Increasing numbers of patients are inquiring about Natural Hormone Replacement Therapy. This may be due to changing population demographics, increased awareness of the benefits of hormone replacement in general (relief of menopausal symptoms, prevention of osteoporosis, reduced risk of heart disease and alzheimer’s, improved lipid profile, improved energy levels and libido). Some patients have animal rights concerns over the use of equine derived conjugated estrogens. Some prefer not to use a chemically altered product. Some have had side effects from commercial preparations.

NHRT refers to "Bio-Identical" hormones - molecularly identical to or same chemical structure as those hormones made in the human body. They are plant-derived, chemically processed from precursors found in yam or soybeans.

Bio-identical hormones available for compounding include the estrogens estrone, estradiol, estriol. Also available - progesterone, testosterone, DHEA, pregnenolone and androstenedione.

Human estrogen is composed of Estrone 10-20%, Estradiol 10-20% and Estriol 60-80%.

Equine estrogen (Premarin) is composed of Estrone 70-80%, Estradiol & others 5-19% and Equilin 6-15%.

A typical estrogen formulation (TriEst) would be 80% Estriol, 10% Estradiol and 10% Estrone. (i.e. TriEst 2.5mg would contain Estriol 2.0mg, Estradiol 0.25mg and Estrone 0.25mg. TriEst 2.5 mg estrogen activity approximates conjugated estrogen 0.625mg.)

Micronized progesterone 100 mg is approximately equal to medroxyprogesterone 5 mg.