Hormone therapy · Sponsored

Bioidentical Hormones Explained: What BHRT Is, and What the Evidence Says

'Bioidentical' sounds like a promise. It is actually a description of molecular structure. Here is what it does and does not tell you.

Updated October 9, 2026

Sponsored. This article features a product from Vea Health. We have a financial relationship with Vea Health. How we make money.

What you'll learn

Bioidentical hormones have the same chemical structure as hormones the body makes, such as estradiol and progesterone.¹
Some bioidentical hormones are FDA-approved; compounded bioidentical hormone therapy (cBHT) is not.^1,2
A 2020 National Academies report found limited evidence on the safety and effectiveness of compounded BHRT.¹
The Menopause Society recommends FDA-approved hormone therapy where it meets a woman's needs.³

What "bioidentical" means

A bioidentical hormone has the same molecular structure as one the human body makes. Estradiol and progesterone are the main examples in menopause care.¹ "Bioidentical" says nothing by itself about safety, dose or quality; it describes the molecule.

Two very different categories

The term covers two groups that often get confused:

FDA-approved bioidentical products: several estradiol and progesterone products are FDA-approved and come with full prescribing information.^3,4
Compounded bioidentical hormone therapy (cBHT): preparations made by a pharmacy for an individual patient, often as creams or combinations. These are not FDA-approved.^1,2

What the National Academies found

In 2020 the National Academies of Sciences, Engineering, and Medicine reviewed compounded bioidentical hormone therapy at the FDA's request. The committee found limited high-quality evidence on the safety and effectiveness of cBHT preparations and raised concerns about how widely they are used.¹ The Menopause Society similarly recommends FDA-approved hormone therapy over compounded preparations where an approved product meets a woman's needs.³

Why women still choose compounded options

Compounding allows formats and combinations that are not sold as approved products, such as a single cream combining estradiol and progesterone. Some women prefer a cream, or a prescriber who manages both hormones together. Those are real reasons, and they are a choice to make with clear eyes about the evidence.

Velora

Velora Hormone Balance, from Vea Health, is a compounded estradiol and progesterone cream prescribed after a licensed clinician reviews your health history, with scheduled clinician check-ins as part of ongoing care.⁵ As a compounded preparation it is not FDA-approved.²

Questions worth asking

Is there an FDA-approved option that would meet my needs?
What doses of each hormone am I being prescribed?
How will my clinician monitor me, and how often?

Important safety information. Estrogen therapy is not appropriate for everyone. Women with a history of breast or uterine cancer, blood clots, stroke, heart attack, liver disease or unexplained vaginal bleeding need specialist advice, and estrogen should not be used during pregnancy.⁶ Women who still have a uterus are generally prescribed a progestogen such as progesterone alongside systemic estrogen to protect the uterine lining.³ Report any unexpected bleeding, breast changes, leg swelling, chest pain or sudden headache to a clinician right away.⁶ Only a licensed clinician who knows your health history should decide whether hormone therapy is appropriate for you.

Your questions, answered

What does bioidentical mean?

A bioidentical hormone has the same molecular structure as one the body makes, such as estradiol or progesterone. It describes the molecule, not its safety.

Is compounded BHRT FDA-approved?

No. Compounded bioidentical hormone preparations are made by a pharmacy for an individual patient and are not FDA-approved. Some bioidentical hormones are available as FDA-approved products.

What did the National Academies say about compounded BHRT?

Its 2020 report found limited high-quality evidence on the safety and effectiveness of compounded bioidentical hormone therapy.

Keep learning

References

National Academies of Sciences, Engineering, and Medicine. The Clinical Utility of Compounded Bioidentical Hormone Therapy. 2020.
U.S. Food and Drug Administration. Compounding and the FDA: Questions and Answers.
The North American Menopause Society. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022. PubMed 35797481.
Estradiol prescribing information. DailyMed, U.S. National Library of Medicine.
Vea Health. Velora Hormone Balance intake. Accessed October 9, 2026.
Estrogen. MedlinePlus Drug Information, U.S. National Library of Medicine.