Understanding the Difference: Bio-identical Hormones VS Synthetic HRT (Hormone Replacement Therapy)

Natural vs. Synthetic Hormone Replacement Therapy

Many women seek hormone therapy for relief from a variety of unwanted symptoms that crop up during the monthly cycle, or at perimenopause/ menopause like period changes, sudden hot flashes or night sweats, frequent waking, foggy cognition, fatigue, weight gain, mood shifts, low libido, and dozens more hormone related symptoms. But available options for rebalancing hormones vary significantly—from natural, plant based options (bio-identical hormones) (BHRT) to the unnatural, synthetic versions (derived from pregnant mares urine) that are commonly used in pharmaceutical hormone replacement, despite research that has shown HRT to be hazardous to women’s health and longevity.

Here we will be reviewing the key differences between the hormone replacement options available – including a review of Hormone Replacement Therapy (HRT) which has been directly linked to an increased risk for breast cancer, stroke, heart disease and blood clots!


Bio-identical hormones made from natural soybean and/or plant-based substances and compounds are designed to work in exactly the same way our own naturally-occurring hormones: like a key in a lock, they fit the cells of the body. Only a bio-identical hormone fits the hormone receptor of the cell perfectly so that the body recognizes that hormone as its’ own and knows what to do with it!

Synthetic hormones such as those found in HRT (Premarin/Prempro), birth control pills, hormonal IUD’s and/or hormone-injected meat and dairy are unnatural and considered by a growing number of researchers, physicians, scientists and other experts to be toxic to the human body. The primary reasoning for this stance being that these pharmaceutical hormones have a completely different molecular structure that does not properly “bind” to receptor sites at the cellular level where hormones do
their work. So instead of duplicating normal hormone rhythms, synthetics disrupt function and cause the imbalances that trigger acute side effects - from heavier periods, PMS and bloating -to chronic stress and anxiety, insomnia, and overlapping hypothyroid symptoms (sluggish energy/metabolism, constipation, muscle weakness, dry skin/hair, depression etc.).

Over the past several years researchers have warned of the health risks of taking mass produced pharmaceutical hormones. In fact, the first and largest randomized clinical trial of HRT in the US, the Women’s Health Initiative (WHI, 2002), was halted three years early, when researchers reported greater risks of heart disease, strokes, blood clots and breast cancer among women users of a combination of equine estrogens + progestin. Further findings from the WHI in 2010, revealed that the breast cancers resulting from HRT were in fact, more invasive and deadly than researchers had originally thought. And while follow-up analyses have questioned the initial findings of the WHI or downplayed the dangers, millions of women have nevertheless moved on, jettisoning horse-derived HRT for more natural plant-based bio-identical options that bring great relief without greater risk.

Thankfully, this awareness resulted in HRT usage plummeting and the use of safer, bio-identical hormones to increase significantly (though it should be noted that there are still millions of women using HRT and synthetic hormones today).


At YHB, we frequently suggest the use of bio-identical, plant-based progesterone for clients whose test results indicate a need. Unfortunately, there is a lot of confusion about the difference between progesterone, which is identical to the progesterone our bodies make naturally, and progestin, the manmade version that is not natural and actually foreign) to our bodies.

Progestin is the artificial, synthetic version of progesterone used in the Women’s Health Initiative Trial in 2002 that in combination with synthetic estrogen (Prempro) was linked to greater risks than benefits, and caused the study to be halted three years early. The reality: progesterone, has been shown in studies to have a better safety profile given that it does not to raise blood lipids, is protective of the uterus, breasts, bones, blood vessels, heart and brain, and to effectively relieve symptoms of hormonal imbalance. (Refer to https://womeninbalance.org/resources-research/)

Furthermore, when used correctly, clinical studies have associated bio-identical progesterone with lower breast cancer risks. See links below:


Before introducing any kind of hormone therapy into the body– it is important to test your hormones to see where exactly your levels lie, pinpoint imbalances and related symptoms to determine if bio-identical hormones are appropriate and necessary for rebalancing. Our at-home saliva collection kit is non-invasive and measures bioavailable (eg. active in target tissues of the body) Estrogen, Progesterone, DHEA, Testosterone and Cortisol. If specific imbalances of one or more of these hormones is detected
through testing (such as estrogen excess, low progesterone or high/low cortisol, etc.) we will suggest reliable, well-established bio-identical hormone formulations available without prescription from trusted sources online and over-the-counter.

Stronger forms of BHRT may also be prescribed by a physician, and the delivery system can range from patches, pills, creams, shots, or implanted pellets.

More potent forms of BHRT may also be prescribed by a physician, with delivery systems ranging from transdermal patches, and topical creams, to pills, pellets or injectables. Our motto here at YHB is “Test, Don’t Guess!” It can be all too simple to align your symptoms with a specific hormonal imbalance you learn about via a podcast or educational materials like these, but until we test YOUR unique levels and get to the root cause, it is never a wise move to self-prescribe. Our hormones need to be in a delicate balance with one another (and can be easily thrown off by improper intervention) which is why we always recommend getting your levels tested FIRST and THEN taking steps to rebalance (which may very well include BHRT) naturally and effectively based on your results.


As you will often hear it said: “we are all uniquely made” so when adding bio- identical hormones to the body, each individual's experience may be somewhat different.  While some women get relief from unwanted symptoms fairly quickly, others may at first experience a spike in symptoms, such as skin breakouts, bloating or breast tenderness, but these flareups will often dissipate once hormone levels balance out and the body has adapted to the reintroduction of substances it has long been
missing. The natural, holistic approach to hormone balance can be a more gradual fine-tuning but is one that will provide long lasting results with far fewer side effects.


In summary, these are the top reasons to consider bio-identical hormones over synthetic HRT.

  • The bio-identical nature of BHRT mimics the structure and function of endogenous hormones & thus is better received by the body with fewer risks and less side effects
  • Plant derived ingredients (BHRT) vs animal/synthetically derived ingredients (HRT)
  • BHRT is tailored to the individual and better suited to your needs as opposed to the standardized one-size-fits-all dose
  • A reduction in hormone imbalance related symptoms
  • Continuous, steady-state delivery at the minimum effective dose


BHRT is the new normal in women’s hormonal health management, but despite the preference of millions of women there are still plenty of ‘old school’ physicians who are more familiar with one size fits all prescribing of HRT. So it is important to do your research and find a specialist to work with who will advocate for and is trained in safe, natural approaches to hormone balance!

Interested in testing your hormone levels and getting started on an all-natural rebalancing plan? Check out our at-home hormone testing + consulting packages HERE.


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