Q. I take hormone replacement in the form of bio-identical hormones from a compounding pharmacy. The prescription is a triple-estrogen compound with progesterone. The compounding pharmacist stated that because all three forms of estrogen are used, the risk that accompanies Premarin or Prempro does not exist. Conventional hormone replacement does not contain all three forms of estrogen.

Is this accurate? I have tried conventional hormone replacement in the past and was completely miserable, while I feel great using the bio-identical product.

A. Conventional hormone replacement therapies such as Premarin and Prempro contain a variety of estrogenic compounds. These are, however, estrogens that horses make, so they may be somewhat different from the estrogens your pharmacist used in compounding your prescription.

There are many claims that compounded hormone therapy is safer than conventional HRT. There are no studies to prove that statement, however. The FDA considers claims that bio-identical hormones are safer or better than conventional therapies to be false and misleading.

To better understand the pros and cons of hormones, we are sending you our Guide to Estrogen: Benefits, Risks and Interactions.

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  1. Sylvia
    Tampa, Fl

    Was wondering if you have any thoughts about Phytob L 4X It contains: Progesterone 40 MG and Estrogen 2 MG. Its made by: Bezwecken.

  2. dj

    Many people are asking where to go for bio-identical hormones. Just go to your regular doctor and tell him that you want to begin hormone replacement therapy. Tell him you want to use the Climara patch, plus Prometrium. These are bio-identical AND FDA approved. You get them at the regular pharmacy and insurance will cover them (you might have to get the generic).
    This is what I did and I am so happy. This stuff gives you your life back. My doctor had never prescribed these before. He gives all his patients Premarin but he looked up the dosages and was happy to give me what I wanted to try. I feel like a new woman. Caution: take the prometrium at bedtime. It has a tendency to make you feel and act intoxicated. By morning, this side effect is gone.

  3. RS

    Yes, bioidentical hormones will help you. Don’t let these hormone balancing Drs talk you into massive doses of testosterone. There are side effects.

  4. Cat-aholic

    I am in the almost exact boat you are in! I have been taking Bio/identical hormone replacement, but it seems to have several undesirable side effects… severe leg cramps, severe sweats, hot flashes and breast pain. Are there different formulations? My doctor has tried different strengths… I am on the lowest dose of Progesterone and Estrogen.

  5. H.T.

    I am 53 years old and have been in menopause for 5 years. I have had hyperthyroidism and hypo, I am taking synthroid have been for 4 years. Ever since I stated menopause my health has been going down hill. I have suffered with numerous issues, such as depression, irritability, horrible mood swings, aching joints, back pain, disc disease in my L5 disc, and chronic fatigue, amongst many, many more problems.
    Now I have never taken hrt in my life, tried to conquer my menopause myself, but I am getting too tired and sick. Just got diagnosed with IBS. Another hormonal imbalance, things just keep happening to me. So I went to see a doctor and now I have started Bio-identical estrogen and progesterone, my question is: how long will it take for this stuff to really, really make me feel better than I have in the past 5 years or so? And will this HRT CREAM honestly make a change in my health and well being???????? NEED TO KNOW, PLEASE HELP ME

  6. H.T.


  7. Cat-aholic

    I am 53 and menopausal. I am currently not taking anything, my concern is that I have been diagnosed as being very low on hormones by a bio-identical doctor. Could this be the reason for sudden wrinkles and losing elasticity in skin?

  8. Meschell

    I started using the Combi- Patch at 45 for Peri-Menopause symptoms. It contains ESTRADIAL…which is bio-identical estrogen, and Medoxyprogesterone…which is man made progesterone. I had no problems with the Medoxyprogesterone. 3 years later I switched to Estradial pills AND PROMETRIUM pills…which is a bio-identical identical form of Progesterone.
    The difference between the 2 forms of Progesterone is outstanding. Within 90 minutes of taking the Prometrium, I’m higher than a kite, and it’s all legal!! It makes me feel pure bliss. I was supposed to take the prometrium at night, taking 2 100mg pills, but I can’t take 200 mg at the same time because it makes me feel drunk and unable to walk straight, and I will slur my words a little.
    Can you imagine what the police might think? I take the Estradial and one prometrium in the morning, and one prometrium in the evening before bedtime. Again, within 90 minutes that high comes back. Sleep like a baby, feel happy, life is GOOD! I’ve heard that women aren’t supposed to use HRT longer than 5 years max…Forget that! After menopause a woman’s chance of having a heart attack equals a man’s!
    I also havde mild Osteoporosis in my left femur, so I clearly NEED the Estrogen. I suffered from mild hot flashes, terrible nightmares, and heart palpitations before I started HRT. Within a few days, everything went bye-bye. If I try to stop using HRT it all comes flooding back with 48 hours. I guess I’m hooked, I consider myself a Hormone Junkie and I’m not ashamed about it.

