Bio-Identical Hormone Replacement for Women

What are Bio-Identical Hormones?

Bio-identical hormones are plant derived and are the exact molecular structure as naturally produced hormones. The most commonly prescribed bio-identical hormones include estradiol (E2) and progesterone, however other bio-identical hormones including estriol (E3), estrone (E1), testosterone, DHEA, pregnenolone and cortisol are available. Because they are identical to hormones found in the body and are custom-dosed to the needs of each patient, adverse side effects and risks for cancer and heart disease are significantly reduced when compared to the use of synthetic hormones.


What is the difference between Bio-Identical and Synthetic Hormones?

Synthetic hormones such as Prempro and Premarin are similar, but not identical, to the body's hormones and can lead to adverse reactions or long-term health risks. Synthetic hormones are only available in standard doses and cannot be tailored to fit individual patient needs. Because bio-identical hormones are physiologically identical they cannot be patented by pharmaceutical companies and must be compounded by the provider or pharmacy. We most commonly prescribe capsules, pellets or creams. To read more about BioTE Hormone Replacement Pellet Therapy click here.     hormone replacement


What are the benefits of Bio-identical hormones?

Bio-identical hormone replacement therapy (BHRT) is very effective in replenishing deficient hormones when the body’s production is lacking. Potential benefits include:

  • Reduced hot flashes
  • Reduced vaginal dryness
  • Increased bone strength
  • Improved sleep, mood, concentration & memory
  • Improved libido (sex drive)
  • Improved skin health

Are Bio-Identical Hormones Safe?

When bio-identical hormones are dosed correctly to compensate for the individual's hormone deficiency, they are safe. While there are no large studies regarding the safety of bio-identical hormones over synthetic hormones, providers and pharmacists alike view bio-identical as a better alternative when hormone replacement is indicated.


As with every medication or supplement, the potential side effects of use versus the consequences of treatment refusal (in this case meaning continued hormone deficiency and associated risks) must be weighed. Use of estrogen (synthetic and bio-identical) is contraindicated for women with cancer. For any woman taking estrogen, it is important to balance it with progesterone, which offers some protection against breast cancer. Studies do show that Progesterone (bio-identical) reduces the risk of breast cancer while progestin (synthetic) increases the risk of breast cancer.


If you are considering BHRT (bio-identical hormone replacement therapy), we recommend that you review your personal risk factors for breast cancer (take the risk assessment test at and determine if the small increase in risk with the use of estrogens is worth the benefits.


How do I know if need Bio-Identical Hormones?

Your symptom picture will give your doctor the first indication of possible hormone deficiencies. At Snohomish Naturopathic Clinic we use blood and/or saliva tests to evaluate your hormone levels. Estradiol, progesterone, DHEA-S, testosterone (free and total), cortisol, TSH, FT3, and FT4 are some of the hormones we test. Together with your physician you can decide which bio-identical hormones, herbal supplements and lifestyle changes would be most appropriate for your situation.


How often will I need testing?

Testing is required yearly or anytime there is a dose change. Your need to be consistently on your dose (no missed doses or changes to your dose) for 2-3 weeks before testing. 


How often do I need an office visit?

It is important for you to make an appointment any time you feel like your symptoms have changed and your regimen is not working for you. At a minimum, we must see you in person every 9-12 months.


Where can I get bio-identical hormones?

These hormones are available at compounding pharmacies. Compounding pharmacies specialize in preparing customized prescriptions. Chain pharmacies like Bartell’s, Rite Aid and Walgreens are not compounding pharmacies.  When choosing a compounding pharmacy, you may want to call the pharmacy and ask the following questions:


  • Does this pharmacy bill insurance for compounds?
  • Does this pharmacy offer competetive pricing? 
  • What type of customer service is offered?
  • What are the mailing fees?