Bioidentical Hormones: Understanding Their Nature and Assessing Their Gentle Attributes

Bioidentical hormones, often referred to as nature-identical or natural hormones, are medications utilized in hormone therapy to address menopausal symptoms and endometriosis. Manufacturers and certain practitioners assert that these substances yield fewer side effects and enhanced efficacy compared to conventional hormone treatments.

Endometriosis: Unraveling Causes, Effects, and Symptoms

Endometriosis, a distinct medical condition, impacts approximately 1.7 million women solely in Germany. Its manifestations encompass a spectrum from pain and menstrual irregularities to heavy bleeding and infertility.

Despite its widespread prevalence and sometimes substantial symptomatology, diagnosing endometriosis typically takes four to eleven years to materialize.

Furthermore, the causes remain incompletely understood, posing considerable challenges in devising effective therapies. The hallmark of endometriosis lies in the presence of tissue resembling endometrial lining outside the uterine confines, spread throughout the abdominal cavity, and occasionally even on the diaphragm and within the lungs, forming what are known as endometriosis lesions.

Parallel to the endometrium within the uterine cavity, these lesions are also influenced by the woman’s hormonal cycle [1].

This article delves into:

  • The various approaches of hormonal therapy for treating endometriosis
  • Unveiling the essence of bioidentical hormones
  • The interplay between bioidentical hormones and conventional hormone preparations

Navigating Treatment Approaches in Endometriosis: Embracing the Significance of Hormone Therapy.

The journey toward an accurate diagnosis of endometriosis often involves a combination of historical interviews, physical examinations, and ultrasounds. Yet, the definitive confirmation of endometriosis hinges on laparoscopic examination (laparoscopy), coupled with tissue sampling for meticulous laboratory analysis [2]. Depending on the condition’s severity, lesion localization, patient age, and potential fertility concerns, a personalized treatment approach is crafted. This approach may encompass several components:

  • Hormonal Therapy
  • Surgical Intervention
  • Synergy between Surgery and Hormonal Therapy

Hormonal interventions, whether administered singly or in conjunction with surgery, play a pivotal role in endometriosis treatment due to the profound impact of estrogen on the condition’s development and persistence [3]. By reducing estrogen levels, existing endometriosis lesions undergo scarring, while the formation of new ones is hindered. Although the objectives of endocrinological (hormonal) therapy include lesion elimination, symptom alleviation, enhanced fertility, prevention of secondary complications, and prophylaxis against disease onset [8], achieving these objectives remains a work in progress.

Unraveling the Enigma: Bioidentical Hormones and Their Definition

The terminology encompassing bioidentical, natural, or nature-identical hormones often conveys the notion of these substances working in a holistic, gentle manner with minimal (if any) side effects. Various platforms [4], including those of alternative healthcare practitioners and some laboratories, assert distinctions such as the fundamental disparity between nature-identical hormones and traditional synthetic counterparts. They propose that bioidentical hormone therapy adopts an approach tailored to individual condition causes. Given the ongoing discourse surrounding hormone therapies, along with the undeniable side effects experienced by some women [5], this narrative emerges unsurprisingly. Women grappling with these challenges seek treatments that exhibit greater tolerability compared to familiar hormone preparations.

The phrase “bioidentical hormones” lacks a standardized definition, contributing to patient uncertainty. Within different contexts, the term implies:

  • Production without artificial means,
  • Sourced from plants or animals, or
  • Chemical correspondence with the structure of the corresponding human hormone.

The “Endocrine Society”, comprising medical professionals and organizations spanning over 100 countries, defines bioidentical hormones as “compounds that have exactly the same chemical and molecular structure as the hormone produced in the human body” [6]. This definition broadly centers on the characteristics of the hormone product, without delving into the origins of the original substances or the manufacturing processes.

Bioidentical hormones, often advocated for menopausal symptoms and endometriosis treatments, encompass a diverse range of drugs and hormone replacement products. The expansive scope of the”bioidentical hormones” umbrella, as highlighted by the broad definition, underscores the need for careful differentiation and consideration.

Navigating the Varied Landscape of Bioidentical Hormones

The term “bioidentical hormones” often serves as a marketing tool, aiming to convey a sense of naturalness to patients considering hormone treatments. However, the comprehensive definition provided earlier unveils the fact that the term “bioidentical hormones” encompasses an array of vastly different preparations.

It is worth noting that some substances labeled as “conventional hormone preparations” are actually derived from plant or animal sources [7]. Patients should remain vigilant about whether a given drug is an officially approved medication or a preparation that falls outside stringent regulatory approval criteria. Approved drugs are required to demonstrate their efficacy and tolerability through rigorous studies, and they undergo continuous monitoring to ensure safety.

Untangling the Claims: Are Bioidentical Hormones Gentler and More Effective?

The sweeping assertion that “bioidentical hormones” are inherently milder, more potent, and cause fewer adverse effects is not substantiated [7]. Some formulations marketed as “bioidentical hormones” involve personalized hormone combinations tailored to individual patients. These formulations often stem from results obtained through saliva tests, which gauge hormone levels in saliva to inter deficiencies or excesses in certain hormones. However, the hormone concentration in saliva differs from that in blood, leading to hormone preparations based on inaccurate data. Moreover, it is important to note that individually crafted hormone compounds of this nature have not undergone clinical trials, rendering any claims about their efficacy or side effects unreliable. Relying solely on the “bioidentical” or “natural” label as a determinant for hormone therapy is ill-advised. Additionally, it is crucial to remember that natural substances used in hormone preparations—whether sourced from plants or animals—are subjected to processing, inherently altering their composition from the pure natural state.

In some instances, bioidentical hormones are mixed directly in pharmacies, such as in the form of creams. However, these processes often lack standardized concentration controls, leading to substantial variations in quality ( For bioidentical hormones, as with any other medications, consistent and controlled production is essential.

Regrettably, scientific studies on “bioidentical hormones” are scant, and those available tend to focus on menopause rather than endometriosis patients.

Particularly in the context of endometriosis hormonal treatment, selecting medications must factor in disease severity, symptomatology, and the patient’s individual circumstances.

While “natural” or herbal medications are indeed medications, they are not exempt from potential side effects. Bioidentical hormones also carry side effects, which, akin to synthetic hormones, can vary in intensity on an individual basis. Therefore, any decision regarding their use should be made in consultation with a healthcare professional.


The term “bioidentical hormones” may imply that these hormone preparations are inherently gentler and cause fewer side effects compared to traditional hormone therapies. However, the broad definition of “bioidentical hormones” encompasses a wide range of preparations with varying active ingredients and manufacturing methods. Even if a substance is naturally present in the body or derived from herbs, side effects can still arise. Hence, it is imperative to seek medical consultation or a prescription before considering their use.


Have you already tried bioidentical hormones?

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