03/11/2026
Some points of interest put forth by the NL Menopause Foundation which are worth the read. Always nice to see these items clarified by a reputable source. See below👇
HRT, MHT, BHRT, Compounded, Synthetic… What Do These Terms Actually Mean?
We often hear different terms used in menopause conversations:
• HRT (Hormone Replacement Therapy)
• MHT (Menopausal Hormone Therapy)
• BHRT (Bioidentical Hormone Replacement Therapy)
• Compounded hormones
• Synthetic hormones
Let’s clarify what they mean.
𝗪𝗵𝗮𝘁 𝗱𝗼𝗲𝘀 “𝗯𝗶𝗼𝗶𝗱𝗲𝗻𝘁𝗶𝗰𝗮𝗹” 𝗺𝗲𝗮𝗻?
“Bioidentical” simply means the hormone is structurally identical to the hormone your body produces.
𝗜𝗺𝗽𝗼𝗿𝘁𝗮𝗻𝘁: many Health Canada and FDA-approved estrogen patches, gels, sprays, and oral micronized progesterone are also bioidentical.
Use of the term “bioidentical” grew after the 2002 WHI study, as many women and clinicians looked for alternatives to traditional hormone therapy and interest in compounded products increased.
𝗪𝗵𝗮𝘁 𝗶𝘀 𝗰𝗼𝗺𝗽𝗼𝘂𝗻𝗱𝗲𝗱 𝗵𝗼𝗿𝗺𝗼𝗻𝗲 𝘁𝗵𝗲𝗿𝗮𝗽𝘆?
Compounded hormones are prepared by a compounding pharmacy and are not approved and reviewed by Health Canada or the FDA for safety, efficacy, and batch-to-batch consistency in the same way as commercially manufactured products.
They may be appropriate in certain situations, such as when someone cannot tolerate a specific ingredient in an approved product, but most major menopause societies recommend approved formulations when available.
Routine hormone blood or saliva testing is generally not recommended to guide dosing in menopausal women, as treatment is usually based on symptoms, response, and tolerability, not a target hormone level.
𝗪𝗵𝘆 𝗱𝗼 𝗲𝘅𝗽𝗲𝗿𝘁𝘀 𝗼𝗳𝘁𝗲𝗻 𝗿𝗲𝗰𝗼𝗺𝗺𝗲𝗻𝗱 𝗮𝗽𝗽𝗿𝗼𝘃𝗲𝗱 𝗛𝗥𝗧/𝗠𝗛𝗧 𝗳𝗶𝗿𝘀𝘁?
Health Canada/FDA-approved products:
• Are tested for safety and consistency
• Have standardized dosing
• Are often covered by insurance
• Are supported by clinical data
𝗖𝗼𝗺𝗽𝗼𝘂𝗻𝗱𝗲𝗱 𝗳𝗼𝗿𝗺𝘂𝗹𝗮𝘁𝗶𝗼𝗻𝘀:
• Are typically not covered by insurance
• May have inconsistent dosing
• Can become costly over time
In addition, progesterone creams may not reliably provide adequate endometrial protection when used with estrogen, which is an important safety consideration.
𝗜𝗺𝗽𝗼𝗿𝘁𝗮𝗻𝘁 𝘀𝗮𝗳𝗲𝘁𝘆 𝗻𝗼𝘁𝗲𝘀
• Transdermal estrogen (patch, gel, spray) has a lower clot risk than oral estrogen and is often preferred when a non-oral route is desirable.
• Oral estrogen carries a small increased risk of blood clot compared with transdermal estrogen.
• Micronized progesterone is generally preferred over some synthetic progestins, including medroxyprogesterone acetate, depending on the individual clinical situation.
That said, the best hormone therapy regimen is individualized. What works well for one woman may not be the best fit for another. Dose, formulation, delivery method, symptoms, and personal medical history all matter.
𝗔𝗰𝗰𝗲𝘀𝘀 𝘁𝗼 𝗰𝗮𝗿𝗲
If you are unable to access menopause-informed care through your family physician, other options may include local menopause-focused providers or reputable telehealth platforms such as Felix. See our page for a recent post outlining currently available virtual care options.
𝗢𝘂𝗿 𝗽𝗼𝘀𝗶𝘁𝗶𝗼𝗻
The Menopause Foundation of Newfoundland and Labrador does not provide medical advice and is not affiliated with any pharmaceutical or compounding entity. Our role is to share evidence-based information so women can have informed discussions with their healthcare providers and make decisions that are right for them.
Menopause care should be individualized, evidence-informed, and accessible.
The Menopause Navigators abide by Menopause Society guidelines and hold ourselves to a high standard of care. To book your appointment with us please call 709-651-7546.
