In four years, 50 million American women will be in menopause. The federal government’s decision in 2002 to suspend the use of synthetic hormone replacement therapy (HRT) in a large scale clinic trial of the effects of HRT, left many women and physicians uncertain about the safety of synthetic hormones and searching for alternatives.

Bio-identical (“natural”) hormone replacement therapy (nBHRT) has been proposed by some doctors as a reasonable alternative, although it is not commonly prescribed. nBHRT, like its synthetic counterpart, requires a physician’s prescription for the hormones estrogen and progesterone. The hormones differ in that nBHRT is derived from plants rather than synthetic chemicals. They also differ in that the synthetic formulations are manufactured by pharmaceutical companies and packaged into specific, standard doses. Conversely, nBHRT is prescribed in person-specific doses and compounded (i.e., assembled) by a pharmacist.

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