Hormone replacement therapy (HRT) and bioidentical hormone replacement therapy (BHRT) are two approaches to supplementing hormones in men and women whose bodies are not producing adequate amounts due to aging or other factors. There are several key differences between these two types of treatment:
- HRT involves prescribing FDA-approved manufactured hormones that are chemically similar but not biologically identical to the hormones naturally produced by the human body. These include equine estrogen compounds like Premarin and synthetic progestins like Provera.
- In contrast, BHRT uses custom-compounded bioidentical hormones that are molecularly identical to the estrogens, progesterone and testosterone made in the human endocrine system. These hormones are derived from plant sources and tailored to match a patient's individual hormonal needs and deficiencies.
Benefits of BHRT Over HRT
Many healthcare practitioners prefer bioidentical hormones over conventional replacement therapy because:
- BHRT more closely mimics the body’s natural rhythms and metabolic processes since the hormones are identical on a molecular level.
- Bioidenticals have not been linked to adverse side effects like synthetic hormones. Some risks associated with HRT include stroke, blood clots, gallbladder disease and breast cancer.
- BHRT delivers hormones directly into the bloodstream via creams or pellet implants, reducing strain on the liver compared to oral HRT.
- Treatment plans are individualized based on medical history and lab testing of hormone levels. HRT medication dosages are standardized rather than customized.
Hormones Used in Each Therapy
There are similarities and differences in the actual hormones prescribed:
- Both therapies may supplement estrogen and progesterone to menopausal women. However, BHRT utilizes estriol along with estradiol and progesterone as the ideal trio for balancing the estrogen pathway.
- HRT for menopause is typically a standardized dose estradiol patch with Provera or other synthetic progestin.
- BHRT for perimenopause aims to get ahead of declining progesterone levels that lead up into menopause. Progestins used in HRT cannot optimally counter estrogen dominance issues.
- For andropause, BHRT employs bioidentical testosterone tailored to the patient's health profile. The most common HRT intervention is testosterone replacement therapy using FDA testosterone medications or synthetic anabolic steroids.
Monitoring and Cycling of Hormones
Administering hormones in a properly balanced and monitored fashion is crucial:
- BHRT involves regular blood tests to dial in on ideal hormonal balance specific to the person while accounting for changes over time.
- HRT does not require the same degree of customization and precision when dosing or transitioning between cycles.
- BHRT physicians may prescribe hormone withdrawal or "cycling" to mirror natural shifts in a woman's menstrual cycle more closely.
- Conventional HRT typically delivers a standard linear dosage over time without fluctuation. This runs counter to the ebb and flow of hormones in real life.
In summary,
bioidentical hormone therapy aims to mimic the body's intrinsic hormonal environment as closely as possible using nature-derived hormones.
Conventional replacement therapy utilizes synthetic or animal-derived hormones standardized to one-size-fits-all dosages. Most integrative and anti-aging focused physicians favor customized
BHRT programs tailored to the individual for optimal safety, results and endocrine balance.
