The Truth about Bioidentical Hormone Replacement Therapy

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Key Takeaways:

  • Menopause happens to all cis-born women.
  • Menopause symptoms can be mild to debilitating.
  • Bioidentical Hormone Replacement Therapy is an effective treatment.

Menopause is a beautiful gift from the universe. There are so many wonderful things that happen during this time. Freedom from menstruation, PMS is history, pregnancy concerns are nonexistent, self-assurance often increases dramatically, and the uterine fibroids many younger women develop begin to shrink, just for starters. 

Although the benefits of menopause are plentiful and recurring, they often slip away in the face of the uncomfortable symptoms of hormone loss, which can be mild to severe and last for years. 

Treatments range from holistic, natural, and over-the-counter and prescription medications to bioidentical hormone therapy. The choice depends entirely on the circumstance and preference of the woman. 

Bioidentical Hormone Replacement Therapy is a viable solution to symptoms such as:

  • Hot flashes
  • Night sweats
  • Weight gain
  • Mood swings
  • Vaginal dryness
  • Decreased libido
  • Headaches

Bioidentical hormone replacement therapy (BHRT) is an alternative option for women who experience early menopause or have excruciating symptoms. Women at risk of severe bone loss from osteoporosis might also consider it, but there are some risk factors. This guide discusses the fundamentals of BHRT, its benefits and risks, and a few alternative treatments that may be just as helpful. 

BHRT Basics

Hormone replacement therapy (HRT) uses non-natural hormones to balance hormone levels due to hormone loss and lessen symptoms. Bioidentical hormone replacement therapy (BHRT) is a form of HRT.

Bioidentical hormones are synthetic forms of the hormones already produced in the body, chemically and anatomically equal to human hormones. They are made from compounds found in plants – most often from wild yam and soy, as they contain compounds that can be chemically converted to estrogen, progesterone, testosterone, DHEA, and cortisol. 

This therapy requires using hormonal substances, making it essential to consult a doctor before embarking on any hormonal regimen. BHRT is used to fight the signs of menopause but also diseases, such as osteoporosis, heart disease, and cognitive issues. Like most healthcare solutions, there are benefits and risks. 


Many of the benefits of BHRT depend on what’s important to the patient, but several factors work for everyone, such as:

Increased Strength

Loss of hormones causes a loss of muscle strength as we age. Replenishing them with BHRT maintains bone density and muscle strength. You don’t just feel stronger – you are stronger.

Improved Sex Drive

Many things happen to a woman during middle age that takes a toll on her sex life, not the least of which are hormonal drops. They can also experience vaginal dryness, body image issues, and even a total lack of interest in sex. The libido increases when hormones return to more normal levels, as do self-esteem and natural lubricant. 

Tailored Treatment

An individual approach is taken for each BHRT patient. Traditional hormone imbalance medications contain a specific ratio of hormones that might not suit some patients. They get individually adjusted dosages to balance their hormone levels with BHRT effectively. That’s a far cry from the traditional “one size fits all” approach. 

Before BHRT medication can start, a doctor examines the patient’s health needs and may measure hormone levels to create a personalized treatment plan to deliver the precise ratio of hormones they need.

Weight Loss

When sex or thyroid hormones are imbalanced, weight gain occurs faster. Excess weight can lead to type 2 diabetes and heart disease. Bioidentical hormones help maintain a healthy metabolism and reduce extra weight.

Improved Mood and Sleep

Sex and thyroid hormone deficiencies affect psychological (mental) and physical health. Low estrogen, progesterone, and testosterone decrease serotonin (the happiness hormone), making us moody and annoyed. 

Left untreated, hormone imbalances can trigger sleep deprivation and depression. Bioidentical hormones help patients cope with stress and feel happier and more relaxed. When you feel good, you sleep better.

Improved Heart Health

Many preventive medicine features are also included in BHRT benefits. Hormones play a significant role in regulating heart function. If corresponding hormone levels decrease, coronary artery disease, high bad cholesterol, and fragility of blood vessels can result. Bioidentical hormone replacement therapy helps averts cardiovascular problems and improves heart health.

