Body identical hormone replacement therapy (HRT) is the recommended treatment for menopause in the UK. It's the lowest risk, and most well regulated form of HRT. We briefly explain what it is, how it's different and what to look out for when you get your prescription.
HRT is when you take a form of medication to replace your body's natural hormones. This is because our female hormones - oestrogen and progesterone - drop during perimenopause and menopause. This drop causes many women to have menopause symptoms.
All forms of HRT contain a type of oestrogen. If you've had a hysterectomy in the past, you'll need estrogens alone. If you haven't had a hysterectomy, you'll need both an estrogen and a progestogen. The type of HRT recommended for you will depend on your risk factors, preferences, symptoms and whether you're still having periods.
Body identical HRT has the same chemical structure as the hormones in your body. That means that when you take it you're literally topping up your own hormones. Body identical HRT is regulated medication that can be prescribed on the NHS and privately.
For oestrogen: almost all forms of HRT prescribed in the UK are now body identical oestrogen. Look out for the term estradiol (often made from the yam plant).
For progesterone: the only body identical progesterone is a tablet called Utrogestan. It's an oral treatment, though it can also be taken vaginally. Look out for the term micronised progesterone. The other way to get body identical progesterone is through the mirena coil, which slowly releases micronised progesterone into the cervix and surrounding area. If you have the mirena coil you do not usually need additional progesterone.
Bio-identical hormones, sometimes called compounded HRT, are are precise duplicates of hormones that are made in the human ovary, adrenal and thyroid. The oestrogen bio-identical hormones (E1,E2,E3) are usually compounded with some progesterone and testosterone and/or DHEA.
Bio-identical hormones are not regulated medications, so they need to be approached with some caution. Bio-identical HRT is not available on the NHS, and not all private menopause clinics will prescribe it.
1 nhs.uk. n.d. Hormone Replacement Therapy (HRT). [online]
Available at: https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/.
2 Hillard, T., Abernathy, K., Hamoda, H., Shaw, I., Everett, M., Ayres, J. and Currie, H., 2017. Management Of The Menopause. 6th ed. British Menopause Society.
3 British Menopause Society. n.d. Bioidentical HRT | British Menopause Society. [online]
Available at: https://thebms.org.uk/publications/consensus-statements/bioidentical-hrt/ [Accessed 20 March 2020].