Hormone Replacement Therapy: Bio-identical vs. Conventional HRT

As a prescriber of Bio-Identical Hormones in Ontario, one question I hear a lot is “What makes BHRT better than the hormone replacement therapy offered by my other medical providers?”


HRT (bio identical or conventional) is often sought by women in peri-menopause as treatment for hormone related symptoms: hot flashes, irritability, insomnia, weight gain, irregular and/or heavy periods, etc. HRT includes estrogens and progesterone


Often, the first treatments women are offered are the birth control pill, anti-depressants, hysterectomies, and/or HRT


Many women are not satisfied by these recommendations, and come to see me for alternatives


The biggest differences:

  • Source. CHRT is commonly derived from horse urine (gross, I know), whereas BHRT comes from plants (yams). CHRT estrogens are then synthesized in the lab, whereas BHRT is more of a simple extraction process. This is important because horse estrogens are much different than human ones. They can activate around 1200 genes in the body, whereas human estrogens activate approx 500. So, you can have genes turned on for things like cancer, weight gain (horses are huge animals, and they have the hormones they need to get big & stay big), and mood disruptions much more easily than you can with yams (which is almost identical to our own estrogen)
  • Customization. With BHRT, healthcare professionals like me can tailor hormone dosages specifically to your unique needs. This approach optimizes the therapeutic benefits while minimizing side effects
  • Toxicity & inflammation. CHRT, owing to its composition, can impose a heavier burden on the liver – it’s more challenging for our bodies to break down synthetic estrogens than bio-identical ones. Synthetic estrogens also come with a lot of inflammation, which is a contributor to hormonal dysregulation to begin with
  • Composition. BHRT usually includes Bi-Est, which is a combination of two estrogens that has a more protective effect on the body than using estradiol (the type of estrogen in CHRT) alone

Key is to undergo hormone testing before embarking on your HRT journey. This provides a solid foundation for achieving optimal results


Download my FREE Menopause Starter Guide & learn which hormones may be out of balance for you!


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