Confusingly there are two types of bioidentical hormones: those that are regulated and prescribed by GPs, and compounded bioidentical HRT – available from private clinics or ‘specials’ from pharmacies – which are not regulated in the same way as medicines by the Medicines and Healthcare products Regulatory Agency (MHRA). 

The British Menopause Society has tried to clear up some of the confusion by defining the two types as conventionally prescribed ‘regulated’ bioidentical hormone replacement therapy (rBHRT) or ‘compounded’ bioidentical hormone replacement therapy (cBHRT). 

Both types are made from plant sources such as yams, but rBHRT is a regulated medicine and has been assessed for safety and efficacy. Meanwhile cBHRT is not subject to the same regulatory pathways of evaluation by the MHRA as conventional pharmaceutical products. For these reasons, the BMS does not recommend cBHRT products . 

Mr Hamoda says: “You don’t know what you are getting with cBHRT – it’s potentially made from the same raw materials, but the purity hasn’t been followed up. There was one report from the States, where cBHRT samples from the 10 main outlets selling them were analysed and some had more oestrogen than was needed and others had less progestogen – which would be of concern because there would be a higher risk of endometrial cancer.” 

The BMS also expressed concerns about individualised serum and saliva tests offered by private practitioners and used to make up treatments tailored for individual hormone profiles, saying there was insufficient evidence to back up the claims.  

Bioidentical hormones are also sometimes prescribed by health care practitioners who don’t have expertise in menopause. Use this resource to find a BMS recognised menopause specialist.