Bioidentical Estrogens Are Safe, Right?

Let’s cut to the chase – it depends. Most of my menopause patients ask about bioidentical estrogens. Women everywhere are talking about them. Oprah did a show about them. Suzanne Somers wrote books about them. And women in book clubs and boardrooms are hearing bioidentical estrogens have all the benefits of pharmaceutical estrogen with none of the associated risks.

But is that really true? Read on.

What is bioidentical estrogen?

Like every hormone in the body, estrogen has a specific chemical structure. It looks like chicken wire made from 18 carbon atoms with one, two or three “OH” groups hanging off some of those carbon atoms. If it has one “OH” group it is called estrone or E1. If it has two “OH” groups it is called estradiol or E2. If it has three “OH” groups hanging off it is called estriol or E3. These are the three main biological estrogen molecules that a woman’s body normally makes. Estradiol is the most potent one and before menopause, is the most abundant.

When people talk about bioidentical estrogens, which estrogens are they talking about?

While there are other bioidential hormones such as testosterone and progesterone, there are only three bioidentical estrogens: estrone, estradiol and estriol. These three hormones can be found in chain drug stores and in compounding pharmacies.

How are bioidentical estrogens different from other estrogen products?

Most of the estrogen molecules that are purchased in a drug store have a similar chemical structure to E1, E2 or E3, but they are not identical to them. Your body thinks non-bioidentical estrogens are close enough to bioidentical ones to respond to them. But they aren’t exactly the same; they might be a little stronger, a little weaker, or just different.

Bioidentical estrogens are exactly the same chemical structure as the biological ones the body normally makes. They may come from plants, but they are not made in plants. You can’t squeeze a plant and get bioidentical estrogen out of it. The only plant they are made in is a chemical plant. So they are not natural. That is why the term used to describe them is bioidentical. The body cannot turn plant estrogens into human estrogens. It doesn’t have the necessary enzymes to do that.

Bioidentical estrogen is safer than non-bioidentical estrogen, Right?

Which weighs more: a pound of feathers or a pound of bricks? They both weigh a pound and are the same. In other words, bioidentical estrogens might be weaker than some pharmaceutical estrogens, but if they are given in equivalent dosages so a person receives an equivalent amount, the benefits and the risks should be the same.

The problem is that while there are many studies with non-bioidentical estrogen medications sold in traditional drugstores, there are very few safety studies on bioidentical hormones. Most doctors believe that if it is given in the equivalent amount, the risk of estrogen is the same whether it is bioidentical or a different molecule.

Is there any real advantage to bioidentical hormones?

For me, the major advantage of bioidentical hormones is that they can be measured in laboratory tests and you can know exactly how much is in your bloodstream. Other estrogens cannot be measured as precisely.

Another benefit of bioidentical estrogens is that the dose can be mixed just for you. So if your needs happen to fall between the available dosages of standard pharmaceutical estrogens, a special dosage or combination can be compounded just for you.

Finally, bioidentical estrogens can be compounded together with bioidentical progesterone and/or testosterone or other hormones and all can be applied in one application rather than having to take more than one medication.

Bottom line.

If you think estrogen is for you and your doctor or health care provider believes the benefits are greater than the risks for you, then consider any estrogen as a possible choice.

Many patients don’t realize that there are bioidentical estrogens available in traditional drugstores both as pills and patches and through other forms. Those formulations must all pass national standards for manufacturing. Most bioidentical estrogens are mixed in the specific drugstore you purchase them in and are not regulated as closely. Most do a great job. But there is a large difference in how closely they are regulated.

Get instant access to a free eBook on how to take estrogen and progesterone and which one to use by clicking here.

How Bioidentical Hormones Can Help Women Before & After Menopause
Risks & Benefits of Hormones in Menopause
6 Things Every Woman Should Know Before Menopause


Natasha Salgado
Past Member 4 years ago


Michele Wilkinson

Thank you

KS Goh
KS Goh6 years ago

Thanks for the article.

Kimberlee W.
Kimberlee W6 years ago

For those sleepless nights, I want to remind everyone again - VALERIAN ROOT - 2x the dosage on the bottle for 3 nights. On that 3rd night, when your body recognizes the stuff for what it is and starts to react to it, BEST sleep of my life!

Lu Ann P.
Past Member 6 years ago


Paul Moodie
Paul Moodie6 years ago

I cant believe people actually believe this dribble about synthetic and bio-identical etc. It is just marketing hype and not science. Science in a lab does not equate to the actual effects on a human being. Your body has all the mechanisms to make all the hormones you need and it does it naturally. Ok, it's as simple as this and without a science lesson all you need to do is improve your levels of DHEA (dehydroepiandrosterone) a pro hormone that is the primary steroid of the body and the precursor to all other hormones and active metabolites. If you are missing this stuff your heading into troubled waters. If you take synthetic or plant versions of hormones they are still not a natural substance and will cause your glands to atrophy away so you have no choice then but to continue with them. It's the old use it or lose it. This can be a complex subject but I would suggest you look up glyconutrients (this subject will be an eye and mind opener for most) and phytosterol nutrients. Welcome to a healthier you.

Annemarie Vidal
Anne-Marie Vidal6 years ago

Useful information!

Holly Lawrence
Holly Lawrence6 years ago


Dolores M.
Dolores M6 years ago

Try bio-identical hormone pellets from Sottopelle. I do. My osteopenia is almost gone according to my DEXA, no more hotflashes, I don't have the spare tire typical after menopause....I feel great!

Mache Seibel MD
Mache Seibel MD6 years ago

Hi Majaana,
You are correct. If a woman has a uterus and takes estrogen, she must take progesterone at least a few times a year to prevent or at least greatly lower the risk of uterine cancer. If she has had a hysterectomy (uterus removed) she does not need to take progesterone. I have several videos on this at and you can also sign up there for my free newsletters and updates.