Bioidentical and body-identical both refer to hormonal medications that have an identical chemical and molecular structure to the hormones made naturally by the human body. There is a common misconception that bioidentical hormones are only available through alternative (non-traditional medical) health care providers and associated “compounding” pharmacies. This is a myth-- in fact, bioidentical estradiol, progesterone, and testosterone are available at regular pharmacies via prescription by a traditional medical provider.

Nevertheless, some health care providers falsely claim that they offer more “natural” or “bioidentical” hormones via compounding pharmacies. In fact, the truth may be the opposite: since compounding pharmacies are not regulated by the government and are not required to demonstrate the safety and effectiveness of their product, they may be less potent and pure. In support of this notion, testing of hormonal compounds from these pharmacies has shown less consistency in formulation and dose than that of normal hormonal prescriptions, meaning that the levels could vary between doses in ways that compromise their effectiveness or provoke symptoms among hormone-sensitive individuals.

Further, many providers ask patients to pay for special saliva tests to determine hormone levels, then prescribe hormones from compounding pharmacies to “fix the hormone imbalance”. There are several scientific problems with this approach:

  • the idea of “estrogen dominance” or “hormone imbalance” has generally failed to find support in scientific studies.

  • hormone levels cannot be accurately tested using this “snapshot” method due to natural variation in levels month-to-month, day-to-day, and hour-to-hour.

  • salivary hormone levels are subject to greater error than blood levels

  • prescriptions from compounding pharmacies appear to be inconsistent in purity and dose.

In light of the scientific evidence, we affirm the positions of the Endocrine Society, the North American Menopause Society, and the British Menopause Society, all of whom recommend AGAINST salivary hormone testing and hormone treatments provided by compounding pharmacies.

If you are interested in switching from synthetic hormones (which are often more potent) to bioidentical hormones, talk with your gynecologist or other medical doctor about it. There are a variety of bioidentical options available for prescription that can usually be dosed to match the effectiveness of the more potent synthetic compounds.

Additional Reading:

What is custom compounded therapy?

Custom compounded biodential hormones -what's the harm?

Visit for lots of evidence-based information and resources for those considering, going through or recovering from surgery for PMDD/PME.

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