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

Natural vs. Synthetic Hormone Replacement Therapy

Many people seek hormone therapy for a variety of reasons including foggy cognition, fatigue, weight gain, mood changes, low libido, sleeping issues, and dozens more hormone related symptoms. But the options for rebalancing hormones vary significantly—from natural, plant based options (bio-identical hormones) to the unnatural, synthetic versions (made by pharmaceutical companies most commonly using mixtures of urine from pregnant mares) common to hormone replacement therapy (HRT) which has been shown to be hazardous to a  woman’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 work: 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 implants are unnatural and considered by a growing number of researchers, physicians, scientists and other experts to be toxic to the human body. The primary reason for this stance being that these pharmaceutical hormones have a completely different chemical structure which does not properly “fit” the cells of the body and thus, can create hormonal imbalances and side effects such as weight gain, belly fat, anxiety, stress, difficulty sleeping, sluggish metabolism and low thyroid symptoms (fatigue, weight gain, constipation, muscle weakness, dry skin, depression etc).

There have been many studies over the years that have warned of the health risks of taking mass produced pharmaceutical hormones. In fact, the largest and most important recent trial of HRT, the Women’s Health Initiative (WHI, 2002), had to be halted three years early, when those subjects on PremPro, the synthetic HRT (combination of equine estrogens and progestin) used in the study found increased risks for heart disease, stroke, blood clots, and breast cancer. Even more alarming, recent follow-up findings from the WHI in October 2010 revealed that the breast cancers resulting from HRT use are more invasive and deadly than researchers originally thought!

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).


In our practice, 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 pharmaceutical synthetic version that is not natural and is foreign) to our bodies.

Progestin was the unnatural, 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 not to raise blood lipids, to be protective of the uterus, breasts, bones, blood vessels, heart and brain, and to effectively relieve symptoms of hormonal imbalance. (Refer to www.womeninbalance.org).

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 – it is important to test your hormones to see where exactly your levels lie and learn IF bio-identical hormones will be necessary for rebalancing.

In our at-home saliva collection kit, we measure bioavailable, (eg.active in target tissues of the body) Estrogen, Progesterone, DHEA, Testosterone and Cortisol – and will suggest reliable, well-established bio-identical hormone formulations that are available online and over-the-counter IF specific imbalances are detected through testing (such as Estrogen Dominance or low testosterone). 

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.

Our motto here at YHB is “Test, Don’t Guess!” It can be easy 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 not wise 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 very quickly, others may at first experience a spike in symptoms, such as acne, bloating or breast tenderness, but will often dissipate once hormone levels balance 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 adaptation, 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 is better received by the body and comes with less risk and side effects
  • Plant derived ingredients (BHRT) vs animal/synthetically derived ingredients (HRT)
  • You will receive an individualized dose better suited to your needs as opposed to a standardized one-size-fits-all dose 
  • A reduction in hormone imbalance related symptoms
  • Continuous, steady-state delivery at a minimum dose


At the moment there are still plenty of physicians who are familiar with HRT than BHRT so it is important to do your research and work with a specialist who will advocate for 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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