Sidney Allen

Bioidentical hormone replacement therapy is a powerful yet all natural alternative to synthetic hormone replacement, and Mr. Allen covers this new form of addressing hormone imbalances in his blog. Mr. Allen aims to provide independent and unbiased information and advice, and does not have a stake in what you choose to do re: BHRT.

Nov 222014

Could bioidentical hormone replacement therapy be the perfect gift for the holidays?  That is quite possible and we want to introduce this possibility here.

Bioidentical hormones have been beneficial for many people for a variety of reasons, and as they have gained FDA approval they have also gained more acceptance.  There is an increase in bioidentical doctors with the experience you can trust, and more compounding pharmacies that have been doing this work for a long time.  So if you have a friend of relative who may be suffering with a hormone deficiency, why not consider BHRT as a potential holiday present?   Perhaps they have already tried synthetics and did not find success, or maybe they have recently had hormone testing and told you the results.  One way or another it could be a thoughtful gift.

Now of course there could be certain drawback to giving bioidentical hormone replacement therapy as a gift during the holidays.  The first, of course, is the fact that this is a hugely practical holiday gift and certainly not romantic or cute.  You’d really have to know that the person who would receive the gift of bioidentical hormones would appreciate it.  Maybe they told you that their insurance would not cover their BHRT, or that there would be a high deductible or co-insurance.  Maybe they said that they did not want to pay, or that the reason they are looking into BHRT was one that would not be covered.  One way or another, if you knew that this was an expense that they could not afford, that they do not mind practical gifts, and that it would bring them relief from symptoms, you might choose this course.

So how would you go about giving bioidentical hormones as a gift?  That depends on what you know about the person’s plans.  So, for example:

  • If they’ve already identified a bioidentical hormones doctor, you could pre-pay some amount, such as the deductible or co-insurance.  This way they can get BHRT without worrying about the out-of-pocket cost.  Between your gift and what insurance will pay for they will be all set.
  • You could more generally give a credit card gift card and say what you were thinking they could use it for.  Some gift cards are even customizable as far as what they look like.  This way if your gift falls flat and they’d rather have the money for something else they would have that flexibility.
  • You could pay for some specific aspect of bioidentical hormone replacement therapy, such as the initial hormone testing.  This might be a good choice if insurance will not pay at all for BHRT or will not pay for some aspect.
  • Finally, you could pay for something peripheral to their bioidentical hormones, such as a nice meal for when they are feeling better, or new clothing for when they feel more like going out.  This way you are supporting them without actually paying for the treatment.

Getting someone bioidentical hormone replacement therapy for the holidays is tricky, and may come across anywhere from thoughtful to intrusive.  You really need to know the person well, and know what kinds of presents they want before making this choice.  That said, for some people this may be a way to help them either afford BHRT or know that people they are close to support their treatment.  Some people do prefer more practical gifts, and this is one way to give something that will make them feel better.  Perhaps if you do not go so far as to buy the gift of natural hormone replacement you might at least be sure that during the holiday season when you spend time together you show your support and hear how your friend or relative is doing if they are pursuing this type of treatment or are considering bioidentical hormone replacement therapy.



Nov 162014

Many people turn to bioidentical hormone replacement therapy because they want to be able to fully understand what ingredients are being used, and they like the assurance that what is being used to replace hormones that are too low is as natural as the original hormones were.  One door that the BHRT path opens is to formulas that are uniquely created for each person – as opposed to synthetics that are mass-produced in pre-made formulas, bioidentical hormones can be custom compounded.  THis may seem like an obvious positive, but things are a little more complicated than that.

Bioidentical hormones that are custom compounded present a unique quandary for those interested in BHRT.  On the one hand, it makes complete sense that if your bioidentical hormone replacement therapy is using ingredients that are not only picked very uniquely for you and your symptoms, and then combined in doses that seem to be a good fit, you may respond even better to this course of treatment.  However, one would think that the research would back this fully, and would be very clear.  Unfortunately this is not the case, but that is not at all surprising: Research into custom compounded natural hormones is merely looking at the whole universe of custom compounding and everyone who has tried it without being able to look at the specific formulas that people were on because by definition they are all different.  In other words, any study is not looking at your custom compounded BHRT ingredients,  but rather a compilation of everyone’s.  Yours may be quite effective, even if in general the world of custom compounding brings mixed results.

So let’s say that your bioidentical hormone doctor wants to prescribe your natural hormones in a combination of doses that she or he thinks are perfect for you, or maybe he or she wants to take a formula that is usually taken by mouth and make it into a gel.  Even if the same ingredients that are in FDA approved bioidentical hormones are to be used, they will perhaps be used in different quantities or different forms so the approval does not hold up.  You will not be able to find a study that says that that formula definitely works, or that method of delivery is optimal.

