Menopause often brings disruptive symptoms that impact a woman’s health and quality of life. Hot flashes, night sweats, mood swings, sleep issues, bone changes, and weight gain that doesn’t seem to respond to diet and exercise are all common frustrations for women in this natural phase of life.
Bioidentical hormones, which are plant-derived compounds chemically identical to the hormones your body naturally produces, are often used in hormone therapy to help alleviate menopause symptoms and restore balance.
Unfortunately, for many years, women were led to believe that hormone therapy for women was dangerous, leaving millions of women unnecessarily suffering. The initial widespread fear of HRT was primarily based on outdated studies and misunderstandings of the risks.
While there are still many myths about female HRT circulating, thanks to updated, more accurate clinical studies and re-analyses of past data, we now know that many safety concerns were largely based on misinterpretations of early data.
Numerous studies show that hormone therapy is considered safe and effective, especially for younger, healthy women, and that the benefits for treating menopause symptoms often outweigh risks when properly dosed and monitored.
If you are considering starting bioidentical hormones during menopause or in the years leading up to menopause, there are many benefits. However, there are also important considerations in determining if customized bioidentical hormone therapy is the right choice for you.
In this article, you’ll learn :
- What are bioidentical hormones, and how they work
- How personalized bioidentical hormones help with menopause
- The advantages of BHRT for managing menopause symptoms
- Bioidentical vs synthetic hormones used in traditional HRT
- The truth about the safety of hormone therapy for women
- How to start BHRT for menopause and customizing BHRT around your needs
- Answers to the most common questions women ask about bioidentical hormones
What Are Bioidentical Hormones and How Do They Work?
Bioidentical hormones are artificial hormones that are created to be chemically identical to the estrogen, progesterone, and testosterone naturally produced in the human body. Due to this structural similarity, they can bind to hormone receptors and mimic the body’s own hormones.
Most bioidentical hormones are synthesized from compounds found in plants like yams or soy. Once processed, they are formulated into various delivery methods, including creams, gels, patches, capsules, injections, or pellets.
Some bioidentical hormones are FDA-approved, while others are custom-compounded by pharmacies that use high-quality ingredients and precise dosing to create individualized therapies tailored to each patient’s needs.
This personalized approach allows treatment to be adjusted based on lab testing, symptoms, and response, which is why many women find compounded bioidentical hormone therapy especially beneficial.
How are Bioidentical Hormones Used to Treat Menopause?
Hormone therapy is being used to help treat numerous health issues. In customized bioidentical hormone therapy for menopause, the primary role of bioidentical hormones is to help restore the natural decline of hormone levels that occurs during this life phase and bring the endocrine system back into balance.
Personalized hormone therapy for menopause does not delay or stop menopause. However, once hormones regain balance, this may help reduce or completely alleviate common symptoms of menopause like hot flashes, night sweats, mood changes, weight gain, vaginal dryness, and bone loss, while supporting overall health and well-being.
The Top Benefits of Bioidentical Hormone Therapy for Menopause
Bioidentical hormone replacement therapy (BHRT) offers relief from some of the most common and disruptive symptoms of menopause.
Because these hormones are designed to mimic the body’s own estrogen, progesterone, and testosterone, they can help restore natural hormone balance, leading to improved overall well-being and a better quality of life.
Bioidentical hormone therapy benefits for menopausal women might include:
Relief from Hot Flashes and Night Sweats
Bioidentical hormone therapy can reduce the frequency and severity of hot flashes and night sweats, two of the most common vasomotor symptoms of menopause. By restoring estrogen levels, therapy helps stabilize the body’s temperature regulation system, which often becomes erratic during menopause.
Numerous clinical studies confirm that hormone therapy remains the most effective treatment for vasomotor symptoms, helping women sleep better and feel more comfortable throughout the day.
Supports Metabolic Health and Weight Management
Menopause often brings weight gain and changes in body composition that do not always respond to diet and exercise. This is largely linked to hormonal decline, particularly a drop in estrogen, which can slow metabolism, increase fat storage, and reduce lean muscle mass.
Another factor in menopausal weight gain is the natural loss of muscle that occurs with age. Lower muscle mass not only slows metabolism but also makes it easier for fat to accumulate. This is why supportive lifestyle habits, along with BHRT, such as regular strength training and a balanced diet, are crucial during this stage of life.
Hormone therapy has been shown in multiple studies to help reduce fat accumulation, improve insulin sensitivity, and preserve lean mass. While not a weight loss treatment on its own, BHRT can support healthier body composition and make weight management more achievable when combined with lifestyle strategies.
