There are many ‘explanations’ of bioidentical hormones; it sounds like a simple answer.  However, there are a few pitfalls out there.   There are hormone formulations that are called ‘natural’ vs bioidentical; they may have an animal based formulation but may not have a human based chemical formula similar to what the human female ovary would make.  The true definition of bioidentical is to be ‘biologically identical’ to the chemical formulation of estradiol or progesterone that the human ovary would make.  Also, that the body would be unable to distinguish between these hormone formulations as they would be handled by the body in an identical fashion.  These formulations can be available in multiple venues, including pills, creams, patches and liquid form; they can also be made pharmaceutically and therefore approved by the FDA and covered by your insurance or they can be compounded by a trained compounding pharmacist and made custom to your needs.  The compounded hormone formulations are chemically identical and can be followed by the same blood tests for levels that pharmaceutically made medications are followed by.  However, the manufacturing process is not overseen by the FDA and thus they are not FDA approved, even though the formulations are the same chemical make-up as the FDA approved.    For those who may have  allergic sensitivities to fillers, compounding allows patients to control for gluten or lactose as fillers.  And for those who may have large out of pocket pharmaceutical expenses, compounding may be a better value for your dollar than a name brand medication that has no generic available. 

Patients in our office are routinely counselled in the options available to them and the best value for their healthcare dollar spent.  There are several compounding pharmacies to choose from and all will mail your medication to you for your convenience. 

Lastly, generics may be a great value but get your levels checked to ensure you are getting the medication you are paying for.   There have been reports of  fraudulent generic medication surfacing and unless you have levels checked, you may think you are getting your medication.  Why not be certain?  When you take blood pressure meds, you follow your blood pressure.  When you are diabetic, you follow your blood sugar.  When you’re placed on hormones, you need to follow your blood levels.

Word to the wise; when you see the term ‘progestins’ used, realize this means synthetic progesterones; these are not the bio-identical progesterone options available and these synthetic progesterones are implicated in the increased incidence of breast cancer, stroke and heart attack seen in the Women’s Health Initiative.