All of this does not mean that you should not pursue custom compounded bioidentical hormone replacement therapy, but rather that you should be careful in your choice of a BHRT doctor and compounding pharmacy.  You should ask questions about why custom compounding is the option that is being chosen, and how much more effective this choice may be vs. the more traditional approach.  You might also want to ask whether the formula you will be on closely resembles a formula that your bioidentical hormones doctor has used before, and what the science is behind the choices as far as ingredients.  In short, when considering custom compounding three additional steps are warranted:

1. Make sure that your doctor generally has a lot of experience with this approach, and more specifically has treated people like you with your symptoms and the likely custom compounding formula that will be used.

2. Make sure that the doctor is using a trusted and well-established pharmacy that will be doing the compounding.  Ask questions about that pharmacy such as how long they’ve been in business and why the doctor chooses to use them.

3. Be even more involved during treatment, letting your doctor know how you are doing so that changes can be made as necessary – this not only takes advantage of the flexibility of custom compounding, but also makes sure that the approach works.

Custom compounding of bioidentical hormones opens up doors of possibility, but also must be approached with care and caution.


Nov 112014

Which formulas are FDA approved bioidentical hormones?  Of course that is a common question that people ask before deciding on natural hormone replacement therapy.  For many it is important to know that what they will be taking has been approved by the FDA.  If you are choosing a custom-compounded route for your BHRT you will not be taking FDA approved bioidentical hormones of course because your formula will be uniquely made.  But if you are taking a formula that is more standard you can look for FDA approved bioidentical hormones.  The following may not be an exhaustive listing but it is a good place to start, and of course the best person to ask is the BHRT doctor you have chosen.  She or he can tell you whether the choice for you includes FDA approved bioidentical hormones and what the benefits and drawbacks might be if you want to make sure that they are.

Before we get to our list we have two words of warning.  First, keep in mind that we strive to be independent and unbiased, and we are not here to promote a particular brand of formula.  So while there are some brand names here we are not qualified to say which ones work best or even that they work at all.  Second, this may not be an exhaustive listing of FDA approved bioidentical hormones and new ones may be approved all the time.  You should still ask your BHRT doctor first to make sure there have been no changes or additions to this listing.

FDA approved bioidentical hormones: Estrogen

By far the largest category of FDA approved bioidentical hormones are the estrogens.  There are not only many choices, but many different modes of use that you can find under the FDA approved label.  A sampling of what you can choose (including some that are the common medical form called estradoil)  includes:

  • Pills such as Estrace, Gynodoil, and Innofem
  • Creams that can be used topically including Estrace
  • Many different types of trasndermal pathches such as Alora, Climnara, FemPatch and others
  • Gels that go on thicker than creams including Estrogel, Elestrin, and Divigel
  • A apray called Evamist

Once again, there may be other choices and we are not promoting any of these choices specifically but rather giving you an idea of your possible options.

FDA approved bioidentical hormones: Progesterone

There is fewer FDA approved bioidentical hormones if progesterone is what you need.  This may change over time of course, but for now that main one comes in the form of pills and is called Prometrium.  You can also find a gel called Crinone.  There are also many combination formulas that contain a bioidentical estrogen and a non-bioidentical progesterone (or other hormones for that matter).  We expect that more progesterone products will achieve FDA approval at some point and when we hear of them we will list them here.  Keep in mind that you are not limited to products that have been approved, but that approval may give you some peace of mind as far as the research and background study that has gone into your chosen product.

You may want to ask your practitioner if your product is either approved, is in line to be approved, or has tried to get approval but did not meet the standards.  We hope you will share your experience with any of these products, and also let us know if you know of others that have been approved.  Of course it is also helpful to let people know how you have done with products that are not approved yet.  We will continue to provide information and advice about the entire field of BHRT, but we will specifically update this page with additional FDA approved bioidentical hormones.

Nov 012014

Bioidentical progesterone side effects are reasonably rare, and in many cases they can be both foreseen and avoided.  Of course the best way to explore bioidentical progesterone side effects is to look at the main three categories: Side effects, interaction effects, and contraindications.  In all cases, of course, you should discuss the potential bioidentical progesterone side effects both with your BHRT doctor and your regular primary care physician, given that you may have a specific predisposition to one of these issues.

