I’ve always been wary of anything that messes with my body chemistry. For most of my life, I’ve sidestepped medications, avoided vaccinations unless absolutely necessary, and trusted my body to sort itself out. And it has – largely – apart from a few blips.
So when HRT entered the conversation, I didn’t leap — I tip‑toed. I read everything I could get my hands on, pored over studies, and spoke to women who had already walked this strange, shifting landscape of menopause. Do read the section I put together on Existing Research.
My aunt — eternally youthful, elegant, and full of opinions delivered in that soft, posh voice of hers — was adamant.
“Oh darling, you want to be as natural as possible.”
She meant BHRT, of course. Bioidentical. Body‑identical. Wrapped in the comforting glow of the word “bio,” which sounds wholesome, earthy, pure. And I get it — the branding is seductive. It whispers of nature and goodness and gentle solutions.
But the truth is far less romantic. Women are often sold the idea that “bio” means natural, when in reality it simply refers to the molecular structure of the hormone — not its purity, not its origin story, not its safety. Both BHRT and HRT hormones are made in labs. And compared with bog-standard HRT, the research base for compounded BHRT is much thinner.
So, stripped of the marketing lines, the differences look more like this:
- BHRT hormones come from plants but are still made in a lab, just like standard HRT. Neither is “natural” in the way the word suggests — both are manufactured, both are processed, both are chemistry.
- Compounded BHRT requires regular doctor visits to adjust doses, because each batch is mixed individually. These compounded products aren’t regulated in the UK, which means their consistency isn’t monitored in the same way as standard HRT.
- BHRT isn’t covered by health insurance, and the cost adds up quickly — consultations, blood tests, monitoring, bespoke formulations. It’s a commitment not just of belief, but of budget.
None of this is about dismissing anyone’s choices. It’s about cutting through the haze of marketing and myth so women can make decisions with clarity, not confusion. And for someone like me — someone who approaches anything chemical with suspicion and a raised eyebrow — that clarity matters.
Commercial BHRT refers to standardised formulation (one size fits all) and Compounded BHRT refers to those that are tailor-made/designed for an individual.
HRT or BHRT – they both start in the lab.
There is no evidence that BHRT is safer or more effective than standard HRT, though in the coming weeks, I will track down a medical professional who is offering BHRT and get their views. Because it is all about looking at all angles of a topic, not be blinkered. Drop me a line at jkfab4050@gmail.com so that I can notify you when I have the info.
Here’s a piece of research related to BHRT by Dr Louise Newson, one of the menopause experts in the UK, on:
https://pmc.ncbi.nlm.nih.gov/articles/PMC6808563
I would still stick to doing exercises and eating healthily as the most important part of menopause self-care.
