--- title: "The Power of Words: clarifying the language of HRT/MHT" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/menopausehormonetherapy" markdown_url: "https://www.drsmithnd.com/llms/blog/menopausehormonetherapy" lastmod: "2025-02-26T19:52:00.000Z" --- I know the terminology around hormone therapy is super confusing for women and I see this reflected in the questions my patients ask me all the time... So I hope this list of definitions is helpful! Bioidentical Hormones are products that are created such that the hormone in the product is molecularly identical to human hormone. Most (but not all) of modern menopause hormone therapy is, in fact, bioidentical. This is a term still commonly used for compounded hormone products (read below) which creates a lot of confusion. Body Identical Hormones are the exact same as bioidentical; these are synonyms. Natural Hormones are hormones that are endogenous, that our bodies make. Perhaps some people are using “natural” as a synonym for body/bio identical hormones, but technically this is not correct because these products are entirely made in a lab from various plants, they are not squeezed from a human! Synthetic Hormones …Often people use this term when referencing hormone products that are not bioidentical such as the progestin in a birth control pill that is not molecularly identical to the progesterone our body makes. Compounded Hormones are hormones that are made at a compounding pharmacy, where the pharmacist has taken additional training to be able to make medicines. This can be useful when someone needs a dose not available in the pharmaceutical market, or a person requires a product without certain adjuvants, emulsifiers or fillers. Historically, bioidentical was the term used to refer to compounded hormones because there were times when that was the only way to obtain bioidentical hormone products. For many years now however, in Canada and in most countries, the national health agencies (Health Canada, or for the US the FDA), have approved and put to market numerous bioidentical hormone products. This is important as often these products will be covered by insurance while compounded hormone products often are not. Interestingly, most medical doctors still refer to compounded hormones as “bioidentical”, not realizing that the Health Canada approved products they’re prescribing regularly are actually….”bioidentical”. This is largely due to history of using the word bioidentical to refer to compounded products, the twisty history of HRT, the lack of critical focus, guidelines and support for this tool (hormone therapy) that can play a vital role in women’s lives. It is still the case that many medical providers are very leery of compounded hormones, but why? This is because there is concern that there is not the level of measured controls and standardization to ensure exactly what is in the final product, every single time the product is made and which could be a safety issue. For example, oral progesterone capsules, which are responsible for ensuring that the uterine lining doesn’t overgrow, precipitating the risk for uterine (endometrial) cancer due to being on estrogen therapy (estrogen makes uterine lining grow). Because progesterone plays a crucial role in the safety of the uterine lining, many providers are nervous about compounded product. There is debate around whether these concerns are still relevant with the technologies, licensing and practices of the regulated compounding pharmacists of today. Is Bioidentical Hormone Therapy Safer? The short answer is yes. Hormone products that are identical to our endogenous hormones are better for us, however there are times when other products for an individual case may perform better and be the wiser choice. The crucial point here is: everyone deserves to have a proper risk-benefits ratio conversation per their individual situation with a perimenopause or menopause literate health care provider. This is not a one size fits all situation; not even remotely. There are times when a non bioidentical product IS the best choice, it just all depends. Pocket Guide from the Canadian Menopause Society To look up products available in Canada, the Canadian Menopause Society created a handy little pocket guide, at the bottom of which is a chart. For bioidentical progesterone you are looking for the word micronized progesterone, for bioidentical estrogen you’re looking for estradiol or estrone (for vaginal cream). You can check it out [here](https://www.canadianmenopausesociety.org/sites/default/files/pdf/publications/Final-Pocket%20Guide.pdf). Spread the Word! I hope this was clarifying. You are officially more literate than your girlfriends (and sadly the vast majority of all types of medical and health care providers) about the ridiculous confusion regarding the semantics around hormone therapy! Feel free to share this blog with anyone you know who might be in need of it. If you have any more questions or want to work with me and you're located in Ontario, Canada, check out my [online booking platform. ](https://drsmithnd.janeapp.com/#staff_member/1) To sign up for my newsletter where we cover breaking news, tips, bust myths and generally provide really valuable and fun content for midlife women, click [HERE.](/newsletter-signup) And don't forget to follow me on [Instagram](https://www.instagram.com/drkirstensmithnd) where I often post fun reels on various women's health-related topics! Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors.