Do You Need Bioidentical Hormones?

by Christiane Northrup, M.D.

Hormones

Many women approach menopause with the desire to take only “natural” hormones to help alleviate their symptoms.  This causes quite a bit of confusion and miscommunication between doctors and their patients.  That’s because all hormones can be marketed as “natural” or “plant-based,” and many pharmaceutical companies are capitalizing on women’s quest for “natural” hormone replacement therapy by marketing proprietary hormone products in this manner.

The problem is, while many of these hormonal molecules may have been derived from plant sources, most are not even close to being anything like human female hormones, nor do they perform as such in the body.  Many proprietary HRT options marketed as “plant-based” and “natural,” as well as purely yam-based creams fall into this category. Moreover, they are often not effectively converted or used in the body, and sometimes have actions that are more deleterious than the symptoms they purport to quell or stave off.

What’s the Difference Between Natural and Bioidentical Hormones?

All hormones are “natural.”  But, what most women mean when they say they want natural hormones, is that they are interested in using bioidentical hormones. The distinction is that bioidentical hormones are identical in their molecular shape, make-up, and structure to hormones made in the human body.  This is what makes bioidentical hormones the perfect “keys” to unlock the body’s receptor sites. In other words, it’s the shape of the molecule, not the source.

Today, most women know that, while natural, the hormones Premarin, Prempro, and Provera, are not bioidentical. My colleague Dr. Joel Hargrove (who recently passed) used to say, “Premarin is a natural hormone—if your native food is hay!” That’s because it’s made from conjugated mare urine. Provera was developed as a substitute for bioidentical progesterone. Pharmaceutical companies do this because they cannot patent a naturally-occurring hormone!

Prempro is a combination of Premarin and Provera.

If you are in doubt as to whether a particular product offered to you by prescription is natural, check the label. If it lists “esterified estrogens,” “progestins,” or “progestogens,” the product is not bioidentical. You can also look up the product in your internet favorite search engine as many have their own websites.

Why Bioidentical Hormones Work Better

Our hormones are comprised of a solid steroid base (cholesterol), decorated with “arms,” “legs,” and “tails” pinned on here and there. These attachments are what turn hormones into specialized molecules, allowing them to plug into receptor molecules throughout the body, turning on and off much of the cellular behavior that makes us tick.

When we take hormonal replacement therapy that doesn’t fit the original design that our cells have evolved to recognize, the end result simply may not feel or act quite right. Hence all those side effects, ranging from annoying and uncomfortable to downright dangerous can occur.

Bioidentical hormones duplicate the structure of our hormones exactly as they are found in our bodies. This is why they work better in our bodies.

What Bioidentical Hormones Should You Take?

The molecules naturally produced in the human female body for which we most often seek replacement include:

  • Estrone (E1), estradiol (E2), and estriol (E3)
  • Progesterone
  • Testosterone
  • DHEA, an adrenal precursor to testosterone.

These truly “natural” hormones are available by prescription.   Estradiol is available as Estrace pills, Estrace vaginal cream, or transdermals as the Vivelle Dot, and Climera. (Pharmaceutical companies have been able to patent the delivery system on these hormones, though the hormone itself is still bioidentical.  Estriol is available only through formulary pharmacies.  Most women do fine with just estradiol plus or minus some progesterone. And sometimes a bit of testosterone—which is available in by prescription as AndroGel.

What is the Best Natural Progesterone Cream?

Many women are confused about the use of progesterone creams, particularly regarding the efficacy of yam-based or other plant-based creams. Unlike soy and flax, which contain plant-based estrogens (phytoestrogens) that are adaptogenic and converted into utilizable forms in the body, wild yam (Dioscorea barbasco) cannot be converted into progesterone in the body.

The conversion can occur in a laboratory setting, however, and therefore, wild yam is sometimes used to synthesize the progesterone found in progesterone creams. Some progesterone creams are yam-based, but the active ingredient is not the wild yam itself, but the USP progesterone that has been added.

For this reason, while the body may absorb wild yam extract through the skin, which may then confer mild effects on menopausal symptoms, results of research on oral and topical applications of wild yam extract have not detected a significant change in progesterone levels in the blood.

If you want the beneficial effects of bioidentical progesterone, make sure the ingredients on the label include United States Pharmacopoeia (USP) progesterone. USP progesterone is available in over-the-counter 2% creams as well as by prescription. Choices for prescription-based bioidentical progesterone include Crinone Vaginal Gel in 4% or 8% concentration, or in an oral micronized form such as Prometrium capsules.

How To Talk To Your Doctor

I receive letters almost daily from women who have taken the initiative to offer their health care providers information on bioidentical hormones.  If you want to use bioidentical hormones as replacement therapy, here are the salient points to know and share with your doctor about bioidentical hormones:

  • They have been prescribed by doctors for many years
  • They are readily available through formulary pharmacies
  • They are easily titrated to suit a woman’s individual needs
  • They are readily absorbed and utilized
  • They are safe and effective

Many formulary pharmacists work in partnership with physicians to provide individualized hormone-replacement solutions. You may want to call a local formulary pharmacy to consult with a knowledgeable pharmacist to develop you customized plan.

What Other Resources Do You Recommend?

For information about compounded hormones, or to locate a pharmacy that provides individualized prescriptions, visit the International Academy of Compounding Pharmacists website.

American Hormones, Inc. is a compounding pharmacy founded by Erika T. Schwartz, M.D., renowned expert in the field of natural hormones. The company offers high-quality pharmaceutical-grade hormones shipped nationwide and internationally. The website has extensive information on bioidentical hormones.

There are also many books that you can consult.  My books, The Wisdom of Menopause, (Chapter 5, “Hormone Replacement: An Individual Choice”) and Women’s Bodies, Women’s Wisdom, (Chapter 14, “Menopause”) provide in depth information. 

