You’ve Heard the Term. Now Let’s Get Clear.
If you’ve been researching hormone replacement therapy (HRT), chances are you’ve come across the term bioidentical hormones more than once. Maybe your friends are on them. Or maybe you stumbled across them while trying to make sense of the symptoms that don’t feel “normal” for your age—fatigue, brain fog, mood swings, weight gain, disrupted sleep, heavy painful periods, or loss of libido.
So what is</i > bioidentical hormone replacement therapy (BHRT), and why are so many women turning to it?
I’m Dr. Sarah Daccarett, MD, a hormone and longevity specialist, and the founder of Inner Balance</a >. I’ve guided thousands of women through the journey of hormone restoration—before, during, and long after menopause—and what I’ve found is this: bioidentical hormones can be a game-changer when used thoughtfully and intentionally.
Here’s everything you need to know about BHRT—the facts, the benefits, the cautions, and how to decide if it’s right for you. Millions of women have taken bioidentical HRT over the last 2 decades in the US alone. Some of their stories</a > are here.
What Is Bioidentical Hormone Replacement Therapy?
Bioidentical hormone replacement therapy refers to the use of hormones that are chemically identical to the ones your body naturally produces. These hormones are derived from plant sources like yams or soy and are compounded or manufactured to match the structure of human hormones exactly.
The idea behind BHRT is simple: if your body is declining in key hormones—like estrogen, progesterone, or testosterone—you can supplement them in a way that feels more natural, more balanced, and often more effective.
The Role of BHRT in Perimenopause and Menopause
Many women first explore BHRT during perimenopause. Symptoms during this stage can include irregular cycles, mood swings, poor sleep, PMS-like symptoms, anxiety, weight gain, and more. But many women don’t get answers or are told to wait until menopause. Anytime you can get started you will benefit your health and wellness.
Inner Balance</a > is a modern HRT approach that is also beneficial for endometriosis, postpartum and polycystic ovarian syndrome. Any woman who isn’t making enough hormones in the right ratio will benefit. It’s not just for menopause anymore</a >.
BHRT addresses the root cause of these symptoms: hormonal decline. Rather than masking symptoms, it supports your body’s natural chemistry in a way that restores equilibrium.
Which Hormones Are Typically Replaced in BHRT?
At Inner Balance, we focus on the three main sex hormones that have the most impact on how women feel: estradiol, progesterone, and testosterone. They all play a role, balance one another and regulate every process in the body. It is outdated for example to say that only estrogen is needed for vaginal health. We now know that testosterone receptors are found in the clitoris and progesterone plays a huge role in sexual wellness for women. All 3 hormones are needed for virtually everything: brain, heart, bone, blood pressure, gut, metabolism, skin, hair, mood and recovery. If a physician tells you that you only need one hormone – find a new doctor!
Bioidentical vs. Synthetic: What’s the Difference?
Let’s clear up the terms:
- Bioidentical:</a > These hormones are molecularly identical to human hormones. Your body recognizes and processes them as its own.
- Synthetic: These hormones differ in structure and may include ingredients like progestins (synthetic progesterone) or conjugated estrogens from animal sources. They bind to receptors and have a different effect on the body. Birth control is a good example, and instead of restoring your hormones, it suppresses your natural hormones. Synthetic hormones</a > DO NOT behave the same way as a natural hormone.
Compounded BHRT: These are custom-made formulas created by compounding pharmacies. They offer flexibility in dosing and delivery.
Bioidentical HRT vs Herbs: Herbs do not equal natural. Women don’t naturally make black cohosh, dong quai, or chaste berry. They naturally make estradiol, progesterone and testosterone. This makes bioidentical arguably the most natural thing you can do to age well. Some people assume “bioidentical” means unregulated or herbal—it doesn’t. Bioidentical hormones have the benefit of being regulated and prescription – so it’s a natural product that is regulated so you can have the confidence in what you are putting in your body. Purchasing a random herb off the internet – not guaranteed what is in it!