Side Effects: The most common bioidentical progesterone side effects are sedation and lack of energy.  Synthetic progesterone has been reported to have a greater range of side effects including fluid retention, breast tenderness, mood swings, and headache.  We are not suggesting that these are not also side effects of bioidentical progesterone as well, but they have not been reported quite as much.  The one side effects that does seem to be lessened with the natural form is mood swings.  There are also some side effects of bioidentical progesterone that are not as frequently reported for synthetics, including breathing difficulties.  Also, some studies reported that one common ingredient in bioidentical progesterone, wild yam, might cause adrenal damage.

Interaction effects: You own medical history and any medications you are on need to be carefully considered before you start BHRT.  We cannot go over every interaction effect that could occur here.  In particular, however, you should ask questions about bioidentical progesterone side effects and interaction effects if you are on any type of chemical birth control.  Other possible interactions involve the kidneys, so if you have any current issues or have a positive family history in this area you should make sure your doctor knows that.

Contraindications: The most important issue for us to mention is that if you are pregnant, may become pregnant, or are nursing you should not pursue a course of BHRT with progesterone.

Aug 242014

Bioidentical Thyroid Hormone use provides an alternative to well-known synthetic hormones that are used in the treatment of hyper or hypo thyroid conditions, and this specific form of BHRT is different from others in that it can be used for people of any age who are seeing an unwanted change in thyroid function.  This information may be helpful for those facing thyroid issues and looking into bioidentical thyroid hormone as a possibility, but as always we cannot diagnose any condition and you would need to go to your own doctor not only for the diagnosis but also recommendations about the correct treatment course for you.

So why is Bioidentical Thyroid Hormone an emerging approach in the BHRT lineup?  It’s actually quite simple: Many doctors have achieved success in treatment of hormonal issues with this approach.  Before we delve further into Bioidentical Thyroid Hormone more deeply, let’s go over what the thyroid does and how: When functioning properly, the thyroid gland makes two hormones, T3 (Triiodothyronine) and T4 (Thyroxine).  The important detail here is that the ratio of these two hormones must be correct. T4 can be seen as a storage hormone, which itself does not do much but can be converted to T3 as necessary.  T3 is then responsible for metabolism and energy level.  Any number of things can affect these hormones, from dietary issues, exposure to certain toxins, to genetics.  (As an aside, make sure you are tested for the “free T3″ hormone available in your body – this is the hormone that can actually be used.

Bioidentical Thyroid Hormone In Practice

If you have had the proper workup and it is clear that you are deficient in T3, Bioidentical Thyroid Hormone is a solid choice.  There are several possibilities in this area, and we leave it to your BHRT doctor to decide which Bioidentical Thyroid Hormone to choose since there are many natural choices, each with different ingredients.  Many of these natural choices can do the trick is a safe and gentle way, just like other bioidentical hormone replacement therapy choices.  The Bioidentical Thyroid Hormone will contain T3 and T4 in the proper ratio, and will stimulate the thyroid to achieve balance.  This is as opposed to synthetic approaches which are usually designed to have either T3 or T4 as opposed to having both in the correct ratio.  Some have postulated that the fact that the BHRT approach has both T3 nd T4 is the reason it works so well, while others have said that it is because the thyroid responds more naturally to natural ingredients.

The most common form of Bioidentical Thyroid Hormone is a supplement taken orally, and of course, even though this BHRT approach is tested and has been used for years, there is no guarantee that you will not feel some side effects.  make sure to keep in close contact with your bioidentical hormone replacement therapy practitioner, especially at the beginning.


Bioidentical Thyroid Hormone is another powerful approach in the BHRT lineup, and we posted this to show an example of a need that is not necessarily related to age, and one that is quite specific and yet well-tested.  Many people have benefited from this natural treatment choice.  The biggest challenges are to make sure you get the most accurate diagnosis, and then to make choices about the specific ingredients that will go into your formula (many BHRT practitioners will have their own favorite, but many will offer a variety of choices).  Whether you have newly acquired this diagnosis, or have had it for a while and tried many things, the natural treatment approach may be something you want to try.

Natural products in the BHRT sphere have worked well for many and are made from ingredients you may have actually heard of, and Bioidentical Thyroid Hormone is no exception!

Aug 142014

Do bioidentical hormones cause weight gain?  This is not an east question to answer, given that there is such a variety of natural hormone approaches and conditions for which they treat.  The short answer to the question of “Do bioidentical hormones cause weight gain” is that they usually don’t, and for some people they actually cause weight loss.  But there can be a little variability, and this can get especially complicated if a little weight gain may be a good thing for someone who has lost too much weight due to hormone imbalances or depression.  For example, many males become less active due to a gradual decline in testosterone, and thus when they take bioidentical testosterone they may experience more energy and a higher metabolism, thereby causing them to lose some excess weight.

