In regards to BIHRT, we generally are talking about estrogens (estrone, estradiol, estriol), progesterone (micronized progesterone specifically), testosterone, and dehydroepiandrosterone (DHEA) that are given to treat levels of hormones that are not optimal.
Bioidentical hormones are defined by the Endocrine Society as compounds that have exactly the same chemical and molecular structure as hormones that are produced in the human body.
We occasionally use prescription options of bioidentical hormones. However, more often, we use compounded bioidentical hormones, which allow us to fine tune and tailor the dosing more precisely to each individual’s needs. The main difference between prescription and compounded bioidentical hormones is that the prescription hormones are one-size-fits-all doses that drug companies produce on an assembly line, and compounded versions are made from scratch by a pharmacist based on a medical provider’s desired formulation. Of note, the prescription medications have gone through the FDA while compounded medications have a different screening process.
Hormone replacement therapy that contains synthetic conjugated estrogens, or progestin, (which are derived from the urine of pregnant mares), are NOT bioidentical to our endogenous human sex hormones.