BHRT can even help men get through the male version of menopause: andropause. These benefits restore your comfort level and love of life, but they’re just the tip of the iceberg. You’ll find many more benefits depending on your symptoms. 

BHRT isn’t a miracle cure, however. It does come with some risks and disadvantages. 


Some companies claim that bioidentical hormones are safer and more successful than traditional HRT because their structure is naturally identical to human hormones. These claims have not yet been confirmed by large-scale, reputable studies, however.

In the past, research showed that certain hormone replacement therapies may increase the risk for conditions such as: 

  • Breast cancer
  • Gallbladder disease
  • Heart disease
  • Blood clots
  • Stroke

More recent research is downgrading the likelihood of these previously accepted side effects. There are many factors to be taken into consideration with each individual, and each woman must be assessed accordingly. 

HRTs can also trigger specific side effects, especially with the first few doses, as the body adjusts to the hormones. The possible side effects differ depending on the type of hormone therapy, so it’s best to ask your healthcare professional what to expect. Some typical side effects include:

  • Weight gain
  • Fatigue
  • Acne
  • Bloating
  • Mood swings

Some people cannot use any form of hormone replacement. The risks vary depending on the patient’s health history. Fortunately, there are a few alternative treatments that provide similar benefits.

Alternative Treatments

Personal reasons, or health issues, such as breast cancer, can prohibit someone from using BHRT. Fortunately, many home remedies and other holistic methods can help ease uncomfortable symptoms. 

Common alternative treatments include:

Diet Changes

Cutting down on caffeine, spicy foods, and alcohol reduces hot flashes. Spikes in blood sugar from too many sweets trigger irritability and drain energy. High-sodium foods cause bloating. How a person eats affects how they feel. 

Certain foods also contain natural hormones. Plants have phytoestrogens that can mimic the effects of human estrogen. Soy, edamame, tofu, flax seeds, peaches, and garlic all boost hormones. 

Herbal Supplements

Herbal supplements such as St. John’s wort, black cohosh, dong quai, red clover, and sage can balance hormones and ease symptoms such as: 

  • Hot flashes 
  • Vaginal dryness
  • Lows libido
  • Improve sleep
  • Maintain bones and muscles

Remember that the FDA doesn’t regulate supplements, so always talk to your doctor before taking any.

Alternative Therapies

Other types of medicine exist outside of the typical standard Western medicine methods. Traditional Chinese medicine, such as herbal treatments, acupuncture, proper foods, and movement, such as Tai Chi, have been shown to relieve symptoms. 

Alternative therapies can be used in conjunction with each other and with any modern medicinal treatment. 

BHRT is an exciting prospect for many women. It means a respite from miserable menopause symptoms and a chance to get back to being ourselves again. Talking to your doctor is the best way to determine if it’s right for you.

Determine Whether BHRT Is Right for You

BHRT is one of the most effective options for menopause relief. Dr. Karen Threlkel, ND, can help you determine whether it’s a good option for you. Dr. Threlkel is a Naturopathic Physician specializing in gentle, natural approaches to healing many common women’s health concerns. 

Dr. Threlkel will work with you to create a roadmap to health and schedule regular checkups to support you along the way. Contact Dr. Threlkel today and learn how her comprehensive services can help you live a healthy life.

About The Author:

Picture of Dr. Karen Threlkel, Naturopathic Physician, Washington DC

Dr. Karen Threlkel, Naturopathic Physician, Washington DC

Dr. Threlkel received her degree of Doctor of Naturopathic Medicine from The National College for Naturopathic Medicine (now called The National University of Natural Medicine) in Portland, Oregon. She also holds a Bachelor Degree in Kinesiology from The University of Maryland. She is licensed in Naturopathic Medicine by the Government of the District of Columbia Department of Health. Dr. Threlkel is a member of the American Association of Naturopathic Physicians, past president & current member of the Washington DC Association of Naturopathic Physicians.

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