BHRT vs. HRT for Menopause: Understanding the Difference

What are the key differences between BHRT and HRT?

BHT and HT are both treatments for menopause symptoms but have some stark differences:

Source of hormones

The main difference between BHT and HT is the source of hormones.

HT uses lab-made (synthetic) hormones that may sometimes be animal-derived. BHT uses plant-based hormones that are modified to be chemically identical (“bioidentical”) to hormones your body produces.

Put another way, the hormones used in HT are similar to those your body produces, whereas the hormones used in BHT are identical to those your body produces.

Ability to customize treatment

HT formulations are standardized by the Food and Drug Administration (FDA). They can come in the form of:

• oral tablets
• transdermal patches, gels, creams
• vaginal rings, tablets, creams

BHT uses plant hormones to match your individual hormonal needs. It can be:

• Compounded: custom formulation prepared by a pharmacy
• Commercial: pre-made and standardized formulation
• Topical: cream or gel formulation to apply to your skin

Is BHRT more effective than HRT?

HT and BHT both aim to relieve symptoms of menopause, such as night sweats and hot flashes. It does this by replenishing the hormones your body makes less of during menopause.

You might have heard the claim that bioidentical hormones are safer and more effective than synthetic hormones because they’re more natural and, therefore, more compatible with your body.

No current evidence suggests that this is true. BHT is a relatively new treatment, and more research is needed on its benefits and long-term effects.

A 2020 statement from the National Academies of Sciences, Engineering, and Medicine says compounded bioidentical hormone therapy should only be used in certain situations, such as if you’re allergic to the FDA-approved formulations.

HT, on the other hand, has been extensively studied in clinical trials. Several formulations have received FDA approval, while BHT is yet to be regulated.

What should I consider when choosing between BHRT and HRT?

Speak with your doctor when deciding between BHT and HT. They can provide their recommendations and determine whether the benefits of one treatment outweigh the risks.

You may want to prepare questions beforehand, such as:

• Is one therapy safer than the other?
• What side effects can I expect with the hormone(s) I take?
• Does BHT or HT increase my risk for certain health conditions?
• How long until I see improvements in my symptoms of menopause after starting therapy?

To help inform your doctor’s recommendation, they’ll also consider:

• your hormonal needs
• your preferred mode of administration
• the latest research

Is hormone therapy the only option for managing menopause symptoms?

HT isn’t for everyone, and it’s only one approach to treating menopause symptoms.

Speak with your doctor to explore all the options available to you for menopause symptom treatment.

Check out Healthline articles on these topics for at-home menopause symptom management:

• alternatives to HT
• tips for coping with vasomotor symptoms
• hair loss prevention tips
• vaginal lubrication products for dryness
• treating insomnia

Takeaway

Bioidentical hormone replacement therapy (BHRT) and hormone replacement therapy (HRT) are two hormonal approaches for treating menopause symptoms.

Which one is right for you depends on your individual hormone needs and preferences. Speak with your doctor to determine the benefits and risks of each treatment.

If a hormone-based therapy isn’t right for you, other treatments and management strategies for menopause symptoms exist. Your doctor can help you explore all your options to find the most suitable one(s).