Bioidentical vs synthetic hormones — understanding the difference and what's available in SA.
Bioidentical hormones are chemically identical to the hormones your body produces naturally — primarily 17-beta oestradiol and micronised progesterone. They're derived from plant sources (soy and yams) and are available in regulated pharmaceutical products as well as custom-compounded formulations.
Regulated bioidentical HRT (patches, gels, pills from pharmaceutical companies) undergoes rigorous quality control and safety testing. Compounded bioidentical hormones (custom-mixed by compounding pharmacies) are not FDA/SAHPRA-approved and may vary in dose and purity. Regulated products are recommended by most medical societies.
Proponents report fewer side effects, better symptom relief and a more 'natural' approach. Micronised progesterone is associated with better sleep and fewer mood side effects than synthetic progestins. The evidence for compounded formulations is limited.
The choice between regulated bioidentical HRT, compounded hormones and synthetic options should be made with a knowledgeable healthcare provider. Regulated bioidentical products offer the best balance of efficacy, safety and quality control. Be wary of marketing claims for unregulated products.