Many people believe that there is only one type of BHRT when, in fact, there are two different types: Bioidentical Hormone Replacement Therapy and Body Identical Hormone Replacement Therapy.
However, when you try to research which kind of HRT is best suited to you, the terminology can make things a bit complicated.
Here, we dive deeper into the language of BHRT to help you understand more about the options available to you.
Bioidentical Or Body Identical Hormones? What’s The Difference?
“In the clinic we are able to prescribe both body identical and bioidentical hormones. When appropriate, we can incorporate body identical HRT as part of a patient’s treatment plan. Both body identical and bioidentical hormones are made with the same ‘ingredients’ – hormones extracted from natural sources that are identical in chemical and molecular structure to those occurring naturally in the human body – but there are certain key differences between the two including the manufacturing process.” explains Dr Ghazala Aziz-Scott, Hormone Doctor at the Marion Gluck Clinic.
Bioidentical hormones are produced by compounding pharmacies. This means that the pharmacy is able to prepare custom doses and application methods to address the individual needs of a patient.
|Body Identical Hormones
Body identical hormones are produced by large pharmaceutical companies in regulated, set doses and application methods. This one-size-fits-all approach works for some patients, but body identical hormones cannot be altered to cater to those with more specific needs.
Why Is There So Much Confusion Surrounding The Difference Between Bioidentical And Body Identical Hormones?
The fact that these two terms sound so similar increases confusion about their definitions. It is easy to hear ‘body identical’ in reference to hormone therapy, and assume that ‘bioidentical’ means the same thing.
Because bioidentical HRT is rarely offered on the NHS, those who seek hormone therapy through public healthcare services will only be exposed to body identical hormones. Unless these patients actively research alternatives, they may never know about bioidentical hormones and their benefits.
Bioidentical hormones are tailor made in compounding pharmacies in specific rather than set dosages. Due to the infinite range of preparations available, it would be impossible for any laboratory to conduct controlled, clinical trials to test the efficacy and safety of each unique dosage of bioidentical hormones. Unfortunately, this means that these hormones are considered unlicensed and unregulated; by contrast, body identical hormones are delivered in set dosages, and because of this they can be licensed and regulated. However, it is important to note that the ingredients or individual hormonal constituents used in both body identical and bioidentical hormones have undergone decades of trials, which in itself indicates that bioidentical hormones are safe to prescribe and use under the correct protocols.
Unfortunately, these facts are often unclear when conveyed in the media, making it difficult for people to distinguish the true meanings of the terms ‘bioidentical’ and ‘body identical’ hormones.
Quality control between compounding pharmacies can be variable, and poor quality control may produce unsatisfactory preparations of bioidentical hormones, which often become available online for consumers to purchase. Once purchased and administered, patients may experience negative side effects. At the Marion Gluck Clinic we only prescribe medication from the UK’s most trusted compounding pharmacy, Specialist Pharmacy. This pharmacy is registered and regulated by the General Pharmaceutical Council, with preparations of the highest standard. All medicines are made by fully qualified pharmacists following correct procedures and standards, prescribed by BHRT specialist doctors and are checked multiple times for accuracy.
What Is The Controversy Surrounding Bioidentical And Body Identical Hormones?
Between the 1960s and 1990s, HRT had established a reputation as the gold standard treatment for menopause. Its benefits – reducing obvious menopausal symptoms such as hot flushes; decreasing the risk of osteoporosis; and improving cardiovascular health, among others – greatly outweighed the risk.
However, it was not until a Women’s Health Initiative Study in 1993 that fear spread amongst menopausal women and the medical community. The study followed the health of over 27,000 women who were undergoing HRT, but stopped abruptly in 2002 when the data began revealing an increased risk of cardiovascular problems, cancer and stroke in its participants. The termination of the study sparked huge media interest, scaring women away from HRT, and causing doctors to stop prescribing the therapy.
Unfortunately, this study had many flaws. It was revealed that most of the women in the study were more than 10 years past menopause and already had pre-existing health conditions so were more likely to develop cancers, heart issues and strokes. Not only that, but not all types of HRT were analysed – in particular, the study used synthetic rather than bioidentical hormones.
Therefore, the damage to the reputation of HRT was unjustified, and discouraged women from getting the treatment that they needed in order to improve their quality of life. Since then, many studies have been conducted which show that there is no increased risk of diseases with HRT use, including breast cancer and cardiovascular disease. Specifically, data shows that bioidentical hormones carry a lower risk of these diseases than synthetic hormones, and are more efficacious.
You can read our recent blog post about breast cancer risk here.
What Kind Of Hormones Can I Get On The NHS?
Bioidentical hormones are not available on the NHS. This is because they are more expensive to produce and require a compounding pharmacy. Instead, patients will likely receive body identical hormones. Whilst some patients will find they get on well with body identical hormones, for others, they can have drawbacks:
|Dosage||Body identical hormones are produced by large pharmaceutical companies and are available in regulated doses, which means that there are a set amount of hormones per delivery method and this cannot be altered. Patients who experience negative side effects from their treatment will not be prescribed a bespoke preparation, as this requires the preparation to be produced by a compounding pharmacy.|
|Supply Issues||Due to funding limitations or other procurement problems, you may be supplied with alternative brands to what has been prescribed. This can result in patients suddenly being switched from one brand to another with no forewarning. Although the dosage will be the same, there may be a difference in formula which can cause an absorption issue, which can then lead to problems with symptom control.|
|Delivery Method||Just as dosages are restricted to set amounts, the available delivery methods are also limited. Patients will receive either a patch, gel or oral application, and will not be given the choice of the many other delivery methods available (see the below table).|
|Delivery Methods Of Body Identical Hormones||Delivery Methods Of Bioidentical Hormones|
Hormone Balancing At Marion Gluck Clinic Using Bioidentical Hormones
We only prescribe medication from the UK’s most trusted compounding pharmacy, Specialist Pharmacy, which allows us to offer precise and personalised care. At the Marion Gluck Clinic, we treat you as an individual. This means that:
- You will have a 40-minute consultation where we can decide what treatment is right for you, and answer any questions that you may have.
- We carry out thorough investigations, including blood tests and lifestyle assessments, prior to prescribing BHRT.
- We monitor you throughout treatment and adjust the prescription where necessary.
- We treat other issues such as sexual health and vaginal sensitivities, which you may not feel comfortable discussing with your GP.
- We can ensure continuation of care because of the quality and consistency of our BHRT.
If you are interested in finding out whether bioidentical hormone replacement therapy is the right treatment for you, don’t hesitate to book a video or telephone consultation with one of our specialist hormone doctors to answer any questions you may have.
Take the first step on your BHRT journey!