One more thing, just because an estrogen or testosterone is bioidentical does not make it completely safe. All estrogens that bind to the alpha estrogen receptor (and testosterone too when converted,) can act as growth promoters in estrogen sensitive tissue, including breast and uterine tissue. This is why some women prefer herbal approaches instead. So, please keep this in mind.  That said, there are many women who have comfortably stayed on low doses of these hormones for years with great results.

I also recommend reading The 30-Day Natural Hormone Plan, by Erika Schwartz, M.D., New Menopausal Years, The Wise Woman Way: Alternative Approaches for Women 30–90, by Susun S. Weed and TCM: A Woman’s Guide to a Trouble-Free Menopause, by Nan Lu, OMD, LAc, with Ellen Schaplowsky

Have you tried bioidentical hormones?  What was your experience? Please leave your comments below.

Last Updated: September 10, 2017

Christiane Northrup, M.D.

Christiane Northrup, M.D.

Christiane Northrup, M.D., is a visionary pioneer and a leading authority in the field of women’s health and wellness. Recognizing the unity of body, mind, and spirit, she empowers women to trust their inner wisdom, their connection with Source, and their ability to truly flourish.

Comments

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  1. Susan Renkes
    2 weeks ago

    Hi Dr. Christiane Northrup, thank you so much for what you do for so many people. I had a question regarding bioidentical hormones. I am using them right now,but I ordered your Amata. I wanted to know when I run out of my hormones can I start taking your product right away? Should I wait awhile before I start taking Amata? I love your book. Energy Vampire. That book so needed to be written!!! Thank you so much for all you do!! Love everything you are doing!!!! Susan

  2. puerariamirifica
    3 weeks ago

    I trust your outcomes are genuine yet I too might want to see a non-orange form of your present self. Incredible story. Thank you for sharing it.

  3. Julie
    4 weeks ago

    Hi Christine,
    I am currently 6 weeks pregnant and my progesterone level is at 21, on the low side according to NaPro technology. NaPro protocol recommends supplementing with progesterone. I prefer to take a bioidentical version of this. Do you have an recommendations on bioidentical progesterone during pregnancy to prevent miscarriage? Any tips on how to request a specific kind from my midwife and where I could get this from? You mention formulary pharmacy in this article. I’m not familiar with what that is. Thanks!

  4. Barbara J Kidwell
    1 month ago

    My prescription plan has been fighting my PCP and I for years over Prometrium, forcing her to write formulary exceptions and other ridiculous letters explaining why I need it over synthetic progesterone.
    Today they cut me off. Sent me progesterone. I am beyond furious with the way prescription plans and health insurance have interfered with the doctor/patient relationship and now prescribe my health care and meds, instead of my PCP. The side effects will likely force me to quit HRT. Nothing else to see here… just had to vent.

  5. Diana Brito
    2 months ago

    They worked until they didnt 🙁

  6. judith citrin
    2 months ago

    I am over 84 years old and have been on bioidentical estriol vaginal creme for many many years…from Women’s International Pharmacy. Should I be on this at such an age? Your opinion would be one that I trust.

  7. Jane Parker
    2 months ago

    Hello- I am 50 years old and have Catamenial Epilepsy. This is epilepsy that is controlled by my female hormones. I am taking Prometrium to help control my seizures. Supposedly, estrogen is a seizure trigger, do you have any other ideas on what I can use to prevent UTI’s and vaginal dryness during sex. Since estrogen is a seizure trigger for this type of Epilepsy can I use the bio-identical estrogen or do I need to stay away from it? Any advice on how to treat this and any advice on bioidentical hormones and Catamenial Epilepsy would be appreicated. Thank you!

  8. Kari
    3 months ago

    How do you feel about hormone pellets? I’ve heard good and bad things about them.

  9. Marianne Kochanek
    3 months ago

    What if you have had an estrogen sensitive breast cancer 5 years ago, can you still take bioidentical hormones? I have taken the Arimidex for 46 months and have recently stopped. My hot flashes disturb my sleep each night and I have been unable to find something to help me. 6 years ago I took Estrogen to help with the hot flashes it only slightly helped and I did develop breast cancer. I know that sleep (rest) is incredibly important to my health and want to do everything I can to find that rest each night.

  10. Tania
    3 months ago

    So far loving bioidentical progesterone! A total life saver after years of debilitating PMDD symptoms!

    1. Deb
      3 months ago

      Which bioidentical progesterone are you using and how long? Thx.

    2. andrea
      2 months ago

      i’m just now trying the progero-life bioidentical. i’m questioning how to know if i should be doing the estrogen cream also?

  11. Kimberly Nelson
    4 months ago

    I had DVT blood clot after cesarean many years ago. What kind of bio identical hormones can I take?

  12. Kay
    4 months ago

    I’ve been diagnosed with female dryness (atrophic vagina) and took estrace for three months, which solved that problem so I went off it. Then I got a raging UTI, took too many antibiotics for this and a root canal, got another UTI then my first yeast infection which seems not to go away (tho it is very mild and causes only slight pain on urination.) Dr. wants me to do both estrace and vagifem estrogen suppositories but this sounds like too much replacement. Cannot find any significant answers to whether or not to introduce vagifem with estrace, also dr. wants me to stay on these for the rest of my life, which is reasonably intimidating. I am post-menopausal. Taking probiotics but just started. PS Anyone with a yeast should try two baking soda soaks a day, put about 4 tablespoons of baking soda in a few inches of water and sit 15 minutes. Really helps. Thanks for any help, Kay

  13. Jo
    4 months ago

    Dear Dr Northrup
    I recently tried Prometrium and estradot patches as an alternative to the Bio identical hormone troche (mainly progesterone and Trieste (4mg) and Progesterone (350mg) troche. I found on the prometrium and particularly the estradot patches I felt weird and that there was something speedy in my system. I had to stop and am now trying a week off everything . I was happy w the bio identical troche which I’ve been on for about 5 years but didn’t like the bitter taste it left in my mouth so decided to try something different. Any ideas what might be happening?

