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Bio-identical hormones have the same chemical structure as those that occur naturally within our own bodies. They are derived from plant sources, such as diosgenin which comes from wild yams and betasitosterol from soya bean plants. These are then manufactured into products which can be taken orally or through creams and skin patches. Some people also market the treatment as BODY-identical hormone replacement therapy. As bio-identical hormones have an identical chemical structure to our own hormones, the body does not reject them, nor consider them to be foreign in any way, and the way that they are handled by the body is the same as for your naturally occurring hormones. For this reason, bio-identical hormones are often referred to as ‘natural’, due to their likeness to the natural molecular structure of our own hormones, (and not because they come from sources found in nature). Synthetic hormones, used in conventional Hormone Replacement Therapies (HRT), which are synthesised by pharmaceutical companies, have a chemical structure that is similar, but not exactly the same, as the hormones produced by our bodies. These chemical differences can mean that synthetic hormones act differently in the body and can produce different effects, as well as some unwanted side effects. Bio-identical hormones can therefore be beneficial to those who have a hormone imbalance or who have previously tried other treatment options, including conventional HRT, and have experienced unwanted side effects; or are concerned about any associated health issues. HRT has been around since the 1930s and their use to alleviate menopausal symptoms has been commonplace in the UK since the 1960s. The hormones used may be derived from the urine of other pregnant mammals such as Premarin® (progesterone) which is taken from mares (female horses). Oestrogens can also be synthesised from other sources, and some have been chemically altered from plant-based extracts. BHRT has only been used within the NHS to treat women for menopausal symptoms if there is a medical reason why they cannot receive the conventional HRT hormones prescribed for this condition. They have been used for approximately 20 years in Europe. Sadly, there is a lack of large-scale, long-term clinical study evidence to support BHRT, even though it is true that there is no evidence that these bio-identical hormones cause the same side effects as conventional HRT. The rise in interest in bio-identical hormones was linked to the 2002 reports on HRT risks and side effects which caused a stampede away from HRT. Research into the long-term effects of HRT has been linked with many side effects such as an increase in uterine, ovarian and breast cancers and heart disease. The latest study published in 2016 seemed to suggest that the warnings released in 2002 underestimated the detrimental effects of HRT. It is not yet clear whether these side effects are due to their structure the medicated dosage, or the way that they are metabolised within the human body. Not surprisingly this meant that doctors and their patients were reluctant to use HRT to treat menopausal symptoms such as hot flushes, sleeplessness and tiredness. Up until 2002 is was not unusual for women to be given HRT when the menopause commenced, and well beyond, in a very long-term course of treatment. Currently, the guidance is for the lowest dose possible for the shortest amount of time. The risk of developing any of these side effects reduces once the HRT course is completed. The other problem with conventional HRT is that the pills come in certain predetermined dosages and can only be prescribed in this way by a GP. Bio-identical hormones are not synthesised or extracted from other animals but come directly from plant sources. They do however have to be processed to make them suitable to be delivered into the human body; to make them absorbable so they can have their effect on their target cells and be broken down metabolically. They can also be prescribed to an exact measure for each patient and made up by a pharmacist to that individual prescription. Therefore, they are becoming a more widely available option for private clinics to offer to their clients. A BHRT programme starts with a consultation and a saliva, urine or blood test to determine if there are any hormone deficiencies. As hormone levels in the human body fluctuate, a hormone level check is only a moment in time and any deficiency should be carefully considered and monitored, along with a discussion of symptoms or problems being experienced over time.

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