What is the difference between bioidentical and synthetic hormones?
Reviewed by Dr. Ana Lisa Carr, MD, MBA · Last reviewed May 10, 2026
Answer published
"Bioidentical" means the molecule is structurally identical to the hormone your body produces. FDA-approved bioidentical estradiol and micronized progesterone are widely available, well studied, and what most evidence-based menopause clinicians prescribe. The term is sometimes confused with compounded "bioidentical hormone replacement therapy" (cBHRT) — custom-mixed pellets and creams from compounding pharmacies — which lack rigorous safety and efficacy data and are not endorsed by NAMS, ACOG, or the Endocrine Society. The distinction matters: pharmaceutical bioidentical ≠ compounded.
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