It’s important to have BHRT prescribed and managed by a provider who understands the complex ways female hormones shift during perimenopause and menopause. The right provider will not only adjust hormones safely but also guide you through complementary strategies beyond BHRT, including exercise and nutrition support, to help protect long-term metabolic health.
Improved Bone Density and Prevention of Osteoporosis
Estrogen plays a critical role in maintaining bone strength. Declining levels during menopause increase the risk of bone loss and fractures. Bioidentical hormones may help preserve bone density, reducing the risk of osteoporosis when therapy is started at the right time.
Extensive, long-term studies show that hormone therapy can help prevent osteoporosis and lower fracture risk in postmenopausal women. While BHRT is not the only option for bone support, it can be a powerful tool within a broader prevention strategy.
Supports Vaginal Health
Declining estrogen during menopause can cause thinning of vaginal tissues, dryness, and irritation. Bioidentical hormone therapy can help restore elasticity and hydration, improving comfort and reducing the risk of infections or irritation.
Numerous clinical studies confirm that hormone therapy effectively relieves vaginal atrophy, which can improve overall quality of life and reduce discomfort in daily activities.
Improved Sexual Function and Libido
Loss of sex drive and discomfort during intimacy are common symptoms of menopause. By restoring estrogen, progesterone, and in some cases testosterone, bioidentical hormone therapy may improve desire, arousal, and overall sexual satisfaction.
Clinical studies show hormone therapy can help address low libido, painful intercourse, and sexual dysfunction in postmenopausal women, leading to improved confidence, intimacy, and relationship satisfaction.
To learn more, read “Enhancing Your Sexual Wellness: Modern Treatments and Solutions.”
Enhanced Mood, Mental Clarity, and Cognitive Function
Hormonal shifts during menopause can contribute to mood swings, anxiety, depression, and brain fog. By helping restore balance in estrogen, progesterone, and sometimes testosterone, bioidentical hormone therapy may ease these changes and support clearer, more balanced thinking.
Clinical evidence suggests that hormone therapy can improve mood stability and reduce cognitive complaints such as memory lapses or poor concentration. Many women also report feeling more emotionally balanced and mentally sharp once their hormones are optimized.
Promotes Better Sleep
Sleep disturbances are common during menopause. Hormonal fluctuations that cause hot flashes and night sweats can make it nearly impossible to get a good night’s rest. By restoring estrogen and progesterone levels, bioidentical hormone therapy may enhance sleep quality, allowing women to fall asleep more easily and stay asleep longer.
Several studies confirm that hormone therapy can reduce insomnia and nighttime awakenings, which has a positive ripple effect on energy, mood, and daily performance.
Customizing Bioidentical Hormone Therapy for Your Unique Needs
One of the most significant advantages of bioidentical hormone therapy is that it can be personalized to your individual hormone levels, symptoms, and health goals. That’s the way it should be, considering there are many signs you might need hormone replacement therapy, and never a one-size-fits-all approach to restoring hormone balance.
Hormone therapy treatment should always begin with a consultation followed by comprehensive bloodwork to measure hormone levels and identify imbalances. A thorough evaluation also examines overall health, including assessments for potential nutritional deficiencies, which are common during midlife and menopause. From there, a custom plan can be created that may include estrogen, progesterone, testosterone, or a combination, depending on your specific needs.
In many cases, custom-compounded bioidentical hormones are used. These are created by specialized pharmacies that prepare precise doses and delivery methods based on your lab results, symptoms, and how you respond over time. This allows therapy to evolve as your body changes, ensuring the most effective and balanced outcome possible.
This individualized approach is one of the key differences between bioidentical hormone therapy and traditional HRT, and it is a major reason why many women feel better supported with BHRT compared to synthetic hormones.
What Forms Do Bioidentical Hormones Come In?
The bioidentical hormones used in bioidentical hormone therapy for menopause can be delivered in several forms. The right delivery method depends on your symptoms, preferences, and your provider’s recommendation.
Common delivery methods for BHRT include:
- Creams
- Gels
- Patches
- Capsules
- Injections
- Implanted pellets
Each form has advantages. For example, many women prefer patches, creams, and gels because they are easy to apply and adjust as needed. However, absorption with topical options can vary by skin type, application site, and consistency of use.
Capsules are another method women often choose for convenience and reliable dosing. Others prefer injections or pellets because they do not require daily application and may provide a steadier release of hormones over time compared with topical forms.
At Relive Health, your provider will guide you in selecting the method that best suits your lifestyle, while ensuring safe and effective dosing. They will also continue to monitor your progress and make adjustments as needed, since hormone therapy is not a one-time prescription but an ongoing process of fine-tuning.
