At first glance, they sound like the same thing, and the terms are often used interchangeably. In fact, both contain hormones that are structurally identical to those produced naturally by the human body.
However, there are some important differences that every woman should understand so that she can make an informed choice about her treatment.
Bioidentical HRT (also known as compounded bioidentical HRT or cBHRT)
• Hormones that are prepared by specialist compounding pharmacies.
• Not licensed or regulated by the MHRA.
• Not routinely recommended by the British Menopause Society due to concerns about quality, consistency, efficacy and safety.
• Not available on the NHS.
Body Identical HRT (also known as regulated bioidentical HRT or rBHRT)
• Hormones that are manufactured by pharmaceutical companies.
• Produced to strict quality standards with consistent dosing.
• Licensed and regulated by the MHRA.
• Recommended by the British Menopause Society and NICE where appropriate.
• Widely available on the NHS.
I often see adverts on social media promoting compounded bioidentical HRT. These treatments can be very expensive and are sometimes marketed as being more “natural”, more personalised, or even superior to the HRT prescribed on the NHS.
What is often not explained is that the regulated 17β-oestradiol and micronised progesterone available on the NHS are also body-identical (bioidentical) hormones. In addition, there are also synthetic hormone options available where clinically appropriate.
Regulated bioidentical HRT can also be highly individualised. Treatment can be tailored by adjusting the hormone type, dose and route of administration (for example, patches, gels, sprays, tablets and vaginal pessaries), allowing treatment to be personalised according to each woman’s symptoms, medical history, preferences and treatment goals.
The terminology can be confusing, but it’s important to know that “natural” does not necessarily mean compounded, and personalised care does not require compounded hormones.