medications on the market rely on synthetic hormones. So do birth control pills.

Bioidentical hormones

Bioidentical hormones come from plant compounds. Unlike synthetic hormones, their chemical structure is identical to the estrogens and progesterone your body naturally produces. There are bioidentical hormones that are manufactured and have gained approval by the FDA (like Prometrium). However, many women may use local pharmacies to compound exact formulations of their medication.

Critics quickly point to a major con of compounded medications: quality control. Compounded medications make prescribing highly customized dosages of hormones possible. But a drawback brings up cause for concern. Namely, inconsistencies can occur. There are stories of patients receiving either too little or too much hormone in a compounded medication. However, this isn’t the norm. In fact, going through a reputable pharmacy helps ensure quality and safety.

Which works better? Which is safer?

First, no quick answer exists as to whether synthetic hormones or bioidentical hormones are right for you. Your decision to start HRT got careful consideration. This one deserves it too. That said, there’s been a strong debate for years over synthetic hormones vs. bioidentical.

But, over time, bioidentical hormones have begun to emerge as a leader. The body easily recognizes them, and they work exactly as your natural hormones. When prescribed in the right dosages, bioidentical progesterone (like natural progesterone) has a lot of benefits and few side effects. It lowers risk for certain breast cancers. Reduces anxiety. Has the ability to help insomnia and much more.

It’s no wonder bioidentical progesterone patients report better results than women on progestins. Synthetic progestins aren’t chemically identical to what your body produces. They aren’t progesterone. They act similarly to progesterone. So, we don’t see the same positive effects. What’s more: it comes with more issues. (Like increased risk of blood clots, blood sugar problems, and more.)

How do I feel good with my decision of synthetics or bioidentical?

The most important thing to remember with any HRT decision is to ask questions, have discussions with your doctor about your goals and medical history, and make sure testing timelines are in place to track your hormone levels.

It can take some time for you and your provider to figure out the combinations and dosages of HRT that help you feel better. If at any time you’re not sure if your HRT is working or you want to make a switch, schedule an appointment or seek out a second opinion. Functional or integrative practitioners may be more open to prescribing bioidentical hormones than more conventional physicians.