- 'Body-identical' HRT has the same molecular structure as your own hormones and is regulated for safety and quality.
- 'Bioidentical' HRT usually refers to unregulated, custom-mixed hormones from private compounding pharmacies.
- The NHS prescribes body-identical HRT because its safety, dosage, and effectiveness are supported by large-scale medical evidence.
- Always be cautious of treatments that are not regulated by the MHRA (Medicines and Healthcare products Regulatory Agency) in the UK.
What is Body-Identical HRT?
Body-identical HRT uses hormones that are precisely the same molecular structure as the ones your ovaries produce: oestradiol, progesterone, and sometimes testosterone. These hormones are derived from plant sources (usually yams) and are manufactured to strict pharmaceutical standards.
Crucially, they are regulated and licensed medicines. This means they have been rigorously tested in clinical trials for safety and efficacy, and every batch is consistent. The HRT you receive from your GP or an NHS specialist will be body-identical.
Understanding 'Bioidentical' HRT
The term 'bioidentical' has, unfortunately, become a marketing term. It is most often used to describe custom-compounded HRT, where a private pharmacy mixes a bespoke cocktail of hormones, often based on saliva tests. These products are not regulated in the same way as licensed medicines.
This means there is no robust evidence to support their safety or effectiveness, and the dose you get can be inconsistent. While they sound appealingly 'natural' or 'tailor-made', the lack of regulation is a serious concern for medical professionals.
Regulation: The Crucial Difference
The key difference is regulation. Body-identical hormones like Estradot patches or Utrogestan capsules are proven treatments. We know their risks and benefits from decades of research involving thousands of women.
Compounded 'bioidentical' hormones do not have this evidence base. The risks are unknown, and the benefits are unproven. For this reason, all major medical bodies in the UK, including the British Menopause Society, recommend using regulated body-identical HRT over unregulated compounded versions.
Frequently asked questions
I've seen adverts for 'natural' bioidentical HRT. Is it safer?
The term 'natural' can be misleading. While the base hormones in both often come from plant sources like yams, body-identical HRT is produced to strict pharmaceutical standards. Unregulated compounded bioidentical hormones do not undergo the same rigorous safety and quality checks.
Why do some clinics offer compounded bioidentical HRT?
These are typically private clinics operating outside of standard NHS practice. They offer bespoke mixtures, often based on unproven saliva tests, but these products are not subject to the rigorous testing for safety, efficacy, and dosage consistency that licensed medicines are.
Is body-identical HRT available on the NHS?
Yes, absolutely. Most modern HRT prescribed in the UK today is body-identical. This includes 17-beta oestradiol in patches, gels or sprays, and micronised progesterone (Utrogestan) capsules.
Are saliva tests to determine my hormone needs accurate?
Saliva and blood hormone testing are not considered reliable ways to guide HRT dosage for menopause symptoms. Your hormone levels fluctuate constantly, and treatment should be guided by your individual symptoms and a collaborative approach with your doctor, not a single snapshot test.
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