Bioidentical Hormone Therapy (BHRT)

Body-identical (bio-identical) hormones have the same molecular structure as the hormones your body makes, such as oestradiol and progesterone. Older hormone therapy often used different molecules, such as conjugated equine oestrogens and the synthetic progestin medroxyprogesterone acetate. An important distinction is between regulated body-identical products, which are licensed medicines with tested doses and purity, and custom-compounded "bioidentical" preparations, which are not.

The Women's Health Initiative (WHI) study that alarmed the medical world in 2002 used conjugated equine oestrogens and medroxyprogesterone acetate. Later research has looked at other combinations. The French E3N cohort study of 80,377 postmenopausal women (Fournier A et al., Breast Cancer Research and Treatment, 2008) found that oestrogen combined with micronised progesterone was not associated with increased breast cancer risk over an average of about eight years, unlike oestrogen combined with other progestogens. It is an observational study, so it shows an association, not proof. The North American Menopause Society supports regulated body-identical preparations, such as oestradiol and micronised progesterone, and advises against custom-compounded bioidentical hormones because their dose, purity and safety are not regulated.

Our BHRT Protocol is relevant for both women and men. In women, perimenopause and menopause produce declining oestradiol, progesterone, and often testosterone — leading to hot flashes, sleep disruption, mood changes, vaginal atrophy, bone loss, and increased cardiovascular risk. In men, age-related hormonal decline affects testosterone, DHEA, and thyroid hormones. Where treatment is appropriate, we use regulated body-identical preparations.

Treatment begins with a comprehensive hormone panel, detailed symptom assessment, and medical history review. Our physician, with endocrinologist sign-off, then designs an individual plan. For women this may include transdermal oestradiol and oral micronised progesterone. Testosterone for women is considered only where international guidance supports it, mainly for low sexual desire after menopause. The aim is the dose that controls symptoms with the least risk, not a target "optimal" level. Follow-up labs at 6-8 weeks allow dose adjustment, and regular monitoring checks ongoing safety.

We prescribe licensed, regulated products and do not use custom-compounded hormones. The route (for example transdermal or oral) is chosen for each patient's needs, risks and preferences. Book a consultation with our longevity physician to have your hormonal health assessed.