  14. KAREN LAWRENCE
    5 months ago

    Dear Dr Northrup, I am writing to you from South Africa. I am 56 yrs old and had a hysterectomy (total)
    a year ago aged 55. I then went into surgical menopause and I suffer from awful hot flushes. I cannot take HRT (medical reasons) so I am forced to search for a natural remedy. I have tried many and recently been advised to try “renewed balance body cream” which is a natural progesterone cream. Are you familiar with it and would it help me ?

    1. Elizabeth Hotte
      4 months ago

      Hi, I too have been introduced to “Renewed Balance” body cream. Have been using the cream for 6 months – have had some relief. Recently discovered pyhotoestrogens and have been trying to achieve some sort of balance. Feeling quite alone in Canada where going natural is discouraged! What are your thoughts?

  15. Barbara
    5 months ago

    Hello Dr. Northrup, I have been on bioidentical hormones for 10 years. I had lung cancer last year, I did smoke when I was very young, in my early 20’s, but only on the weekends, I am 62 years old. Do you think the hormones gave me the lung cancer ? Thank you

  16. Elissa Donghit
    5 months ago

    I just started 20 mg compounded oral progesterone day 6-28 of my cycle for insomnia. This first month for most part seems to help except for before ovulation and bleeding. Is this dosage even affective? Doctor said it could take a month to really feel it.

  17. Michelle Lingle
    6 months ago

    Hello,

    Im on progesterone cream due to excessive hair loss. It’s helped stop the hair loss but is giving me severe hot flashes. Is it possible I would do better with bioidentical hormone replacement?

    1. Lauren
      5 months ago

      You’re taking too much progesterone, so just cut back and titrate up.

      1. Lauren2
        5 months ago

        You a doctor??

  18. Carol
    6 months ago

    Hi, I wanted to know if it is safe to start on HRT( a hormone patch) I am 64 years old I would love to take bio-identicals but my insurance will not cover it and I can not afford them.Thank you

    1. Marg
      5 months ago

      I take Pro-gest by Emerita. It is on Amazon and gets great reviews.

  19. trudi
    7 months ago

    I took Bioidentical hormones and experienced even worse ( I have been having them 20- 30 times a day – night and day) . Didnt improve my sleep and one afternoon my face started to swell and was told to stop taking the gel and progesterone pill. I only took it for 5 days but my body didn’t like it which was so disappointing. I have had a lot of stress which may also be a factor. My doctor (A private consultation as I wanted the time to get all the facts) said to leave it for a month and try a lower dose of one pump of gel a day for a month and slowly build it and introduce the pill. On a positive note, I did notice an increase in my labido but other that that i felt horrible.

  20. Kristen Park
    7 months ago

    I’m taking estradiol and progesterone. They are a complete lifesaver for me, but I wish I could get off them. Although my doctor has said I can take them for up to 5 years without increased risk of cancer.

    1. Karla
      7 months ago

      Just don’t take the progesterone, you really don’t need it, and that is what causes the bad side effects of bad heart, etc.. I only use Estrace vaginal cream and I have had a full hysterectomy (no ovaries) And I just started taking Black Cohosh with soy in it. Do your own research first though, but it has stopped my hot flashes.

      1. jlee
        4 months ago

        the progesterone is what protects us from cancer due to the estrogen. don’t stop taking it.

      2. Sierra
        2 months ago

        Any woman who still has a uterus and who is taking systemic estrogen (meaning the type that goes throughout the body and prevents hot flashes, etc.) must take progesterone to prevent emdometrial cancers. You don’t need progesterone because you had your uterus removed. Women with a uterus need to balance the estrogen with progesterone.

  21. Ignisandra
    8 months ago

    It’s amazing how so many women, including myself, are blindsided by menopausal symptoms and their doctors are of absolutely no use whatsoever. I am 48 and suddenly began experiencing very painful sex. I turned to the internet and found it’s called ‘vaginal atrophy’ I’m sitting there wondering why the don’t call penile dysfunction ‘penile atrophy’. It sounds absolutely dreadful. So, off I go to visit a female gynecologist, who I asked for bio identical hormones, she then prescribed me prem pro which I didn’t want but didn’t know what exactly she prescribed until I went to the pharmacy. My nurse practitioner said she’d get back to me on what to prescribe, but that was 3 weeks ago. Finally I’m trying Karen Leggett’s happy hoo hoo line. Hopefully they work as the medical community seems largely useless when it comes to women.

    1. Shari Farmer
      5 months ago

      How is Happy HOO HOO working for you?

    2. Miranda
      4 months ago

      Also just started happy hoo hoo… any luck with it?

    3. Cat Bee
      3 months ago

      Find a doctor who is educated, well-versed and comfortable prescribing bio-identical hormones. The GYN I had for years never EVER recommended any hormones (let alone bio-identicals) although he knew all my (typical) menopausal symptoms. I also had had both my ovaries removed two years prior because due to a large (benign) tumor on one ovary. Of particular interest is the severe pain with sex over the last 15 years and which has nearly destroyed my marriage–make no mistake, I always enjoyed sex and never had pain before peri-menopause and menopause!! Never a peep from the GYN when I would tell him time and time again, how painful sex was and that I had stopped having intercourse. “Use a quality lubricant”, he would instruct me…wow dude, why didn’t I think of THAT one! Biggest shocker for me is when I had my bone density scan last Fall, I’m in full blown OSTEOPOROSIS! Talk about a wake up call! I was in total shock! When I questioned my GYN asking HOW this can be (I’m normal weight, very active, eat well, take my calcium and Vitamin D faithfully), he told me it was because I was “caucasian and petite”. That’s it. I didn’t believe him. So I did a lot of research and learned that the lack of ESTROGEN is the number one reason osteoporosis develops in the first place!! Women are being done a great, great disservice and it’s unacceptable. I have osteoporosis because my body really needed some estrogen. Not to mention, my testosterone levels were very low but GYN did nothing about thatt either. My fellow sisters, wake up, find a doctor who will prescribe bio-identicals for you so you don’t shrivel up (literally), die sexually and be discarded by our men or society! I’ve had it! Oh, and one more thing. All you sisters who have incontinence, this too is a result of uro-genital tissue changes due to the LACK OF ESTROGEN. It’s NOT a normal part of aging as many of your doctors are telling you! Wake up, educate yourself and take back your womanhood.