How BHRT Dosing May Be Adjusted Over Time
Bioidentical hormone therapy is not static, especially in the beginning. It may take some trial and error to find the right balance for your body and symptoms.
Your dosage is carefully monitored and adjusted as your needs change. Treatment typically begins with conservative dosing, followed by regular follow-up visits and laboratory testing to monitor hormone levels and response.
Adjustments may be made to the type of hormone, the dosage, or even the delivery method, depending on how well symptoms are managed and whether side effects occur. For example, if hot flashes and night sweats improve but sleep issues persist, your provider may fine-tune progesterone support.
At Relive Health, we always take a personalized approach. Dosing is never one-size-fits-all. Ongoing evaluation ensures that your therapy evolves with you, helping maintain symptom relief, safety, and long-term well-being.
Bioidentical Hormones vs. Traditional HRT: What’s the Difference?
The main difference between bioidentical hormone replacement therapy (BHRT) and traditional hormone replacement therapy (HRT) is that bioidentical hormones are chemically identical to the hormones your body naturally produces. In contrast, traditional HRT often uses synthetic or animal-derived hormones.
Traditional HRT medications may contain conjugated estrogens derived from the urine of pregnant mares (Premarin) or synthetic progestins that are similar to, but not the same as, natural progesterone. These forms of HRT are standardized and FDA-approved, but they do not exactly match the structure of human hormones.
Bioidentical hormones, on the other hand, are designed to match the body’s own estrogen, progesterone, and testosterone. Some bioidentical hormones are available in FDA-approved products (such as estradiol and micronized progesterone), while others are custom-compounded by pharmacies for more individualized dosing and delivery.
Both traditional HRT and bioidentical hormone therapy can relieve menopause symptoms, but many women prefer BHRT because of its structural similarity to natural hormones and the ability to personalize treatment. The best choice depends on your health history, goals, and the guidance of a qualified provider.
Here’s a quick comparison chart of BHRT and traditional HRT:
| Feature | Bioidentical Hormone Therapy (BHRT) | Traditional HRT |
| Hormone Source | Plant-derived (yams, soy), synthesized to match human hormones | Synthetic or animal-derived (e.g., conjugated equine estrogens) |
| Chemical Structure | Chemically identical to estrogen, progesterone, and testosterone naturally produced by the body | Similar, but not identical, to natural hormones |
| FDA Status | Some FDA-approved forms are available (e.g., estradiol, micronized progesterone); others are compounded | Standardized, FDA-approved medications |
| Customization | Can be tailored to individual needs with custom-compounded formulas and varied delivery methods | Typically prescribed in standardized doses and limited formulations |
| Symptom Relief | Shown to relieve common menopause symptoms like hot flashes, night sweats, vaginal dryness, and bone loss | Also effective for many menopause symptoms, but with fewer personalization options |
Safety, Side Effects, and Risk Factors of Bioidentical Hormones
When prescribed and monitored by a qualified hormone replacement therapy provider, hormone therapy for women, including bioidentical hormones, is generally considered safe for most women, with risks similar to those of traditional HRT.
Modern medical research on bioidentical hormones supports this. However, the safety of any hormone therapy depends on several factors, including risk factors such as age and individual health history, as well as sourcing, proper dosing, and monitoring.
Are Bioidentical Hormones Safe?
Bioidentical hormones can be safe when appropriately dosed and monitored by a qualified healthcare professional.
When started within 10 years of menopause or before age 60, hormone therapy is generally considered safe and effective for many women. In this group, research shows the benefits often outweigh the risks.
For women who start therapy later (more than 10 years past menopause or after age 60), studies are more limited, and risks such as stroke, blood clots, or heart disease may be higher. Your provider can help you weigh the potential benefits against these risks and determine if BHRT is appropriate for your situation.
Source and provider knowledge can also play a significant role in ensuring both the safety and effectiveness of treatment, since expertise is required to choose the right hormones, dosing, and delivery method.
FDA-approved bioidentical hormones, such as estradiol and micronized progesterone, have been well studied and meet strict safety standards. Compounded bioidentical hormones, while valuable for personalization, are not FDA-approved and may vary in quality depending on the compounding pharmacy. This makes choosing a trusted provider that uses a reputable compounding pharmacy essential.
Unfortunately, for years, women were led to believe that hormone therapy could be dangerous. The reports that prompted concern linked certain forms of hormone therapy to higher risks of breast cancer and heart disease, causing many women to avoid treatment.
However, follow-up analyses and newer studies revealed that the risks were overstated and misunderstood. Today, research shows that many hormone therapies can be safe and effective for many women.
