Bioidentical Hormones & Synthetic Hormones: Key Differences
Sunday 11/21/2021

How are bioidentical hormones different from synthetic hormones?

It is important to understand that The Center for Disease Control (CDC) and the Food and Drug Administration (FDA) group all types of hormones together. According to their classifications, there is no difference between synthetic and bioidentical hormones. They lump them together in the same category and assume that because synthetic hormones are dangerous, bioidenticals must be hazardous, as well. That is a false assumption. There is a world of difference between the two. 

For example, governmental regulatory agencies classify both natural progesterone and medroxyprogesterone (or MPA) as progestins, but these two are vastly different. They may produce some of the same effects in the body, but they are vastly different in terms of their chemical makeup, how they are manufactured, what sources they are derived from, and how the body ultimately responds to them over the long-term.

The disparity between these two products is so significant that it can be a matter of life and death. Studies have shown that natural progesterone decreases the likelihood of breast cancer while synthetic progesterone (MPA) increases the risk by up to 69%.

Progestin is an extremely broad classification. To discover whether a progestin is dangerous or safe, we must look at the source and structure of that hormone.

If the ingredients sourced to create a hormone are foreign to the human body, it is far more likely to pose dangers and cause harmful repercussions.

If the ingredients are sourced from food and are identical to those produced naturally in the human body, it makes sense that the body would receive them positively.

All the research on this subject makes clear and evident the fact that the complications and problems associated with hormone replacement are only found when using synthetics, both because of their chemical makeup and their mode of application. Synthetic progestins, such as MPA, undeniably increase the likelihood of breast cancer.

Bioidenticals, on the other hand—and pellet therapy, in particular—mimic the body’s natural process, with the gradual release of an organic substance over several months. I have administered bioidenticals to thousands of my patients with remarkable success and have found no major adverse side effects.

The bottom line is that we should only put what is natural to our bodies inside of our bodies.

Drug Companies are Intentionally Creating Confusion

I had a patient ask me the other day, “Why is it that, suddenly, I see ads everywhere on television, in drug stores, and in magazines, advertising hormone replacement therapy, and testosterone boosters? Those advertisements and therapies weren’t around when I was a kid. Why now? Was it just me not noticing them, or is this truly a new problem or even a fad? And the lingo is confusing. Not only do I hear about hormone replacement therapy, but now I see ads for bio-equivalent hormones. Is it the same thing? I’m confused. What’s the difference?”

Those are excellent questions—questions that I have been asked by thousands of clients I’ve treated successfully. With a background in obstetrics and gynecology, I want both women and men to experience health and vigor, and to age gracefully.

After years of being uninformed about these topics, I began investigating with an open mind. I discovered how, with the right hormone treatment, we could achieve that younger, stronger, more energetic, and sexier reality. But it must be the correct treatment with the right hormones.

When it comes to replenishing hormone levels in our bodies, we have two options to choose from: synthetic hormone replacement or bioidentical hormone replacement. Let’s look more closely at the differences between these two methods of treatment, the benefits and dangers of each, and come to a rational conclusion about which is safer for both men and women today.

First, if a substance is introduced into your body and your body cannot metabolize it or break it down, that causes problems. Synthetic hormones, as we will see, are made from substances that are foreign to our systems.

Second, the television ads touting synthetic hormones refer to them as bio-equivalent. This term has been coined because it sounds like bioidentical. The pharmaceutical companies selling synthetic hormones want you to believe that bio-equivalent and bioidentical are the same. They are deliberately creating confusion around these two terms, but the differences between these two products are vast.

Our consumerist marketplace is rife with clever marketing tactics designed to reassure unsuspecting buyers. For example, because of the dramatic increase in the consumption of organic foods, many food manufacturers have started labeling their products as natural, hoping that most consumers will equate the term natural with organic. Many people assume that natural food is safe, minimally processed, hormone-free, antibiotic-free, and chemical-free. The reality is, neither the FDA nor the USDA has any rules or regulations in place for companies to claim that their products are natural—only a loose set of guidelines that are not enforced. Ultimately, any food manufacturer is free to use this term on its food packaging, regardless of the ingredients it contains.

Organic foods, however, are regulated by stringent guidelines. They cannot contain synthetic pesticides, herbicides, fertilizers, antibiotics, or growth hormones. Organic farmers are subject to frequent unannounced certification inspections by third-party inspectors. Organic growers and food producers go through extremely rigorous testing for the privilege of placing the term organic on their packaging.43 As a result, the quality of a product marked organic is usually far superior to one labeled natural, even though those two terms might appear to be indistinguishable at first glance.

This comparison illustrates why it’s essential to be educated and aware of who wants to sell you what. The pharmaceutical industry wants you to think bio-equivalent and bioidentical are the same, precisely the way industrial food producers want you to think organic and natural are the same things. Pay close attention to the phrasing of companies trying to get you to spend your money on their products!

Synthetic Hormone Replacement Therapy

For years, doctors have prescribed synthetic hormone treatment for menopausal women. The two most common hormones prescribed are Premarin® and Provera®. With the best of intentions, doctors gave these drugs to women experiencing menopausal symptoms such as hot flashes, night sweats, hair loss, poor sleep, anxiety, and depression.

It is important to realize that Premarin and Provera are not natural. They are chemical compounds alien to the human body, and they cause some dangerous side effects.