  22. Mountain Lion
    8 months ago

    Thank you so much Dr. Northrup, for being available for these concerns!
    I am 67 years old and have been using bioidentical hormone drops as prescribed by your former colleague Dr. Hargrove for about 15 years. At age 47 I experienced chemo induced menopause from treatment for non Hodgkin’s lymphoma. At age 58 I had a total hysterectomy following a stage 1 cervical cancer diagnosis but chose not to take chemo again. I am now concerned about the length of time I’ve been using the bioidentical hormone drops and their potential effect on the likelihood of a cancer recurrence at my mature age. Also, I’ve been diagnosed with high blood pressure and have started medication for that in the last 5 months. I’ve had low blood pressure all my life. I have two questions: is it possible that high blood pressure is related to the bioidentical hormone drops use? My second question involves getting off the drops. I have been reluctant to do that because they prevent dryness and itching, which I had very badly before taking them and I am still sexually active with my partner. Can you recommend how I can safely get off the drops but still retain my vaginal health/libido? What would you recommend that I replace it with? God bless you and thank you your amazing wisdom and generous spirit!

  23. Sharon wold
    8 months ago

    I’m 63 years old and just went off biodentical hormones two months ago because I just had a breast cancer scare and my breasts were very painful. My doctor said I was on the lowest dose. Since getting off them my breast pain went away, however, most of my joints are hurting me and I feel like an old women now. I have always stayed in shape and exercised and ate good all my life. I’m wondering if I should go back on them or just take progesterone?

  24. Maddy
    8 months ago

    Is 37 too young to be considering supplementing with bioidentical progesterone? My PMS has gotten much worse in the past couple of years. I have a mostly clean lifestyle, lots of self-care, get acupuncture, and have been taking Vit E, Selenium, Cod liver oil, and Cal Mag for some time, with no improvement. Major breast swelling and body aches, fatigue, depression, for a full 2 weeks before my (often late) cycle. Considering progesterone, but am worried it will set up a dependency and I’ll need to be on it indefinitely. Is that something I should be worried about. I have no health insurance, so most of my medical information is from my own research.

    1. Denice N.
      8 months ago

      I started taking progesterone in my late 30’s and wish I had started even earlier. When I was researching it, I found that my period discomforts…severe cramps, heavy bleeding, etc. was caused from an imbalance between the estrogen and progesterone. I had always had cramping and heavy periods since I started menstrating, but within 30 days or less after taking the progesterone I was cramp free and didn’t notice I was going to get a period. You have to stop taking the progesterone 3 days before your regular period so that the period will start. There should be some directions with the product. I used it regularly for about 4-5 years, then started to skip because I felt so good. If I started to have some of the symptoms come back, I just started using it again for awhile. I also had a friend with discomfort from endometriosis and it helped her immensely also.
      Just another note: My doctor had put me on Provera, a chemical replacement to help regulate my periods, but that was too harsh. It causes depression and other side effects. The natural bioidentical progesterone did not have the side effects.

      1. Jennifer
        7 months ago

        Can teenage girls take this? Was this a cream?

      2. Deb
        3 months ago

        Which bioidentical progesterone brand and form did you use? Thx.

    2. Try diet first instead of any hormones. In my late 30’s I started nibbling on kale on the way to collecting eggs every morning. After a month I noticed, that my cramps mellowed out. So the next month I ignored the kale. The cramps were back full force. Mind you I have had horrible cramps since my teenage years. Now hardly any since I ate about 3 bunches of kale a week for a couple of years since I discovered that it helped. My cramps went away completely, as did my moodiness, and breast swelling and tenderness. My ND Satya Ambrose helped explain how the brassicas help me metabolize my high estrogen levels. Now after loading up on kale I just need to eat a few bunches a month. Other dark greens or brassicas didn’t work and I have patients of my own that have horrible PMS and state that they eat lots of kale. I have however had immigrant patients from Asia in their 20’s and 40’s that never had PMS until they came to the US and their diets changes (less fruit and veges). So supplements of some sort and high intake of veges are likely what most needs.

  25. Patricia
    9 months ago

    I am a 68 year female with a history of female organs removed at the age of 40. For reason cancerous cells.
    Now for 2 years I have been experiencing very difficult nite sweats!
    I go regularly to a health food store here in the Houston Texas area. They recommend the Ultra Pro 50 the natural form of Progesterone which is dispensed in cream once a day on inside of my arm.

    1. Mary Johnson
      7 months ago

      Hi Patricia, im just wondering if you used the ultra pro 50 progesterone cream? I go to the same health food store in houston and i used the cream. I didnt see a change in my symptoms. Previously to using that one i was using a much cheaper one name natural source. This one worked better than tbe one recommended. I think for me it made my symptoms worse. This is only my experience.

      1. Yiyi
        6 months ago

        How do you know you arn’t putting too much of th cream on? In other words with pills you know exactly the dose but with the cream how do you know if you apply the correct amount?

  26. Gayle
    9 months ago

    Hello, I just turned 68 and am going to start bio-identical hormone pellet therapy. I’m healthy and on no meds except Armour Natural Thyroid for about 2 years. My bone density is very good, did a sleep study and I do not have sleep apena, had circulation checked in my legs as I tire easily walking or standing. Basically my entire body aches, all my muscles and joints seem to hurt, low energy, fatigue, moody depressed etc. General blood work is all normal but the blood work for hormones showed estrogen below normal range. My testosterone was in the “low normal range” so I decided I just wanted to start with estrogen pellet and the oral progesterone, my MD agreed. I’m still feeling nervous about trying this but am at a point where I cannot continue to feel so generally crummy all the time and have done the process of elimination of other possible causes for how I feel. Seems hormones could be the solution? Guess I just would like some feedback and assurance to go ahead with it?

