Bioidentical hormones

What are bio-identical hormones?

Hormones are said to be bio-identical when their molecular chemical structure corresponds to the hormonal structure as produced naturally by the human body. Bio-identical hormones are therefore also called "body-identical" or "nature-identical".

In contrast, the chemical structure of so-called synthetic hormones differs from that of hormones produced by the body. From the point of view of structural formula, synthetic hormones are certainly similar to endogenous hormones, but there are subtle differences in the desired effects, i.e. in the treatment of disorders and in possible side effects.

Diosgenin, a natural plant substance, is the basis for the production of the bioidentical hormones 17β-estradiol and progesterone. Diosgenin is found mainly in the tuberous roots of yams(Dioscorea). Stigmasterin, a natural substance found in soybeans, can also be converted into bio-identical hormones.

However, the human body is unable to transform diosgenin or stigmasterin into 17β-estradiol or progesterone. For this reason, the basic substance extracted from plants is adapted to natural hormones in various stages using a standardized manufacturing process that offers significant advantages:

• it guarantees consistent quality
• a standardized manufacturing process approved by the health authorities is a prerequisite for bio-identical hormone preparations subject to medical prescription
• it is subject to strict quality controls
• in addition, the efficacy and safety of hormone preparations must be proven by scientific studies.

Bio-identical hormones are considered to have particularly few side effects. Studies indicate that bio-identical hormones, such as progesterone or estradiol applied to the skin, offer advantages. ¹ The results of these studies are based on authorized prescription drugs.

There are now also non-prescription options available from pharmacies. These individually prescribed products in capsule or cream form also contain bio-identical hormones. However, unlike pharmaceutically manufactured hormone substitutes, these hormone preparations are not subject to strict quality controls, and their manufacture is not standardized.

Pharmacy-approved drugs and preparations - a comparison

Because of their individual composition, pharmacy preparations may, by law, be dispensed without package inserts. This does not mean, however, that the preparations are free of side effects. Moreover, it is not known how many active ingredients are actually absorbed by the body in the various preparations. There is therefore a risk of over- or under-dosing. ²

Similarly, the efficacy and safety of pharmacy preparations have not been sufficiently proven, so experts and international specialist societies advise against the use of such preparations when they contain bio-identical hormones. ^3-5

The Swiss Society for Gynecological Endocrinology and Menopause also notes that the data from medical studies are conclusive only for hormone replacement therapy or hormone therapy, and not for all other treatment options. ⁶

Another important point is that, as a general rule, health insurance companies do not reimburse prescriptions for hormones dispensed in pharmacies, which must therefore be paid for by the patient themselves.