  9. DJ

    How does one find a doctor that prescribes bio-identical hormone therapy?

  10. dba

    I took HRT (prempro) for 11 years and when I stopped, my sometimey headaches turned into frequent migraines. After two years off, controlling headaches somewhat with Topamax, I am considering going back on prempro. I am 61.

  11. S.B.S.

    I have been taking a compounded hormone for the past 15 years since my hysterectomy. I could not tolerate the regular HRT pills, but have had no problems with the compounded ones. I have however reduced the amount I am taking to one pill per day instead of two.

  12. Cindy

    I was taking bio-identical HRT and was very happy with it, but it was taken away from me because I had a history of DCIS (ductal carcinoma), a “stage zero” breast cancer — too early to even test for estrogen-receptivity!
    Plus I am doing EVERYTHING POSSIBLE to reduce the numbers re any relapse (massive greens, gallons of green tea, all products and foods 100% natural and organic, etc. etc.) I’m certain the resulting reduced-risk more than offsets any increased-risk from the HRT. WHY aren’t there any studies proving bio-ident. HRT safer? Because there isn’t any money in it! Pure and simple. If I can find a willing MD, I’ll be back on the bio-HRT.

  13. Christy B.

    I took Premarin for 10 years. Soon after I stopped, my frequent, severe migraines virtually ceased, and did not recur when I began using generic estradiol. I will never again use horse estrogen.

  14. Joy

    I am very interested in the Bio-identical hormones. Do they come in different dosages as the synthetic one?
    Are some of better quality?

  15. GMSava

    I don’t know why you Joe and Terry, never have Jonathan Wright, developer and major authority on BHRT on your program. He would provide you with a wealth of information on BHRT. There is indeed a wealth of research as well as over 20 years of use of BHRT, although the FDA has not been “paid” for their approval. Please consider having him on your excellent program. Also, my wife has used tri-est, nat. progesterone and nat. testosterone for years with great success. She would experience severe depression when she tried to use the “horse” estrogens and synthetic progestins. She is now 65 and in great shape.

  16. Carol

    My experience with BIO/Identical HRT was the following; After taking them for 3 months I started having pains in my breasts. They took another Mamogram which was OK. I was rec to stop taking the compounded HRT. The pain did go away.
    Yes I did feel better while on the Compounded HRT. My insurance did cover it also. Or most of it.
    I was told by my Dr even though it is labeled Compounded and Bio/Identical Hormone it is still a Hormone.

  17. J.S.

    I was unable to tolerate traditional HRT due to several side effects. I also found the overall benefits of those procduts to be less than what I am getting with Bio-Id/compounded therapy. This has worked with increased effectiveness for me; without some of the side effects I had on conventional HRT. In the beginning I did not wish to take ANY of these products but since my symptoms were severe and not helped by other means such as black cohosh, etc, I sought further help. Bio-Id. hormones have been the way to go for me.

  18. FR

    I had used bioidentical hormone therapy for 10 years but eventually I developed a thick lining in the uterus and had to have a D&C. My doctor felt that the natural form of progesterone was not strong enough and she insisted I take Provera. I then stopped all replacements.
    I am not sure if the same thing would have happened if I had been taking the artifical hormones all along.

  19. Annette

    I, too am taking bioidentical HRT and have been very pleased with them. The testosterone I’m taking (as well as estrogen and progesterone) have given me my life back and my libido! And NO hot flashes. Whether or not the FDA approves of these (they get NO kickbacks from the pharmacies who make them), I believe that they are safer and the psychological benefits are great.

  20. Betsy

    Bad reactions-severe reflux-to bonedensity meds led to research on other factors causing bone density loss. Local practioner, not my doctor, suggested my hormone levels might be a factor(I dont take any , am 63, many life aspects counter my low readings) Interest in bioidenticals is high if less risky. Family history of cancer though not breast cancer steered me away from hormones early.

  21. Barbara

    I agree with this woman, I feel much better on a low dose of compounded HRT. My insurance does not cover the medication but I gladly pay for it because I am so much more comfortable on it!

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