In fact, following a unanimous recommendation by an expert panel in July 2025, the U.S. Food and Drug Administration (FDA) is expected to soon remove or revise the black box warning on certain hormone therapies for women, particularly low-dose vaginal estrogen.
To learn more, read “Bioidentical Hormone Therapy: Safe Solutions for Hormonal Balance.”
What Are the Risk Factors of Bioidentical Hormones
Hormone therapy is not appropriate for everyone. Risk of serious side effects and complications may be higher for women with a personal or family history of breast cancer, heart disease, blood clots, or stroke.
Age is also an important factor. Starting hormone therapy more than 10 years after menopause or after age 60 may carry greater risks compared to beginning treatment earlier. Lifestyle factors such as smoking, obesity, and uncontrolled high blood pressure may also increase risk.
Any form of hormone therapy, including therapy that uses bioidentical hormones, should never be started without a complete evaluation, including bloodwork and a review of personal health history.
Possible Side Effects of Bioidentical Hormones for Menopause
Like all hormone therapies, BHRT may cause side effects. Most side effects from hormone therapy are mild and improve with time or dosage adjustments.
These can include:
- Breast tenderness
- Stomach bloating
- Headaches
- Mood changes
- Spotting
- Blurred vision
If side effects occur, they typically do so when therapy is first started or when doses are being adjusted. Most side effects improve with time or dosage adjustments, but they should always be discussed with a provider.
Increased facial hair, acne, and clitoral enlargement are also side effects that some women experience if testosterone is needed as part of their hormone replacement therapy protocol. However, this typically only occurs when dosages are too high.
While rare, more serious side effects of hormone therapy have been reported, including blood clots, stroke, and certain types of cancer. The likelihood of these complications depends on factors such as age, timing of therapy, medical history, and lifestyle, which is why ongoing monitoring with a qualified provider is essential.
Frequently Asked Questions About Bioidentical Hormones
What are bioidentical hormones for menopause?
Bioidentical hormones are artificial hormones used in bioidentical hormone replacement therapy (BHRT) that are chemically identical to the hormones produced by the human body.
Bioidentical hormones are used in hormone therapy to help relieve menopause symptoms by restoring balance in estrogen, progesterone, and testosterone levels. Many women find menopause symptom relief and long-term health benefits from personalized BHRT.
Can you take bioidentical hormones before menopause?
Yes, some adult women begin BHRT before menopause to address hormone imbalances that cause disruptive symptoms or health issues. During perimenopause or in younger women with conditions that affect hormone levels, bioidentical hormones may help restore balance.
The decision of whether or not to consider bioidentical hormones for a hormone imbalance should always be guided by lab testing and a provider experienced in hormone therapy.
Can you take bioidentical hormones after menopause?
Yes, many women choose to begin hormone therapy after menopause to relieve ongoing symptoms and support quality of life. Even years after periods stop, hot flashes, night sweats, sleep disturbances, mood changes, vaginal dryness, weight gain, and bone loss can continue.
Bioidentical hormones may help reduce these issues and promote long-term well-being when used under careful medical supervision. The safety and effectiveness of BHRT after menopause depend on several factors, including age, the time since menopause, and personal health history.
Are bioidentical hormones safe after menopause?
Studies show that hormone therapy is safest when started before age 60 or within 10 years of menopause onset, but it may still be an option for some women beyond that window with careful evaluation.
Safety depends on individual health history, timing, and the type of hormone used. A qualified provider can help determine whether bioidentical hormones are the right option for you and guide you through the safest way to begin treatment.
Is there a black box warning for hormone therapy for women?
Hormone therapies for women containing estrogen have previously carried a black box warning, which is the strongest alert the FDA can apply to a drug label. However, in 2025, this warning is expected to be removed and/or revised.
This follows a July 17, 2025, FDA advisory panel meeting, where members urged the removal of the warning label due to new evidence and updated research findings that suggest the risks were overstated in the original 2002 study that prompted the warning, especially in younger women and those starting hormone therapy near the onset of menopause.
Do bioidentical hormones delay menopause?
No. Bioidentical hormones do not delay or prevent menopause. Menopause is a natural process that happens when the ovaries run out of follicles and estrogen production declines. Hormone therapy using bioidentical hormones can ease and often eliminate menopause symptoms, helping you feel better through the transition, but it does not change the timing of menopause or prevent it from occurring.
Does bioidentical hormone therapy cause weight gain?
For most women, hormone therapy does not cause weight gain. In fact, it may help with the hormonal weight changes linked to menopause. Some women may notice small increases on the scale, but this is usually related to water retention rather than an increase in body fat.
