BHRT vs traditional HRT: which should I ask for and where?

BHRT vs Traditional HRT: A Practical Guide

Quick Answer

For most people, FDA-approved hormone therapy is the better starting point. Here's why:

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Traditional HRT (FDA-Approved)

What it is: Standardized, tested formulations

Recommended brands:

• Estradiol: Vivelle-Dot patch, Climara, Divigel gel, or generic estradiol
• Progesterone: Prometrium (bioidentical actually, just FDA-regulated)
• Combined: Bijuva, Combipatch
• Testosterone (off-label for women): AndroGel or compounded

Where to get it: Your OB/GYN, primary care doctor, or menopause specialist

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Compounded BHRT

Legitimate use cases: Allergies to fillers, need for custom dosing, testosterone for women Concerns: Inconsistent potency, limited safety data, often expensive

If you want this route:

• Seek a NAMS-certified menopause practitioner (menopause.org has a provider finder)
• Use an accredited compounding pharmacy (look for PCAB accreditation)

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Bottom Line Recommendation

1. Start with a NAMS-certified provider
2. Ask about FDA-approved bioidentical options first (Prometrium IS bioidentical)
3. Consider compounding only for specific clinical reasons

The marketing around "custom BHRT" is often more hype than science.