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Bio-identical Natural Hormone Replacement Therapy vs. Conventional (Traditional) HRT

by Lara Pizzorno, MDiv, MA, LMT

BHRT and conventional HRT are fundamentally very different

Bio-identical human hormones used for hormone replacement in women are precisely identical in their biochemical structure -- and thus also in the way they function within our bodies -- to those a human woman produces on a daily basis; the body cannot distinguish them from those it produces itself. When your body sees bio-identical hormones, it welcomes back old friends and knows exactly what to with them.

In contrast, the compounds used in conventional HRT are strangers to humans. Conventional patented HRT uses estrogens derived from female horses, specifically, from the urine of pregnant mares. These powerful horse estrogens work perfectly in pregnant mares, but wreak havoc on the much more delicate physiology of human females. Conventional HRT combines these pregnant horse estrogens with a never-before-seen on planet Earth molecule called medroxyprogesterone (MPA), a lab creation that is structurally and biochemically different from human (or even horse) progesterone, but partially mimics some actions of human progesterone. For this reason, it has been dubbed a “progestin” (or “progestogen”), a name devised to suggest progestins have some progesterone-like effects.

Since the drug companies, medical journals and many doctors frequently refer to the compounds used in HRT “estrogen” and “progesterone,” you may be surprised to learn that conventional HRT does not use human bio-identical hormones, but instead gives women daily oral doses of Premarin®, patented pregnant horse-urine-derived estrogens (thus the brand name pregnant mare’s urine, but also referred to as “conjugated equine [as in horse] estrogens” or CEEs), along with Provera® (medroxyprogesterone), the patented, new-to-nature-“progestin” that manages to imitate a few of the actions of actual progesterone.

Human and horse estrogens are not the same!

To help clarify why bio-identical hormone replacement and conventional HRT are so unlike each other, let’s take a look at some of the key differences between human and horse estrogens. (The many differences between progesterone and the progestins are discussed in the article Side Effects of the Progestins – the Drugs Used to Replace Human Progesterone in Conventional Hormone Replacement Therapy.)

“Estrogen” is not a single hormone. It’s actually a group of hormones with estrogenic activity, the “estrogens,” which occur in both human women and in female horses. Even though two forms of estrogen –estrone and estradiol—occur in human women as well as in mares, the horse versions of these estrogens are much more potent than the versions human women produce. In addition, in horses, estrone (the most potent estrogen of all) makes up a much larger percentage of the animal’s estrogens than it does in women. Because of their much higher potency, horse estrone and estradiol cause adverse effects in a woman’s body ranging from breast tenderness, fluid retention and weight gain to blood clots, strokes and cancers of the breast and uterus.

Notably missing from horse estrogens is the very gentle, lowest potency human estrogen, estriol, which comprises as much as 10% of human estrogen. Estriol is only ¼th as potent as human estradiol and only 1/8th as potent as the horse estrogen, equilin and its metabolites, which constitute as much as 50% of the estrogens found in pregnant mares – and therefore in the estrogens used in conventional HRT. In the medical literature, and on the label of HRT estrogen replacement drugs, these are called CEEs or “conjugated equine estrogens.” These horse estrogens are so potent that they are not even produced by mares unless they are pregnant!

Using these super potent pregnant horse estrogens in Premarin® to deal with hot flashes is like wielding a fire hose to snuff out a candle. Researchers have found that when a woman takes Premarin®, her body levels of equilinin can remain elevated for 13 weeks or longer, resulting in a surge in estrogenic activity that is potentially damaging enough all by itself. In addition, however, equilinin gets further metabolized into compounds 8 times more potent than any of the human estrogens – and therefore 8 times more likely to cause excess growth and promote tumors in the lining of the uterus – than bio-identical human estrogens.

Since research showed that Premarin® causes endometrial cancer (cancer of the uterus) if these excessively potent horse estrogens are not opposed by something that can at least partially mimic the protective actions of human progesterone, the drug companies created progesterone-like compounds, which they named “progestins.” HRT is typically given as Prempro®, which is a combination of Premarin® and the progestin, Provera®. Even in women whose uterus has been surgically removed, Prempro® is used rather than just Premarin®, since Premarin® alone greatly increases their risk of stroke, among numerous other adverse side effects, including:

  • Increased risk of invasive breast cancer
  • Increased risk of blood clot formation
  • Increased risk of heart disease and stroke
  • Increased risk of urinary incontinence
  • Increased risk of all kind of dementia, including Alzheimer’s disease


In contrast, in many thousands of women for more than 40 years, BHRT has been shown to relieve common menopausal symptoms without increasing risk for any of the adverse effects caused by conventional HRT. BHRT effectively eliminates:

  • hot flashes
  • night sweats
  • sleeping difficulties
  • vaginal dryness, atrophy and infection
  • decreased libido
  • urinary incontinence
  • urinary tract infections
  • increased skin wrinkling
  • memory loss, dementia and mood swings


And also safely helps prevent additional long-term adverse consequences of hormone loss:

  • osteoporosis
  • cardiovascular disease


As explained in our article Bio-identical Hormone Replacement Therapy Safety, unlike the standardized dosages and dosage schedule used for everyone given HRT, not only is each prescription for BHRT tailored to specifically meet the individual woman’s needs, but BHRT’s  dosage schedule mimics the ebb and flow of the woman’s premenopausal normal menstrual cycle.

The most recent medical studies confirm what resulted in the findings of the Women's Health Initiative of 2002 and should have been obvious from the beginning, replacing women’s waning hormone levels with estrogen and progesterone that are bio-identical to their own human hormones is much safer and more effective than using estrogens derived from pregnant mares’ urine and the never-before-seen on planet Earth, progestin.

Stay Young & Sexy with Bio-Identical Hormone Replacement: The Science Explained

This article summarizes key points presented in-depth in almost 500 pages in Stay Young & Sexy with Bio-Identical Hormone Replacement, the Science Explained by Jonathan V. Wright, MD, and. Lane Lenard, PhD. This book is the definitive resource on Bio-identical Hormone Replacement Therapy and fully explains why BHRT is the best option for women, not only to alleviate the discomforts of menopause, but to prevent the long-term negative health consequences of our aging-related decline in sex hormones.

Editor's Note:

The natural health solutions described in these article are available through many on-line retailers including those listed below. By clicking these links you help support the important alternative health research we provide.

Visit NutriStand – The Nutrition Newsstand from the Supplement Man for Science-Based Nutritional Supplements!

Visit International Antiaging-Systems for hard to find therapies. They specialize in Tomorrow's Treatments Today™.

Visit www.amazon.com – a great way to find competitive deals on supplements offered by many different manufacturers.

Visit VitaE8 - The Ultimate Vitamin E – to learn more about the importance of full-spectrum vitamin E supplements.

These articles are not intended to diagnose, treat, cure, or prevent any disease. Always consult with a physician before embarking on a dietary supplement program.

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