Bioidentical is believed to be the best and safest because it is identical in molecular structure to our body produced hormone. Since it is exactly the same it should be the safest. Chemically produced or processed hormone is believed not a natural compound and may cause more side effect than benefit.
“Natural” hormones would be better or safer — but the term “natural” is open to interpretation.
The product that has the principal main active ingredient sourced from an animal, plant, or mineral source is called natural, in a technical term. We do not take into consideration whether the substance is ground, put into capsules, and sold over the counter (OTC). Or for that matter if it is extracted in a laboratory, manufactured by a pharmaceutical company, and made available only as a prescription drug. Take for an eg, the soy plant is the source of supplements that some women take to ease menopausal symptoms. The soy is also used, along with yams, to make the estrogen in the FDA-approved hormone drug Estrace.
Estrace is regulated and is a prescription hormone. The soy supplements aren’t regulated and haven’t been rigorously tested in humans, so we don’t know whether they’re safe or effective. But in general, we presume it is safer. There’s some evidence that certain soy components may actually stimulate breast tumor growth. So “natural” may not necessarily equal “safe” — and may simply be a euphemism for “unregulated”.
Enter “bioidentical” hormones
The bioidentical hormone is not found in this form in nature but are synthesized, from a plant chemical, which is extracted for eg from yams and soy.
Bioidentical estrogens are:
Bioidentical progesterone is simply progesterone. It’s micronized (finely ground) in the laboratory for better absorption in the body.
Bioidentical hormone therapy is often called “natural hormone therapy” because bioidentical hormones act in the body just like the hormones we produce.
However, that tricky word natural muddies the waters. Take an illustration. Pregnant mares’ urine is natural, but Premarin is not bioidentical, at least not to human estrogen. This is because in technical term, the molecule is not exactly the same for horse and human although it is found naturally in the house. The same goes for Cenestin, which is made from plants but is not bioidentical.
Technically, the body can’t distinguish bioidentical hormones from the ones your ovaries produce. The natural hormone from the horse gives a very similar metabolic behavior. When you do a blood test, your total estradiol reflects the SUM TOTTAL of bioidentical estradiol you’ve taken PLUS the estradiol your body makes.
On the other hand, Premarin is metabolized into various forms of estrogen that aren’t measured by standard laboratory tests.
Proponents of bioidentical hormones say that one advantage of bioidentical estrogen over Premarin is that estrogen levels can be monitored more precisely and treatment individualized accordingly.
However, the skeptics counter that it hardly matters, because no one knows exactly what hormone levels to aim for, and symptoms, not levels, should be treated and monitored.