    1. Katrina Puetz
      7 months ago

      You might want to get tested for Epstein-Barr and if it shows re-activated you may have your answer. I had similar symptoms for years and good blood work but then last draw they tested for EBV and I have two strains re-activated and one new active strain.

      1. Jane Thomas
        5 months ago

        What do you do to address the reactivation of your EBV? Any advice of experience with putting EVB back into hiding is much appreciated. Many thanks!

        1. Maria
          3 months ago

          Check out Anthony William website, he talkes a lot about EB, some great info on food and diet, good luck!

    2. Lauren
      5 months ago

      Your physical complaints sound very much like they are thyroid related. If you, by chance, have Hashimoto’s your thyroid hormones will fluctuate a lot, therefore a one size fits all thyroid supplement probably won’t work for you in every circumstance. You might want to become more familiar with thyroid symptoms for both hypothyroidism and hyperthyroidism, since the symptoms are quite insidious. Thyroid hormones are master hormones. They make the world go around, so to speak.

      I’m not sure about doing bio-identical hormone pellets. You have no control over them. With creams you can cut back or increase as needed. Just saying.

  27. Lisa
    10 months ago

    For Osteoporosis, Will the .25 estradiol patch help build bone or is it too late for a 58 yr old in the throws of Osteoporosis and surgical menopause of over 21 years. Will the patch cause side effects and cancer?

  28. MtnGirl
    10 months ago

    I’m 61 and have been on BHRT for 12 years, feeling great. I never stopped having periods, so started the hormones due to debilitating hot flashes. After a recent visit with a new ob/gyn, she was shocked I was still having periods and suggested it might be a sign of uterine cancer (assuming I must be menopausal with bleeding due to cancer, not cycles). She didn’t know if BHRT extends periods and I don’t either. What’s normal on BHRT for periods? I put estrogen and testosterone creams on 2/x day and progesterone 2/x day unless I’m menstruating. Then I hold off for 2 weeks. Can’t seem to find any answers on the internet and have been given conflicting responses from doctors. Any answers out there?

    1. Lisa Crowe
      8 months ago

      I’m reading a book right now (Ageless: The Naked Truth About Bioidentical Hormones) that indicates BHRT does extend periods. I think that’s what’s going on with you, especially since you stop the hormones for two weeks. It’s very informative and I suggest you give it a look – https://smile.amazon.com/gp/product/B000JMKVG2/ref=oh_aui_search_detailpage?ie=UTF8&psc=1

    2. Marie
      2 weeks ago

      What was the outcome?

  29. Lori DeCillis
    12 months ago

    I am 55, 2 years post-menopause and recently diagnosed and treated for breast cancer caused from estrogen. I never took any type of birth-control or hormone my entire life. I am now on an estrogen blocker for 5 years. This has caused a lot of problems with painful sex and dryness. My OB gave me a prescription for DHEA suppositories (on for a month now) and there has been some improvements. However, sexually it’s as if a light went out overnight. Are there any additional creams that may help that will be safe for me?

  30. Denise
    1 year ago

    I AM SO CONFUSED with it all 🙁 I just turned 50 and have always had bad PMS and
    lately a lot of fatigue and hormonal mood swings…i do not get hot flashes and i am a pretty good sleeper , my Dr prescibes the tri est bio dentical hormone cream but i am not sure
    why i would be taking it..yes i would like to take something that will ease this PMS and i also don’t feel like i used to as far as my sex drive, i think it drove away…and my self confidence is practically non existent..feel kinda down but not sure why, i blame everything on hormones because thats what seems to be the “issue”..should i take the bio dentical cream to make me feel like i used to!!!! i am tempted because i am tired of being tired and grumpy

  31. cecile marie
    1 year ago

    At 2 months shy of 65, I have been taking bio-identical hormones, compounded specifically for me, for over 10 years. No side affects, but best of all NO hot flashes, night sweats, or irritability. I sleep well and the only weight gain I have had was caused by too many antibiotics given for multiple surgeries 6 years ago that destroyed my micro biome. With help from Metformin ER the weight is coming off and thanks to probiotics my micro biome has recovered. My hair is thick and I have retained my hair color while my two sisters have lost all color and have thinning fine hair. Maybe this is another result of the hormones?

    1. Lisa
      10 months ago

      Cecile, where do you get your hormones? How were they prescribed?

  32. Sylvia Gruner
    1 year ago

    I am a 70 year-old who has been taking bioidentical hormones for approximately 10 years. I went through menopause in 2000. I was prescribed BHRT’s not for menopausal symptoms, but for anti-aging and overall improved health. However, I had cardio-vascular surgery 1 1/2 years ago and 4 of my traditional doctors have strongly suggested that I get off BHRT’s as there are risks for me. My doctor who prescribes the BHRT’s is adamant about my remaining on them. I’d like to get off and would like to know a safe way to wean myself from them. Any thoughts of suggestions? Is it safe for me to continue with BHRT’s for life? My traditional doctors feel that HRT’s of any kind should not be taken long term. Thanks for the help.

    1. Idell
      11 months ago

      There are studies that show a correlation between the Prempro type of HRT (CEE, oral route) and cardiovascular issues, but I could not find any studies that showed that correlation with bio-identicals or with transdermal route hormones in general.
      Do your own research. It is not that hard to do. Most of the articles can be found at Pub Med, and even some at the National Institute of Health.

      That being said, there is still a correlation with any kind of estrogen and breast cancer.

  33. Angela Rodney
    1 year ago

    Hello I am 53 and was taking synthetic prescribed HRT prescribed by my GP, but did not like the side effects. I was menstruating until I stopped the HRT mid August 2017. I recently commenced bio identical HRT of estrogen and progesterone cream a week ago, but have experienced symptoms and not sure if its normal. I have pins and needles and feel excessively hot at night. I just feels at a loss as to what to do, I am not sure whether to persevere or stop. My hormone cycle is all over the place and wish I had never started the synthetic HRT, but don’t want t make things worse.
    PLEASE HELP.