What to Expect From Bioidentical Hormone Therapy
I can only speak from what I’ve seen firsthand—both in my clinical practice and in the transformations I’ve witnessed in thousands of women. Women tend to have common symptoms – although there are hundreds of symptoms since hormones regulate every process in the body.
Most women begin to feel shifts within a few weeks</a >. Here’s what they commonly report:
- More stable moods and fewer emotional swings
- A clearer mind and reduced brain fog
- Deeper, more restful sleep
- Increased libido, sensitivity, ease to orgasm and satisfaction
- More energy and reduced fatigue
- Better skin, hair, and metabolism
- A feeling of being “back in my body again”
Want to hear it directly from the women themselves? Visit our before-and-after stories</a > to learn more.
For a full breakdown of benefits, see our upcoming article: Benefits of HRT Before and After Menopause.
Forms of Bioidentical Hormone Replacement Therapy
Bioidentical hormones come in several delivery methods:
- Topical creams or gels
- Vaginal applications
- Patches
- Oral capsules
- Sublingual troches or lozenges
- Pellets
Each has pros and cons regarding cost, convenience, absorption, efficacy and consistency. Some forms have more side effects than others as well. Some women prefer to get a traditional FDA-approved option covered by their insurance and don’t expect to cover all of their symptoms and just want to feel OK. Others want to feel their best, want a custom cream tailored specifically to them and are willing to pay out of pocket to age well. Read here for how vaginal application</a > gets you the best whole body, anti-aging result. There are also less side effects with vaginal delivery.</a >
What Does Bioidentical Hormone Therapy Cost?
Costs vary depending on the type of hormone, the delivery method, and whether you’re using compounded or traditional options. Typically they are cheaper out of pocket due to the tiered approach that insurance uses.
- Compounded personalized therapies with progesterone: $100-$400/month
- Traditional patches, pills and low dose vaginal creams: May be covered by insurance; out-of-pocket costs $30–$100/month
- Pellets: $300–$500/month and placed every 3 months (often not covered by insurance)
Consultation and lab work may be an additional cost depending on your provider.
Who Prescribes Bioidentical Hormones?
Not all providers are trained in or comfortable prescribing BHRT. Here’s who typically does:
- Functional and integrative medicine doctors
- Anti-aging or longevity physicians (like myself)
- Some OB/GYNs or nurse practitioners with hormone training
- Providers at menopause clinics or telehealth HRT practices
If you’re looking for a provider who understands the nuances of hormone optimization, make sure they go beyond “normal lab ranges” and treat the whole person</i >.
Is Bioidentical HRT Safe?
This is the question I get asked most—and it’s a valid one. The short answer YES!</a > They are also the preferred method of HRT based on the science.</a >
What the Research Shows:
- Data shows that bioidentical hormones are associated with lower risks</a >, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts. Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT</a >.
- FDA-approved bioidentical hormones (like estradiol and micronized progesterone) are considered safe and effective when prescribed and monitored correctly.
- Compounded combinations use FDA-approved bioidentical hormones but are not manufactured and therefore the finished product is not FDA-approved.
- Working with a compounding pharmacy that is certified, licensed in the united states is important.
Breast Cancer and BHRT:
- The history and misinformation between HRT and breast cancer risk is complex. MOST studies have shown no increased risk with bioidentical estradiol and progesterone, and even a </span >lower risk </a >compared to synthetic progestins. With the largest study (randomized control trial) showing a protective effect.
- Anyone with a family history of hormone-sensitive cancers is eligible. This is NOT a reason not to get started. If you have a personal history, your quality of life matters too, and a risk benefit conversation with a qualified provider can help you make you make your decision.
The bottom line? BHRT is safe for the vast majority of women when prescribed by a trained hormone specialist and proper followup.
You don’t have to navigate this journey alone—and you don’t have to settle for feeling “off.” You were made to feel good and with Oestra it’s easy.