We are still left with the question do bioidentical hormones cause weight gain, and even if this is rare, it can happen.  Any time we introduce a change to our system the result can be a change in our appetite or metabolism.  In this case it is possible that a side effect of BHRT is a change in either one that causes weight gain.  But again, as with the example above, it may actually be a positive change that makes you less depressed, less lethargic, and more interested in daily activities that makes you more likely to get out more, go to restaurants with friends,  enjoy your meals, move around so that your body craves calories, etc.  In other words, the real answer to do bioidentical hormones cause weight gain in many cases is that they do because they make changes that make you want to live more fully.

We cannot guarantee that you will lose weight or stay the same if you try BHRT, but we can say that adding pounds is not a common effect and in many cases where it does happen its not because the BHRT does anything problematic, but because the weight gain is positive or the result of other positive changes.  You need to talk to your doctor and BHRT practitioner about this and get a prediction of how bioidentical hormone replacement therapy might affect your weight, but keep in mind that for most people the answer is either “no” or “only for good reasons” to the question do bioidentical hormones cause weight gain?

Aug 082014

There can be a lot of confusion over the difference between bioidentical hormones and “natural” hormones, and with good reason.  Bioidentical hormones are all natural, but not all natural hormones are bioidenticals.  Therefore, if you are making the choice to pursue bioidenticals which have been tested and specifically formulated as part of BHRT, make sure that they are labeled as such.  That said, and just to make things a little more confusing, there may be nothing wrong with pursuing natural hormones that are not bioidentical.

Here is how we can make things clear: Bioidentical Hormone Replacement Therapy involves specifically formulating things so that the ingredients mimic the hormones your body needs, thereby becoming a natural part of your hormonal system.  In other words, high quality bioidentical hormones are designed to trick your body into thinking it once again has the hormone levels it needs.  Natural hormone therapy on the other hand may do other things instead, such as attempt to encourage the body to produce more of certain hormones or helping reduce symptoms even if hormones levels are not changed.  They may also be able to produce the same effects as BHRT without literally mimicking the hormones that have been lost or decreased.

Many in the bioidentical industry, especially bioidentical doctors, may argue that a full effect or the most effective approach is with true bioidentical hormone replacement therapy that leaves you with a hormone balance.  We agree with that, but would also say that for some with less pronounced problems or where symptom relief is the main goal, an approach that uses natural hormones but not true bioidenticals may work well.  Just make sure you are fully aware of the difference.  Also note that with the permission of your bioidentical doctor an approach that combines true BHRT with some other supplements labeled as “natural hormones” may be okay.


Jul 132014

If you are looking to bioidentical hormone replacement therapy to treat the specific symptoms that have been known to occur with certain hormone imbalances and deficiencies, and you have some reason to think you have such a hormone deficiency or imbalance, then this natural hormone replacement approach is likely to work for you.  Take the most obvious example of a woman who is again and feeling symptoms that have been associated with the decrease in estrogen that comes with the aging process.  She has reason to be confident in this approach.  But in situations that are less than obvious, or for problems that have less of a direct association with hormonal issues, you should be careful and know the limits of bioidentical hormone replacement therapy.

Some examples of how the natural hormone replacement hype got away from itself involves anti-aging claims that appear too general.  Wrinkles on the skin, for example, are a natural part of aging and any connection with a hormone imbalance, as well as any related suggestion that a natural hormone treatment could dramatically reduce the incidence or severity of wrinkles has got to be treated with extreme caution.  The problem with looking to bioidentical hormone replacement for treatment of these problems is two-fold: First it is likely to work only minimally if at all, and second it is likely to require you to stay on the treatment for very prolonged periods of time, which can be expensive and increase your chances for side effects.

Even if your own primary care physician is skeptical of bioidentical hormone replacement therapy, she or he can at least tell you whether your symptoms are related in general to hormonal imbalances or deficiencies.  If they are not, and just merely a sign of aging or due to a genetic predisposition that exists completely aside from any hormonal issue, then the natural hormone therapy is unlikely to do a thing.

Jul 032014

If you are considering natural hormone replacement you will be happy to know that some of the most common formulas are FDA approved.  The fact that there are a good number of FDA approved bioidentical hormones helps the industry overcome perceptions that all-natural somehow means that they do not work as well, or that there could be problems that engineered hormones would not have.  This approval gives these formulas legitimacy and takes some of the worries about risk away.  Of course the natural hormones that do get approved are more standard formulas, and anything that is custom compounded for you cannot be specifically approved, though it is possible that something quite close is.