By restoring hormone balance, BHRT can actually support a healthier metabolism and body composition, especially when combined with lifestyle strategies.
Can bioidentical hormones cause bleeding after menopause?
Yes, some women may experience spotting or bleeding when starting hormone therapy, including hormone therapy using bioidentical hormones. This can happen when doses are being adjusted and typically resolves quickly. However, any unexpected bleeding after menopause should always be evaluated by a healthcare provider to rule out other causes.
How long do hot flashes last after hormone therapy?
The exact timeline of when hot flashes improve after hormone therapy varies from woman to woman, and some may need dose adjustments for the best relief. Some women notice improvements within weeks. For others, it takes a few months after starting hormone therapy to see meaningful differences.
Does hormone therapy affect bone density?
Hormone therapy can help preserve bone density and lower the risk of osteoporosis in postmenopausal women. Estrogen plays a crucial role in maintaining bone strength, and replacing declining levels during menopause may help reduce the risk of fractures.
How does hormone therapy improve mood?
Hormone therapy can improve mood by restoring estrogen, progesterone, and sometimes testosterone levels that naturally decline during menopause. These hormones interact with brain chemistry and neurotransmitters like serotonin and dopamine, which influence mood, stress response, and emotional stability.
When levels drop, women may experience mood swings, anxiety, or even depressive symptoms. By bringing hormones back into balance, therapy can reduce irritability, stabilize emotions, and support a greater sense of well-being. Many women also report improved sleep and energy, which further contributes to a more positive mood.
Once started, do you have to take hormone therapy forever?
Not always. For menopause-related symptoms, many women use BHRT only during the years when symptoms are most disruptive, and therapy can be tapered when symptoms improve. However, some women may need hormone support long-term for other conditions, such as:
- Premature ovarian insufficiency (POI) or early menopause
- Surgical menopause after hysterectomy with ovary removal
- Certain endocrine disorders or hormone deficiencies unrelated to aging
In these cases, hormone therapy may be recommended as an ongoing or even lifelong treatment, because the deficiency doesn’t resolve naturally. The duration should always be individualized and based on your health history, goals, and provider’s guidance.
Are bioidentical hormones safer than synthetic hormones?
Bioidentical hormones are processed hormones that are designed to be chemically identical to the body’s natural hormones. This structural match is one reason many women prefer BHRT over conventional hormone replacement therapies that use synthetic or animal-derived hormones.
Current research shows that the risks and benefits are generally similar when dosing and monitoring are appropriate. The biggest safety factor is not whether a hormone is bioidentical or synthetic, but whether it is prescribed correctly and monitored by a qualified provider.
How long does it take for bioidentical hormones to start working?
The amount of time it takes for bioidentical hormones to work varies. Some women report feeling significant improvements in many symptoms within only a couple of weeks. However, most of the time, it takes about three months to feel the full effect of any type of hormone therapy.
How much does bioidentical hormone therapy cost?
The cost of BHRT varies widely. Factors include the type of hormone, delivery method (such as patches, creams, or pellets), whether compounded or FDA-approved forms are used, and how often monitoring and follow-ups are needed. For this reason, costs can differ significantly from one person to another.
Is bioidentical hormone therapy covered by insurance?
Sometimes. FDA-approved forms of bioidentical hormones are often covered by insurance, while compounded prescriptions usually are not. Coverage also depends on your insurance plan and provider, so it’s best to confirm directly with your insurance company.
Conclusion
There are many innovative therapies and solutions for women’s sexual wellness, with bioidentical hormones leading the way. Bioidentical hormone replacement therapy offers more than just symptom relief; it can help women move through menopause with greater comfort, energy, and confidence.
From easing hot flashes and night sweats to supporting bone, metabolic, sexual, and emotional health, BHRT has been shown in numerous studies to improve quality of life when prescribed, dosed, and monitored appropriately.
At Relive Health, we focus on how BHRT can not only relieve common discomforts but also support long-term well-being through a personalized approach. Hormone therapy is not one-size-fits-all. Your plan should be tailored to your unique health history, goals, and lifestyle.
If you’re ready to learn how bioidentical hormone therapy could benefit you, use our location finder to connect with your nearest Relive Health center. Our experienced providers are here to guide you safely and effectively through every stage of this often challenging time that women face.
You can also explore the articles section of our website, where we have many educational articles, including the “Ultimate Guide to Hormone Therapy for Women”, an article that explains signs that might indicate you should explore hormone replacement therapy, and a blog that busts 5 Common Myths About Female HRT.
