Bioidentical hormone replacement therapy (BHRT) is a type of hormone therapy that uses hormones that are structurally identical to those produced naturally in the body. The following hormones are typically candidates for BHRT:
Because your body can't tell whether the hormones came from your glands or the pharmacy, BHRT is arguably safer than synthetic hormone medications merely mimicking the function of these hormones.
In addition, there are many studies over the last 30 years that have shown BHRT as a safe and effective strategy for treating hormone imbalances – provided that appropriate hormone testing is used to individualize your dose to your specific needs.
In addition, because you're supplementing the natural hormone levels with the identical hormones, we are able to properly monitor hormone levels through standard lab tests measuring progesterone, estrogen, testosterone, DHEA, cortisol and T3/T4 thyroid hormones.
As we age, our hormones naturally decline – which can cause symptoms that are obviously hormonal while other symptoms may be falsely attributed to other causes.
Often, your doctor may not connect the dots of certain symptoms (like muscle pain, anxiety, insomnia or weight gain) with hormonal imbalances.
They may prescribe painkillers or antidepressants, or simply tell you to “eat better and work out more” when none of those recommendations will actually address the underlying issues.
They may also tell you “it’s just a sign of getting older”! While some physical wear and tear as we age is perfectly normal, hormonal imbalances can blindside you with a wide range of crippling symptoms and increase your risk for chronic illnesses down the road like cognitive decline, heart disease, depression and more.
Responsible BHRT practitioners excel at testing your hormone levels to better understand which symptoms might actually be hormone-related. This also allows them to give you a more customized dose to address your unique needs without "megadosing" your body with excess hormones that can create additional symptoms.
Depending on your situation, lab tests often involve a mix of blood, urine or saliva tests and you may get repeat-tested once you are on BHRT to be sure you are on the optimal dose. Here are some of the chronic symptoms that might be helped with BHRT:
BHRT and traditional HRT differ in the hormones that are used:
Bioidentical hormone replacement therapy uses hormones that are structurally identical to those produced naturally in the body.
Traditional hormone replacement therapy (HRT) relies on synthetic hormones mimicking the naturally occurring hormones (for example, medroxyprogesterone also known as progestin) – these synthetic hormones aren't an identical match to the naturally occurring hormones.
The most common form of hormone delivery is oral tablets and capsules. These are taken daily and can be easily integrated into a patient’s routine.
This is one of the simplest forms of delivery and they come in standard doses (which you can find in any local pharmacy) or can be compounded to give you a more personalized dose depending on your needs.
In some cases, your BHRT practitioner may recommend other forms of delivery such as injections or creams if an individual requires larger doses or may have any absorption issues with oral medications.
Another way to deliver hormone replacement is through injections or placing pellets under the skin, which are usually done every three months depending on what type of hormone is being administered.
Pellets administered under the arm or hip area bypass the digestive system which may be a better for people with severe digestive conditions.
The disadvantage with injections and pellets, especially for women, is that hormones are delivered all at once and can cause spikes or peaks, whereas daily oral medications and other forms are more gradually released which better mimic their natural cycle.
That said, finding the right form of BHRT delivery is a case-by-case consideration and many clients see excellent results with hormone pellet therapy.
Creams, gels and patches are another popular form of hormone delivery. These topical treatments allow for easy absorption through the skin and provide an accurate dosage each time they are applied.
Furthermore, they eliminate any potential risk associated with injections since there is no need for needles or syringes when administering these treatments.
The downside is that they may not always provide enough medication for those who need higher doses due to their lower potency levels compared to other forms of delivery such as injections or tablets/capsules.
It’s important to work with a qualified BHRT practitioner who can not only help with current symptoms and but also guide the correct dosing and delivery system such as pills, creams, patches or pellets.
Once we do the correct testing, we craft a precise BHRT plan so you can live an energized, confident life feeling and looking your best… especially if you feel unheard and literally don’t know what to do next.
So if you’re ready to explore how to approach hormonal imbalances, then claim your free discovery consult with to help you map out an effective BHRT strategy based around…
We’ll explore your desired treatment goals, we go over what’s expected and whether BHRT is right for you.
We offer these short discovery consult for FREE so you can get more clarity & confidence and to understand if BHRT is right for you so that you can make an informed decision. We believe you can't make new decisions without new information, so this discovery consult is your chance for a personalized assessment.
Your safety comes first. Hormone therapy is considered when symptoms are bothersome and benefits outweigh risks for you. If you still have a uterus, estrogen must usually be paired with a progestogen to protect the uterine lining. If you’ve had a hysterectomy, estrogen alone may be used. We review your history (breast/uterine cancer, blood clots, stroke, heart disease, liver disease, migraines with aura, unexplained bleeding), medicines, and goals before making a plan. We also check blood pressure and discuss family history.
Pellet therapy uses small implants placed under the skin that release hormones over months. Because pellets are typically compounded (not FDA-approved products), dose consistency and safety data are more limited than with approved patches, gels, sprays, or pills. Pellets can’t be removed easily if the dose feels too strong. Local site issues (tenderness, bruising, infection, or rare extrusion) can occur. For these reasons, major medical groups recommend using FDA-approved formulations when possible and reserving compounded pellets for special situations. If a pellet route is chosen, we’ll set a careful follow-up plan and keep the dose as low as needed for symptom control.
Most healthy women who start systemic hormone therapy before age 60 or within 10 years of menopause have a favorable benefit–risk profile for hot flashes/night sweats and bone protection. Risks depend on type, dose, route, and timing; we’ll personalize and reassess regularly. Seek urgent care for chest pain, trouble breathing, sudden severe headache, one-sided weakness, vision changes, or heavy unexplained vaginal bleeding.
No. “Bioidentical” describes molecular structure, not risk. Safety depends on dose, route, timing, and your personal history. We individualize and monitor.
If you have a uterus, yes–adding a progestogen protects the lining. If you’ve had a hysterectomy, estrogen alone may be used.
Transdermal estrogen may have a lower risk of blood clots for some women and avoids first-pass liver effects. We choose the route that fits your risks and preferences.
Pellets are usually compounded and can’t be quickly adjusted or removed. Some women prefer them, but major groups recommend FDA-approved options first. If pellets are used, we monitor closely.
Many notice fewer hot flashes and better sleep within a few weeks. Fine-tuning dose and route can take a bit longer.
That’s a specialized discussion with your oncology team. Non-hormonal options are often preferred. We’ll coordinate care.
By improving sleep and vasomotor symptoms, BHRT often helps mood and daily function. Lasting weight changes still rely on nutrition, activity, stress, and sleep.
Telehealth is available after your first in-person visit at Halo Concierge Health.
We review your goals and history and outline smart first steps. We can go over specific tests, treatments, and services as part of that call.
You may also want to read about Perimenopause, and Medical Weight Loss, since these areas often interact with hormone balance, sleep, energy, and long-term health.
Medically Reviewed By: Halo Concierge Health
Halo Concierge Health is located in Raleigh, NC and serves practice members throughout North Carolina and Virginia. These areas include but are not limited to Raleigh, Wake Forest, Durham, Chapel Hill, Cary, Morrisville, Apex, Holly Springs, Fuquay-Varina, Garner, Clayton, Rolesville, Zebulon, and Mebane with options for follow-up telemedicine appointments.