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HRT basics · Bioidentical

BHRT (bioidentical hormone replacement) explained

BHRT — bioidentical hormone replacement therapy — has become a marketing term. Some clinics use it to mean compounded hormones with unregulated dosing. But the technical definition is simply: hormones molecularly identical to what the human ovary produces. The good news: FDA-approved estradiol patches, gels, and micronized progesterone are all bioidentical.

The bioidentical hormones we prescribe

  • Estradiol — patch, gel, spray, ring, vaginal cream/tablet
  • Micronized progesterone (Prometrium) — oral, at bedtime
  • Vaginal DHEA (Intrarosa) — for GSM
  • Testosterone (compounded cream) — for indicated cases

What we do not use

  • Compounded pellets (over-dose women; not adjustable)
  • Estriol-only creams (not sufficient for systemic HRT)
  • Salivary hormone testing for treatment decisions
  • Synthetic progestins when micronized progesterone works

Bottom line

Bioidentical HRT is the standard of care at Kindr — but we get it from FDA-approved products, not marketing-driven pellet clinics.

Frequently asked questions

What does "bioidentical" mean?

Molecularly identical to endogenous human hormones — estradiol, estriol, estrone, progesterone, testosterone.

Are FDA-approved HRT products bioidentical?

Most modern HRT is. Estradiol patches, gels, and sprays are bioidentical estradiol. Prometrium is bioidentical progesterone. These are our defaults.

Are compounded BHRT pellets better?

No evidence they are. Pellets often over-dose women, are non-adjustable once implanted, and lack FDA oversight. We do not use pellets.

What about salivary hormone testing?

Salivary testing is unreliable and not endorsed by NAMS. Symptoms plus serum labs when needed drive treatment decisions.

Is compounded ever appropriate?

Yes — for testosterone (no FDA-approved female product), for combination creams, or for specific allergies. Not for routine estrogen/progesterone.

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Related: FDA peptide review July 2026 briefing · Peptide therapy hub · Longevity service

Medically reviewed by Kindr Health Clinical Team · Last reviewed 2026-06-19. Compounded medications are prepared by FDA-registered 503A pharmacies and are not FDA-approved drug products.

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