  34. SunnySweetSpot
    1 year ago

    What do you do if you are allergic to grain and soy? Doesn’t this mean that flaxseed and all soy HTR would be off limits?
    Thanks for responding.

  35. Mel
    1 year ago

    Hello
    I am 44 years old and I am post menopausal
    I have been on estrogen and progesterone and thyroid regiment for almost 20 years now
    I was in fosamax for bones and went off now have to go back on
    I’m a rare case but thought maybe you had an answer
    I’m thinking of going off everything for 6 months and see if I can just change by what I eat
    Anyways I figured I’d ask and see
    Thank you for all your great advice

    1. Lauren
      5 months ago

      Do whatever you have to do for your osteoporosis. I too have thyroid issues and had both ovaries removed at 42. Two years ago I fractured 8 vertebra. You don’t want this, believe me. At least you have a health care provider that seems to be on top of it. I would highly recommend that you don’t go off everything. Your diet is not going to take care of your issues, quite the opposite. I know that there’s a website that proposes that you can do this. Not in your case, because you have a couple of issues that could work together to cause a perfect storm. Please don’t go off everything.

  36. Wendy Norfolk
    1 year ago

    Dr. Northrup, I am interested in the vaginal creams for menopause symptoms. Most of the initial symptoms that I experience in the first couple of years of menopause have significantly diminished, but I am very concerned because (for the first time in my life) I have started to have significant pain during sex. I am happily married, and I have always enjoyed sex. I don’t intend to stop now! However, it is hard to have an orgasm when you are experiencing pain, especially with deep thrusts. I believe that the bioidentical vaginal creams are what I would like to try (I haven’t had a hysterectomy and am age-appropriate for menopause at 53), but I am concerned that most, if not all, of the creams’ bioidentical estrogens are derived from soy. Since most of the soy grown in the US (well over 90%) is genetically engineered, I am not very enthusiastic about slathering glyphosate or bt toxins into my vaginal area!! Are there any products available that are made either from non-soy plant derivatives (that are still bioidentical and therefore usable by the human body) or are soy-derived, but are 100% certified organic and/or non-GMO certified soy sources? I have searched, but haven’t found much on this to date.

    Please help!!

    Thanks so much,

    Wendy N.

    1. Ava
      12 months ago

      Hi Wendy,
      My name is Ava and after reading your post, I am in a very similar position as you (same age and same concerns and objectives). If you get an answer to your question, I would like to know what it is. I will give you my email address so that you can let me know if you find a non-GMO BHRT vaginal cream if you are willing. My email address is: 13ava63@gmail.com. Thank you in advance for any help that you can provide!
      Take care,
      Ava 🙂

    2. Erin Keiper
      11 months ago

      There is a product you can look into called Julva. It is not estrogen, just DHEA and natural moisturizers. I am a women’s health provider and have given out some free samples of it for women with low DHEA.

      1. Mary
        7 months ago

        Is Julva safe to use if your dhea-s is high?

    3. Lisa Allyn
      9 months ago

      I’m trying to find organic or atleast non GMO bio identical hormones too. I am not comfortable using daily glyphosate in estrogen cream either.
      I saw Dr Karen Leggett has a line of organic, therefore Non GMO, BIH’s online, but am still researching. Please post if anyone knows of any non GMO BIH source in USA.

      1. Cynthia Kritikos
        8 months ago

        I started researching non GMO bioidentical hormones 6 years ago. I called at least 15 different compounding pharmacies all over the country, wrote the International Academy of Compounding Pharmacists (IACP) and the Pharmacy Compounding Accreditation Board (PCAB) with no luck in responses to my concerns. Several of the compounding pharmacists told me I was the only one with this concern but one told me i opened a can of worms. It’s going to take a whole lot of us to expose this travesty to those of us who eat organic food and try to omit as many chemicals as possible in our environment. Also compounding pharmacies are not strictly regulated by the states and unfortunately there is a lot of violations by the Pharmacy Boards in that state when they do get inspected. I have personally switched 5 times due to various reasons and my Dr. has also said there is a lot of variability between the actual dosages someone receives and what was written. It’s a major problem.

        1. john picch
          6 months ago

          Cynthia,
          Go to http://www.lifeextension.com/magazine/2008/8/Estriol-Its-Weakness-is-its-Strength/Page-01 for some background on the science of the issues.

          John/biology research

      2. john p
        6 months ago

        Lisa,
        Go to http://www.lifeextension.com/magazine/2008/8/Estriol-Its-Weakness-is-its-Strength/Page-01 for some background on the science of the issues.

        John/biology research

    4. Tz
      8 months ago

      Did you get a response back on this?? just wondering, as I can relate.

      Thanks

    5. john p
      6 months ago

      Wendy,
      Go to http://www.lifeextension.com/magazine/2008/8/Estriol-Its-Weakness-is-its-Strength/Page-01 for some background on the science of the issues.

      John/biology research

  37. Karyn Palmer
    1 year ago

    Hi Christiane,
    I have come across your work only recently and I have a great respect for what you have done and continue to do. Your fabulous female body course was indeed fabulous .
    So…I am wondering if your Pueraria mirifica would serve me atm or whether i need progesterone as prescribed by the doc.
    I was diagnosed with a dvt in my calf 5 weeks ago along with 2 large PEs and am therefore on blood thinners. This has lead to my already heavy periods (due to fibroids) to become excessive. Probs being that the usual antidote for reducing bleeding ie clotting medication, I cant have. Up till now i have been a very healthy and fit 47yr old with no health issues at all so Im struggling to keep on top of these new developments and trying to keep as drug free as possible!
    I would greatly appreciate some advice!
    Thanks and love to you!

