Bioidentical versus Synthetic Hormones Explained: Dr. Amy and Shauna
In this clip, Shauna Sandford, APRN and Dr. Amy break down one of the most common questions in hormone therapy—what’s the difference between bioidentical and synthetic hormones? Learn why molecular structure matters, how hormones can be safely delivered (pellets, patches, creams), and why progestins are not the same as micronized progesterone.
We dive into the real science behind HRT safety, the role of progesterone in protecting the uterus, and why bioidentical options offer improved compatibility with the body. If you or your patients are navigating hormone replacement therapy, this is a must-watch.
➡ Topics Covered
• Bioidentical vs synthetic hormone structure
• Route of delivery & absorption differences
• Why progestins carry risks
• Benefits of micronized progesterone
• How to make informed decisions with your provider
Watch the full interview for a deeper discussion on HRT, menopause, and modern hormone care.
Full Transcript
Bioidentical vs. synthetic hormones 0:00
So while I feel like this is a very positive thing that's happened, I did want us to talk about the black box removal doesn't address the difference between synthetic hormones and bioidentical hormones. And in our clinic we use bioidentical, but I wanted to talk about why that's important. So bioidentical hormones are plant-based. still created in a lab, but they look very similar to your natural molecular makeup of your natural estrogen testosterone. So your body tends to absorb it better, you have less side effects, and so people tend to respond better with those plant-based hormones.
Whereas synthetic is man-made also, but it is not a plant-based. It does not look anywhere near what your natural molecular makeup is. So people tend to have a little bit more side effects, but also some different risks with them. And I think the method of delivery is also very important. A lot of, or I think all of the synthetic, or most of them, hormones are delivered orally.
Delivery methods and liver metabolism 1:07
So when we take something through the mouth, it has to go through the digestive system and pass through the liver, and then a lot of times metabolites occur from that, and that's where a lot of the side effects occur. Whereas, you know, some of the methods we use that are topical or implanted do not go through the liver. And that's another reason why they're healthier. Yes. And cut back on the risk of blood clots, because you have women who are smokers, still have hot flashes, need estrogen. But you're not going to give a smoker a pill, but she at least has the opportunity to get a pellet or a cream and skip the liver and still get relief of her symptoms.
Yes. So another really important thing that I don't think has been in the news is progestins, because the Women's Health Initiative did find a correlation between
Progestins, progesterone, and black box warnings 2:01
progestins and blood clots and heart disease. Yes, and those are your synthetic, again, so your plant-based, your progesterone that we use from a compound pharmacy is yams with a peanut oil or an olive oil and there was no clarification between progestins progesterone and where it comes from and so they haven't removed any black box warning from the progestins
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