Understanding Bioidentical Hormones and Compounding Pharmacies

Often patients have misinformation about bioidentical hormones and compounding pharmacies since there is so much confusing and misleading information out there about both of them. Hopefully this sheet will clear up some misunderstandings and misconceptions.

Bioidentical hormones – are products in which the chemical makeup of the hormones exactly matches the chemical makeup of the same hormones in your body. They can be man-made but the molecular components are exactly the same. For example, if you look at bioidentical estrogen under a microscope it would look exactly the same as the estrogen your body produces. It may have been created chemically, in a laboratory, but the components of the compound match your body’s compound.

  • Bioidentical hormones” does not mean that the hormones are “organic.”
  • Bioidentical hormones” does not mean that the hormones are “natural.”
  • Bioidentical hormones” does not mean that the hormones are “not really hormones.”

So why does anyone make non-bioidentical hormones?

Bioidentical hormones cannot be patented. The same way you can’t patent water, unless you add some flavorings to it, you can’t patent estrogen unless there is something different about your estrogen.  So drug companies are incentivized to change the chemical compound and make it “unique”. Sometimes makers of specific hormones suggest that the difference they have made is a “good” difference and thus justify the changes. We haven’t found that to be the case. In general we find that women seem to respond better to bioidentical hormones.

Since many women prefer the bioidentical compounds, drug companies have found ways to patent bioidentical hormones by developing better or unique delivery systems. While they can’t patent the product itself they can patent a specific cream that was created to contain the hormone or the spray, patch or pellet which contains the hormone.

Compounding Pharmacies – are pharmacies that make medications on the premises. They are often used when a physician does not want to use a standard medication but wants to personalize a medicine for a particular patient. Compounding pharmacies can make bio-identical or non-bioidentical hormones. It just depends what is ordered by the prescribing doctor. Sometimes patients assume that if the medicine (or hormone) is being mixed specifically for them it must be safer or more natural. That is not necessarily the case. Products bought from FDA approved companies have rigorous safety standards and are not as subject to human error. For that reason, where possible we try to use bioidentical products that are prepackaged for commercial use and not compounded by a compounding pharmacy. When we are using a medication that is not available in a pre-prepared product, we will have them compounded by a compounding pharmacy.

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