Menopause is a natural phase in a woman’s life, but its symptoms can be challenging. Hormone therapy offers relief, with two primary options: bioidentical hormone therapy (BHT) and traditional hormone replacement therapy (HRT). Understanding their differences is crucial for informed decision-making.
Understanding Hormone Therapy for Menopause Management
Menopause brings a range of symptoms, from hot flushes and mood swings to an increased risk of osteoporosis and heart disease. Hormone therapy can be an effective way to manage these symptoms and protect long-term health. The two primary types of hormone therapy are:
- Bioidentical hormone therapy (BHT) – Derived from plant sources and designed to be chemically identical to human hormones.
- Traditional hormone replacement therapy (HRT) – Includes synthetic or animal-derived hormones that have been clinically studied for decades.
- Includes body identical which are hormones with the same structure as those naturally produced in the human body.
Both treatments have potential benefits and risks, making it essential to understand their differences before choosing the best option for your menopause management.
Comparing Bioidentical Hormones and Traditional HRT
Here’s a comparison between bioidentical hormones and traditional HRT:
Factor | Bioidentical Hormones (BHT) | Traditional HRT |
Source | Derived from plant-based compounds (e.g. yams or soy) and designed to be chemically identical to the hormones naturally produced by the body. | Can be synthetic or derived from animal sources (e.g. conjugated equine oestrogens from pregnant mares’ urine). |
Regulation & Approval | Compounded versions are not TGA-regulated, raising concerns about consistency and safety. | Fully TGA-approved and subject to strict quality controls with well-documented safety data. Standardised body identical hormones are TGA-approved (e.g. oestradiol patches, micronised progesterone). |
Customisation | Compounded bioidentical hormones can be tailored to an individual’s hormone levels (often based on saliva or blood tests). Standardised bioidentical options come in fixed doses. | Comes in standardised doses that have been researched extensively to determine the safest and most effective ranges. Can be customised with your doctor to manage symptoms. |
Safety & Efficacy | Compounded versions lack large-scale studies, making their effectiveness and risks less clear. | Backed by decades of research, with well-documented benefits and risks. The long-term effects are well understood due to extensive clinical trials. |
Menopause Symptom Relief | Helps alleviate hot flushes, night sweats, mood swings, vaginal dryness, and sleep disturbances. Some women report fewer side effects, but there is limited scientific evidence supporting this. | Proven to be highly effective for reducing menopause symptoms with predictable outcomes. |
Long-Term Health Benefits | May help with bone and heart health, but more research is needed. | Proven to reduce osteoporosis risk and may support cardiovascular health in certain groups of women. |
Risks & Side Effects | Compounded bioidentical hormones may carry unknown risks due to a lack of standardisation. Inconsistent dosing could lead to overdosing or underdosing. | Potential risks include blood clots, stroke, and breast cancer, but these are well-studied and vary depending on factors like treatment duration and individual health history. |
Administration Methods | Available as creams, gels, patches, pills, or pellets. | Available as pills, patches, creams, gels, vaginal rings, or injections. |
Monitoring & Adjustments | Often monitored with saliva or blood tests, though medical experts debate their accuracy for dosage adjustments. | Dosage is adjusted based on symptoms, medical history, and clinical guidelines rather than hormone level testing. |
Are Bioidentical Hormones Safer Than Traditional HRT?
There is no conclusive evidence that bioidentical hormones are safer or more effective than traditional HRT. The standardised versions of body identical hormones (e.g. TGA-approved oestradiol patches) are safe and effective, but compounded formulations are not regulated, meaning their safety and consistency remain uncertain.
The risks of hormone therapy—whether bioidentical or traditional—depend on factors such as:
- Age and health history (e.g. risk of breast cancer, heart disease, or blood clots).
- Type of hormones used (e.g. oestrogen alone vs. combined oestrogen and progesterone).
- Duration of treatment (long-term use carries different risks than short-term use).
Consulting a menopause doctors ensures you choose the safest and most effective option for your needs.
Who Can Benefit from Hormone Therapy?
Hormone therapy is recommended for women experiencing moderate to severe menopause symptoms, particularly when lifestyle changes and non-hormonal treatments are insufficient. It may be beneficial if you have:
- Frequent hot flushes and night sweats
- Severe mood swings or anxiety linked to menopause
- Disrupted sleep patterns
- Vaginal dryness causing discomfort or pain during intercourse
- Osteoporosis or high risk of fractures
- Early menopause (before age 45) or surgical menopause
However, hormone therapy may not be suitable if you have a history of:
- Breast or ovarian cancer
- Uncontrolled high blood pressure
- Blood clotting disorders
- Heart disease or stroke risk factors
Bioidentical vs Traditional HRT: Which One is Right for You?
Deciding between bioidentical hormones and traditional HRT depends on your symptoms, health history, and treatment goals. Consider the following:
- Do you want a treatment with strong clinical backing and TGA approval? → Traditional HRT or standardised body identical HRT may be the safest choice.
- Are you looking for a personalised approach despite regulatory considerations? → Compounded bioidentical hormones might be an option but require careful monitoring. Please note that our doctors do not prescribe compounded bioidentical HRT due to safety concerns.
- Do you have specific health concerns that require a tailored plan? → A menopause doctor can assess your risks and recommend the most suitable therapy.
Every woman’s menopause journey is unique. Consulting a qualified healthcare professional ensures you receive safe, effective treatment tailored to your individual needs.
Seeking Expert Guidance for Menopause Management in Brisbane
At Sirona Women’s Health, we offer expert menopause management in Brisbane, including both bioidentical hormone therapy and traditional HRT. Our all-female GP team provides personalised care to help you make informed decisions about your hormone therapy options.
Frequently Asked Questions
It is generally recommended to taper off HRT gradually under medical supervision to reduce withdrawal symptoms like hot flushes and mood swings. Stopping suddenly may lead to a sudden return of menopause symptoms.
There is no strong evidence that HRT directly causes weight gain. However, hormonal changes during menopause can lead to fat redistribution, particularly around the abdomen. Some women may experience fluid retention when starting HRT, but this is usually temporary.
Yes, men experiencing andropause (age-related testosterone decline) or other hormonal imbalances can be prescribed bioidentical testosterone therapy. However, treatment should only be undertaken under medical supervision due to potential risks like prostate issues and cardiovascular concerns.
Most women start noticing symptom relief within a few weeks, but full benefits may take three to six months. The timeframe varies depending on the dosage, method of administration, and individual response to treatment.
If you are still perimenopausal (not fully menopausal) and have a uterus, pregnancy is still possible while on HRT. It is recommended to use contraception until at least 12 months after your last period if you are over 50, or 24 months if under 50.
Yes, HRT can interact with certain medications, including:
Some antibiotics and antifungal drugs (which can affect hormone metabolism)
- Blood thinners (HRT may increase clotting risk)
- Thyroid medications (HRT can alter thyroid hormone levels)
- Corticosteroids and epilepsy medications (which may affect hormone absorption)
Always inform your doctor about all medications and supplements you’re taking before starting HRT.
Schedule your consultation today and let us help you find the best menopause management plan for your needs.