Now we should mention that just because there are FDA approved bioidentical hormones does not mean that they will necessarily work for you or that there are no potential side effects.  Before we provide a listing of the FDA approved bioidenticals we want to offer the strong caution that any natural hormone replacement must be preceded by a comprehensive assessment that helps to show whether you need this approach and whether they are likely to help given your unique presentation.  And during treatment there is no guarantee that you will not experience side effects just because they are approved.  Those qualifiers aside, we do want to offer information that helps you know which choices have been studied and approved.

The following is a brief listing of the FDA approved Bioidentical Hormones:

Estrogens: Many forms of estrogens are FDA approved Bioidentical Hormones including the most common which comes under the name estradiol.  You can get estradiol in many forms, all of which are FDA approved, including pills, creams, patches, tablets, lotions and gels.  Of the FDA approved bioidentical hormones, estradiol is the most commonly used and has been the most widely studied and reported on..

Progesterone: Another of the common FDA approved bioidentical hormones is progesterone, which comes most commonly in pills and gels.  While progesterone does not have the base of information and scientific study that the estrogen have, it has been studied enough to pass all of the scrutiny that comes during the approval process.

Combinations: The last one of the FDA approved bioidentical hormones are combinations that often include estradiol.  Many of these combinations involve a non-bioidentical second ingredient.  Both ingredients are approved in these cases, but only one is a natural hormone.  These combinations do allow you to get as much of the natural hormone as you can while augmenting with something else that is approved.

Just because a formula does not appear on this listing of FDA approved bioidentical hormones does not necessarily mean it is unsafe or that you should not try it.  Approval takes time, and some formulas are too new or have not been studied enough to get approved.  You may need to ask additional questions, however, such as how long that formula has been in use, what the science is behind it, how long that practitioner has been using it, and what are the known risks.  There is certainly an added comfort that comes with the use of a formula that has been approved, so if progesterone or estrogen is what you need you can choose something that provides that added security.

We will of course keep this post and the entire site updated as there are more FDA approved bioidentical hormones.  Many are in process now and with more information and research the pipeline may continue to be strong.  And we will also cover those formulas that have not yet been approved on this website so this may be a good page to refer back to if you are wondering about the approval status.

Jun 042014

Many people are concerned about starting BHRT for fear of certain side effects or effects that are not quite side effects but may not be wanted.  The fact that bioidentical hormones have been tied to possible weight gain may scare some people off, though this effect has been overplayed and is not as likely as you might think.  In fact, the major link between bioidentical hormones and weight gain may actually be reversed.  We wanted to provide more information to help you understand this link, but of course your BHRT doctor is the best one to turn to for more information about your own unique formula and hormone imbalance.

Hormones in general can affect your weight.  There are two possible mechanisms of action by which this happens, one involving metabolism and the other through the indirect effect they have on energy and activity level.  When hormones are in a correct balance they allow you to have the energy you need and ensure that your metabolism is functioning well enough so that you can address any extra weight through diet and exercise.  For example, as men age they often experience a drop in testosterone, and with low activity this drop can happen even faster.  When this hormone is too low both metabolism and energy become too low, and that can lead to weight gain.

But the question for this post is more directly about bioidentical hormones weight gain.  The short answer is that there is little likelihood that you will experience a problem with bioidentical hormones and weight gain.  If you truly needed BHRT and it is done correctly, all that is happening is that you are fixing an imbalance and the result should be that you come closer to your natural weight, especially if one of the symptoms of your imbalance was an increase in pounds.  The longer answer is that you could experience a temporary increase in what you weigh due to changes in fluids – there could be some bloating and water retention as you get things corrected.  While to be fair this certainly falls into the category of bioidentical hormones and weight gain, this type of gain is not permanent and will resolve over time.

You should certainly approach your provider and get a prediction or estimate of any potential problems you might experience with bioidentical hormones and weight gain.  You should know what to expect, and there may be ways for your provider to estimate this possibility given your unique body type, history, and symptoms.

One final note.  Keep in mind that even if you do end up with a problem related to bioidentical hormones and weight gain that this may not be important enough to stop your BHRT treatment.  In other words, in many instances you may get relief from other symptoms and want to stay on the treatment, even if you may have to work harder to maintain your weight.  A lot of this depends on why the BHRT is causing this problem – if they are merely causing you to have less energy, for example, you may want to try to power through and still maintain a string exercise regimen.  If they are causing you to have a slower metabolism, however, this may be a harder decision.

As we said up front, it is unlikely that you will experience a problem with bioidentical hormones and weight gain, but if you do the problem may be correctable whether by overcoming the challenge, switching formulas, or even maybe putting up with the problem for a little  while to see if it goes away.  And of course you need to assess whether there actually is a relationship between your bioidentical hormones and weight gain in the first place.