  38. Teresa
    2 years ago

    I had a total hysterectomy there for I am in surgical menopause. I’m taking a black Kosh blend
    And OTC mendapause cream. Both seemed to work well. Then my doctor prescribed Premarin vaginal
    Cream, since the start of the Premarin cream and stopping the OTC cream I was using I have NOT had one good night sleep…any suggestions for sleep and what the heck can help me? Thank you

  39. Kim
    2 years ago

    I can’t seem to locate this website or database of physicians. Can you let me know where to find this as am looking for excellent physician in my area of Boston/southern MA who does bhrt. Thanks
    “NWI maintains a database of physicians and health practitioners nationwide who prescribe natural, bioidentical hormones. “

    1. Rhonda
      1 year ago

      Perhaps ” Body Logics MD” could help.
      My “go to” in the Chicago area for BHRT.
      1 Year now. I sleep so much better, etc.

  40. Sandy
    2 years ago

    I started taking 450mg of PM in June 2016 and twice now I have had extra long (2wk) periods that are heavy. No cramping really but heavy bleeding. I’m currently in the second one. I started retaking the pills hoping for the period to stop but so far it hasn’t. When I restarted the pills I took 2 the first day and 2 the second day and one today. I need help. Am I taking too much or what. I am post menopausal I’m 65 almost 66. I like the effect of the PM and really don’t want to stop taking it. What would the schedule be or the amount be for someone like me. If my period does start (which I have had one every month since I started PM) do I stop taking the pills or continue. Should I reduce the amount I take? I have looked for answers for months and haven’t gotten anywhere. Thank you

    1. Susan
      1 year ago

      I would suggest your see your GYN and ask about an oblation.

  41. Ericka
    2 years ago

    Christiane,

    Is topical progesterone safe and effective to stop hair loss and regrow hair? I am about to order a minodoxil/tretinoin/azaelic acid product to try to regrow my hair and it is progesterone in it. I asked if the progesterone is bio-identical or synthetic but the customer service rep did not know and said she would have to contact the compounding pharmacy to find out. If it is synthetic, is it ok to use? Or will it mess up my natural progesterone production? What else can I do to stop the hair loss and get my hair back? Every day I have less hair.

    Thank you.

  42. Sheila crone
    2 years ago

    My GYN recommends Bio-Te Identical Hormone implantable pellets every four to six months. I noticed more muscular strength within two weeks. The drawback is my sexual feelings exploded and I have no partner. I asked to have less testosterone but was told it was the hormone making me feel better overall. My question is : Is Bio-T identical hormones safe? My family practiioner says it will kill me by stroke or heart attack. But she also thinks the only test I need for regulating my thyroid is TSH. No, my hypothyroidism is not managed well at all. Can you help me with finding out how safe the Bio-Te is?

    1. Annette Wellington
      1 year ago

      I am also looking into Bio-Te pellets. I have a GYN that does this. I am 60 had a hysterectomy 15 years ago. I have no sex drive, I do not sleep well, depression, anxiety, brain fog. Looking for help! I see the post above and wonder if this is safe. I read another post about soy and gmo’s. I am looking for direction. I can not have gluten and corn so the pellets sounded better than oral. Any advice?

    2. me
      8 months ago

      Your doctor is an idiot. Biodentical hormones will NOT Give you a heart attack. And if your doctor thinks all you need is a t s h test, then you need to find another doctor. They are just another one of those who really don’t give a s… about you.
      And if you are hypothyroI’d like I am sounds like you have estrogen dominance and no progesterone and that right there will wreck your thyroid. Find another doctor who can prescribe you a compound of
      B I e s t & Progeststone.

  43. Cathy
    2 years ago

    I am 67 and never took hormone replacement of any kind, nor did I ever take birth control pills during my fertile years. Would bio-identical hormones help me with aging symptoms in general such as forgetfulness? It would also be nice to feel a bit more like the woman I was hormonally before menopause.

    1. Jill
      2 years ago

      If you find an answer, please let me know! I am soon to be 63 & recently started bioidentical hormones for healthy aging. I never took birth control pills & had a natural menopause & have never take. Hormones! I am having trouble finding info regarding post-menopausal women just starting BHRT & the benefits. Most info seems to target women in perimemopause or just going through menopause. I started BHRT to slow down aging, improve skin & hair – is this a falsehood or true. Responses would be appreciated & thanks!

  44. Heather
    2 years ago

    Hello! I was wondering what works for perimenopause and having extra heavy periods? The doctor prescribed nuvaring? Seeing now it is synthetic and worried about the side effects?
    Please let me know if a patch or cream can work like the ring to calm and lighten the periods?
    Thanks,
    Heather

  45. Heather Martin
    2 years ago

    Is there a particular brand of bioidentical progesterone cream you recommend or like better than another?

  46. Michelle
    2 years ago

    I am 52 had radical hysterectomy last year and naturopath put me on compounded bio identical hormones 50mg oral progesterone, .5mg testosterone and 1mg estriol suppository for atrophy. I’m doing better than I was but I’m still symptomatic with insomnia, depression and brain fog. Western doc suggested .25 mg estradiol patch. I have had a kidney pancreas transplant 12 years ago and high risk for cancer due to meds causing cancer. Is estradiol patch safe or can u suggest something else that can help. Thank you.

    1. Christiane
      2 years ago

      The biggest contributor to cancer is excess sugar intake and emotional stress. Alcohol also contributes. Of course mammalian hormones can contribute as well. You probably know all this. You might try Pueraria mirifica liquid or capsules and see if they help. Then wean off the hormones. But all women are different. And at the end of the day, your inner wisdom is the best way to get your questions answered. Still, check out http://www.amatalife.com

      1. Cheryl Edwards
        1 year ago

        Is your product also good for osteoporosis or is an ultra low bioidentical estrogen patch a better choice to make to build bones? Or can I use both? I am 61 and have no other health issues except mild osteoporosis a -2.5 T score.

        1. Lisa
          10 months ago

          Looking for the same answer to this question regarding Osteoporosis. Will the .25 estradiol patch help build bone or is it too late for s 58 yr old in the throes oh Osteoporosis and surgical menopause o er 21 years. Will the patch cause side effects and cancer?

