Updated September 26, 2026. This BHRT overview corrects earlier statements implying that “natural” hormones are universally safe or prevent cancer.
In bioidentical hormone replacement therapy (BHRT), bioidentical describes a hormone’s chemical structure: it matches a hormone the body makes. However, it does not mean a medicine is risk-free. For example, some FDA-approved estradiol and progesterone products are bioidentical; the term is not limited to custom-compounded preparations.
Approved products and compounded hormones are different
The FDA does not approve compounded medications. Evidence does not establish that compounded bioidentical hormones are safer or more effective than approved menopausal hormone therapies. ACOG recommends approved options over routine use of compounded products when suitable approved treatments are available. A specific medical need may warrant an individualized discussion about compounding. See ACOG’s clinical consensus.
What can menopausal hormone therapy help?
Hormone therapy can relieve hot flashes and night sweats. Certain local vaginal treatments can address dryness and discomfort, and systemic estrogen can help prevent bone loss. The choice depends on symptoms, medical history, and the formulation. Clinics should not advertise it as a guaranteed treatment for hair loss, weight gain, depression, or every symptom associated with aging. Learn more in ACOG’s patient guide.
Consider BHRT benefits and risks together
Hormone therapy can carry risks including blood clots, stroke, and certain cancers; risk varies with the medicine and the person. For someone with a uterus, systemic estrogen generally needs appropriate progestogen protection to reduce endometrial cancer risk. This is different from claiming that progesterone prevents breast cancer. In addition, a history of cancer, unexplained bleeding, blood clots, stroke, or liver disease needs careful review.
FDA advises using hormone therapy to treat menopausal symptoms rather than to prevent heart disease or dementia. “Plant-derived” and “bioidentical” are not substitutes for evidence about a specific product. See FDA’s menopause information.
A personalized plan includes reassessment
There is no universal three-to-nine-month course and no requirement for every patient to take hormones indefinitely. Discuss your symptoms, preferences, treatment alternatives, and how follow-up will assess benefit and adverse effects. Do not change an existing prescription based on this article alone.
Finally, bring a medication list and your relevant health history to a consultation. Explore our menopause support guide or book an appointment to discuss an individualized plan.