Premarin is a conjugated equine estrogen (CEE) derived from the urine of a pregnant horse. Women, do you want something made from horse urine in your body? Think about that for a moment. Does it make sense to introduce a chemical long-term that is entirely unfamiliar to your genetic make-up? Premarin changes the standard ratio of estradiol to estrone (two forms of estrogen) in a woman’s body from 2:1 to 1:2. That in and of itself is unnatural.

Provera is another synthetic chemical made from medroxyprogesterone acetate, which is a chemical derivative of progesterone. However, it offers none of the positive benefits of natural progesterone. A high percentage of women who start taking Provera discover the side effects are so uncomfortable that they discontinue its use.

Dangers Associated with Synthetic Hormones

Some of the risks and common side effects of Premarin include: increased risk of breast cancer, blood clots, high blood pressure, fluid retention, headaches, leg cramps, increased risk of stroke, gall stones, tenderness of the breasts, worsened uterine fibroids, increased risk of diabetes, worsened endometriosis, increased risk of endometrial cancer, impaired glucose tolerance, nausea, and vomiting.

Similarly, some of the possible side effects of taking Provera include hair loss or hair growth, depression, fluid retention, skin rashes, breast tenderness, weight gain, acne, impaired glucose tolerance, menstrual irregularities, blood clots, breast cancer, and congenital anomalies.

Prempro, a pill combining both Premarin and Provera, has been shown to cause an increase in breast cancer by 26% after four years of ingestion.

The Women’s Health Initiative (WHI) was a long-term national health study focused on strategies for preventing heart disease, breast and colorectal cancer, and osteoporotic fractures in postmenopausal women. In 2002, WHI proved that synthetic hormones cause breast cancer, heart attacks, strokes, dementia, and blood clots.

In 2004, the results of The Women’s Health Initiative Memory Study were released. Their research proved conclusively that not only was Prempro failing to protect women from declining mental capacity, but it also doubled the risk of dementia for women who took the drug.

Bioidenticals vs. Synthetics

An article published in the 2005 issue of The Journal of Cancer reported on a study analyzing the health of over 54,000 female patients. Half of the patients were treated with a combination of bioidentical estrogen and bioidentical progesterone. The other half were treated with a combination of bioidentical estrogen and synthetic progesterone. The first group had a 10% decrease in the incidence of breast cancer. The group that was treated with synthetic progesterone saw an increase in the rate of breast cancer by 40%.

Two years later, a follow-up study analyzed the health of another 80,000 women over a longer period. The researchers reported zero cases of breast cancer in the bioidentical group and a 69% increase of cases in breast cancer in the synthetic progesterone group.

Here’s my question. Why would you want to ingest any foreign substance—such as horse urine—when there are better, more effective, and healthier alternatives? Why would you want to do that to yourself?

If you are a horse suffering from hormone imbalance, then Premarin might be just what you need. But if you aren’t, I strongly encourage you to stay away from it, or any of its derivatives.

My Patient, Jan

Jan, one of my OB/GYN patients, came to see me in my office recently, dissatisfied with the Premarin she was taking, and scared of the side effects. Her initial reaction was to get off hormones completely, but she knew what the consequences were of discontinuing hormone therapy entirely.

We talked for a while, and as I described the alternative of BHRT, she lit up with excitement. Was it possible that there could be a solution both safe and effective?

Within two months of starting treatment, Jan returned to see me, elated with the results, and relieved of her fears. She said, “I feel like I have my life back again.” She did—and without the dangerous side effects of synthetic treatment.

My Experience Prescribing Both Types of Hormones

As an OB/GYN, when I prescribed Premarin I never got the opportunity to follow up with a patient and monitor her blood labs. I just prescribed the drug. Besides, the conventional medications used to treat menopause such as Premarin and Estrace do nothing to lower a woman’s FSH level, which is what she needs to relieve her symptoms.

I have a unique background, being a doctor who has treated thousands of menopausal women, with both conventional drugs and bioidentical hormones. There are very few doctors who have had the experience of treating so many women and observing the effects of both forms of hormone treatment on their patients. I can tell you beyond a doubt, after having plenty of exposure to and familiarity with both, that bioidenticals are by far the superior method of treatment in terms of safety and effectiveness.

Synthetic Hormones are Unnatural

To summarize, here is my case against the use of synthetic hormones in replacement therapy:

  • Synthetic hormones are unnatural and foreign to the human body. Premarin is made from a pregnant horse’s urine and contains more potent estrogens than the human body can handle.
  • The body has serious trouble assimilating synthetic hormones and will react against them. Conjugated estrogens are estrogen products that contain blended equine estrogens—including estrone sulfate, equilin sulfate, and equilenin sulfate. Taken orally, they must pass through the liver before entering the blood system, and that is where the problems occur. The liver primarily metabolizes estrogens, and conjugated estrogens inhibit the production of bile, sometimes causing jaundice. Premarin has also been known to elevate liver enzymes, causing a rise in clotting factors, which increases the chances of clots in the veins and lungs. When bioidentical pellets are the method of hormone replacement therapy used, there is no danger to the liver. Pellets are inserted into the fatty tissue of the buttocks and dissolve there over time. Hormones will be absorbed naturally and gradually into the bloodstream without ever even passing through the liver. In addition, bioidentical hormones are not nearly as potent as those conjugated estrogens from horses.
  • The side effects of Premarin, Provera, Prempro, and other conjugated estrogen products are dangerous and well-documented. They cause more problems than they solve.
  • Synthetic hormones are formulated to treat symptoms but do not get to the root of the problem.

Find a Location Today





Southern Pines




Charlottesville, VA


Schedule an appointment now