  47. Terri W.
    2 years ago

    I am 51 and in perimenopause. Should I be using bio identical progesterone cream daily if I’m still menstruating? I also take estrogen and testosterone. My latest urine test shows I’m a little estrogen dominate and my Dr. Is ok with that? Something doesn’t seem right to me.

    1. Kim
      2 years ago

      I would like to know this also.

    2. Christiane
      2 years ago

      The biggest contributor to estrogen dominance is excess insulin from a diet that is too high in sugar. ( A huge problem around the world). So– I recommend that you check out the book Always Hungry by David Ludwig, MD or go to http://www.drdavidludwig.com Progesterone is fine. If you’d like to do something non-hormonal that is often very effective, try Pueraria mirifica. And check out my company http://www.amatalife.com

  48. Kathy M
    2 years ago

    I’ve been on bio-identical hormones for more than 10 years but would like to get off of them. Is there any information available about how to do that safely?

    1. Christiane L NOrthrup
      2 years ago

      There are a couple ways to do this: The first is just to slowly wean off your hormones by taking one less pill per week the first week, two fewer the second week, etc. Until you are totally off the hormones.

      The SECOND way to do this is to get some Pueraria mirifica — an herbal supplement very rich in phytoestrogens but without ANY of the adverse effects of prescription hormones. Start on this one capsule in the morning and one at night. ( I started a company to bring this herb to the attention of women cause it’s so effective. http://www.amatalife.com) Then– after a couple weeks on the Pueraria mirifica, just wean off your hormones in about 2 weeks time. This will give your body a nice transition. And you may well find that all the things you experienced on the hormones that you liked are now possible with another type of approach. Thanks for asking!!

  49. Marie
    2 years ago

    Hello I just did a natural IUI , for unknown infertility, and after 5 days I had a blood test to check my progesterone level which seems to be in the normal range but doctor prefers I take progesterone to help implantation. I asked for a more natural one and they prescribed crinone. I am a very sensitive and allergic person and I am just concerned that this could just harm me instead of helping. What do you think? Thank you

    1. Christiane L NOrthrup
      2 years ago

      Crinone is bioidentical progesterone. And I believe you will do just fine on it!

  50. Carol
    2 years ago

    Now that i am on the other side of menopause, what would be the reason to take any kind of hormones?

    1. Christiane L NOrthrup
      2 years ago

      This all depends on how much hormone your adrenals and ovaries are still making. I personally take the the herb Pueraria mirifica for the phytoestrogen content. It keeps everything quite nicely moisturized. And there are also bone, heart, and reproductive system benefits. I started a company to let women know about it. Check out http://www.amatalife.com But trust your inner wisdom. You might be just fine with what you’re currently doing!

      1. Mia
        5 months ago

        Shouldn’t you take Pueraria mirifica with progesterone? You should never take estrogen by itself, correct?

  51. Karen T.
    3 years ago

    I have been using Pro-Gest progesterone cream for over 20 years(1/4 tsp. 2X a day and then 1/8 tsp. 2X a day). I originally started it to balance Premarin and continued it after stopping the estrogen pills. However, is it possible to have too much progesterone in your body tissues? After all this time, I have developed low thyroid issues, with a lot of joint and muscle pain, popping joints, etc. I wonder if these two are related. Does the progesterone cream have a build-up effect after many years of use? I am 68 years old, normal blood pressure and weight. Thanks so much for your help.

  52. Dyan
    3 years ago

    I think this slideshare will be a good complement to the article: https://www.youtube.com/watch?v=WDM9SMA637U

  53. Tisa C
    9 years ago

    I had to stop and thank you for all your courage and fortitude for standing up against traditional medicine and religion in a loving manner to make our world a better place. You are a hero for women of all ages and I have been privileged to discover your work on my journey. Blessings & Love!

  54. Coleen B.
    9 years ago

    This is so interesting. I recently heard a minister tell of healings in Africa during a mission trip. He said that these healing could take place because there were no obstacles being generated in the mind of the people seeking help. No other options except faith in the healing power of God.

    In a book I am reading, the author states, “we must ALLOW the Spirit (Divine Love-healing stream) to work. I find that statement very powerful.

  55. Stuart M.
    9 years ago

    I loved the meditation that you did on your Wednesday evening Hay House event! Wow! I am so excited to read the book, arriving from Amazon soon! I am sure the book will be wonderful and yet I feel as if I already know this. It feels so true and perfect! Since Wednesday night I have twice found myself stopping what I was doing to follow an urge to send energy to someone far away who has no knowledge of my sending it. Somehow I know it is important for me to send and that they are receiving it and it is healing them. Our paths have crossed many times. You would be amazed to know how you have showed up in my life over the years. As far back as 26 or 27 years ago when I came to a clinic that you were working at. Then at OZ Books in SW Harbor, Maine nineteen years ago next month. I remember because my now 19 year old daughter was a baby asleep in my arms as I listened to a most exciting and provacative lecture! A wonderful Louise Hay event in Atlanta 10 years ago or so…. now with 4 kids I can not be so sure of what happend when as I was when I only had one and she slept all the time …. I have followed your work, read your books and watched your PBS specials and other TV appearences. I have given your books, told people about you! I could go on and on about how much I love and appreciate you and your work! Thank you for the energy and light you put out into the world! Once again you have given me something at the exact time that I needed it. Love and blessings to you!

  56. Kim L.
    9 years ago

    Thank-you so much for bringing this information to us….I feel the healing all around me, as I did after the meditation with you at the “I Can Do It” conference in San Diego….Same Kim that spoke to you on air today….I feel it everytime I meditate with Bruno Groening, the music, with Divine Love guiding the way…..I never would have thought something could feel so right & Divine!! I bless you, & Hayhouse, & Louise Hay, & all involved in this wonderful event we shared today!! Totally Awesome!!! Thank-you………Light & Love KL

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