Understanding Body-Identical HRT - A Personalised Approach to Hormone Replacement Therapy

When it comes to managing perimenopause and menopause, the world of hormone therapy

can feel overwhelming. Terms like body-identical, bioidentical and synthetic are often used

interchangeably, which can make it difficult to know what’s safe, what’s natural, and what’s right for you. At The Parkwood Clinic, we believe in cutting through the jargon. This guide explains what body-identical HRT really is, how it differs from older synthetic forms, and why a personalised approach makes all the difference.

What Is Body-Identical HRT?

Body-identical HRT uses hormones that are molecularly identical to those your body naturally produces. They are typically derived from plant sources, such as yams, and then processed in a laboratory so the final product precisely matches human hormones.

There are two main ways these hormones can be prescribed:

• Licensed, regulated products – for example, Oestrogel (estradiol gel), Utrogestan (micronised progesterone), and licensed testosterone gels. These are manufactured to strict quality standards and regulated by the MHRA.

• Compounded bioidentical HRT (cBHRT) – custom-made by a specialist pharmacy to a clinician’s bespoke prescription. These products use the same hormones as licensed versions, but can be blended to create tailored combinations (for example, a single cream containing oestrogen, progesterone, and testosterone). Because each cBHRT formulation is unique, it cannot be licensed in the UK. However, when prescribed and monitored by a qualified clinician and dispensed by a reputable pharmacy, it is considered both safe and effective.

Body-Identical vs Synthetic HRT

Earlier generations of HRT used hormones that were similar, but not identical, to those naturally found in the body. One of the most well-known examples is conjugated equine oestrogens (CEEs), derived from the urine of pregnant mares and found in older products such as Premarin. Because these hormones differ slightly in structure, they can behave differently in the body and sometimes cause unwanted side effects (Stuenkel et al., 2015). By contrast, body-identical HRT provides hormones that are an exact molecular match to human oestrogen, progesterone and testosterone — supporting balance and symptom relief in a more physiological way.

What About Testosterone?

Testosterone isn’t just for men — it plays a vital role in sexual desire, energy, concentration,

and mood in women too. There’s currently no testosterone product licensed specifically for

women in the UK, but both NICE (2024) and the British Menopause Society support its use

when low libido is an issue and other causes have been excluded. When prescribed and

monitored by a qualified clinician, testosterone can be a safe and effective part of an

individualised HRT plan.

Benefits of Body-Identical HRT

Research suggests that body-identical HRT can: • Relieve hot flushes, night sweats, mood

swings and sleep disruption (NICE, 2024) • Support bone health and reduce fracture risk

(Stuenkel et al., 2015) • Improve cholesterol balance and cardiovascular health (Scarabin et al., 2003) • Support cognitive function and mood regulation (Davis et al., 2019) • Improve vaginal dryness, urinary urgency, and skin and hair quality.

How We Personalise Treatment at The Parkwood Clinic

Every HRT journey begins with a comprehensive consultation, exploring your full medical

history, lifestyle and goals. Depending on your individual situation, this may include:

• Blood testing (especially helpful for monitoring testosterone) • Discussion of symptoms and wellbeing priorities

• A tailored treatment plan built around your needs • Regular reviews to fine-tune your

hormones over time In some cases, your GP may also be able to prescribe part of your HRT via the NHS. Even so, we continue to support and monitor your progress to ensure your care

remains safe and personalised.

Is Body-Identical HRT Safe?

Like any treatment, HRT carries both potential benefits and possible risks. The balance

depends on factors such as your age, health history and the form of HRT used. That’s why

ongoing monitoring and individualised care are essential. At The Parkwood Clinic, treatment

decisions are guided by the latest research and reviewed regularly to ensure the benefits

continue to outweigh any risks. Where appropriate, blood tests are used to check that hormone levels — particularly testosterone — remain within a safe and therapeutic range.

Final Thoughts

Body-identical HRT isn’t a miracle fix, and it’s not the right approach for everyone. But for many women, it can bring transformative improvements in energy, mood, sleep and overall quality of life. If you’ve been told to “wait it out” or simply feel that something isn’t right, it’s worth exploring whether a more personalised approach to HRT could help you feel like yourself again.

Written by Tracey Miles

References

• NICE (2024). Menopause: diagnosis and management.

https://www.nice.org.uk/guidance/ng23 • British Menopause Society (2024). Bioidentical

Hormone Therapy Position Statement. https://thebms.org.uk • Stuenkel C.A. et al. (2015).

Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline.

https://doi.org/10.1210/jc.2015-2236 • Scarabin P.Y. et al. (2003). Oral and transdermal

estrogen therapy and VTE risk. https://doi.org/10.1016/S0140-6736(03)13013-2 • Davis S.R. et

al. (2019). Global consensus on testosterone therapy for women.

https://doi.org/10.1080/13697137.2019.1637074