Bioidentical hormone therapy

"Bioidentical" is a marketing term, not a regulatory or pharmacological category, and this is the central thing to understand about it. Regulator-approved body-identical products (transdermal estradiol, micronised progesterone, testosterone) have genuine randomised evidence, but for symptom control in menopause and for treating diagnosed hypogonadism, not for extending healthspan or lifespan. Custom compounded bioidentical preparations are a separate case: the 2020 US National Academies review found a lack of rigorous safety and effectiveness evidence from well-designed or properly controlled studies, and recommended their use be restricted. The Australasian Menopause Society states it cannot endorse compounded bioidentical therapy, noting there are no data on the efficacy of compounded oestrogen for maintaining bone density, that compounded progesterone delivery has been documented as inadequate for endometrial protection with associated endometrial cancer risk, and that excipients in the preparations are unknowable. Salivary hormone testing, frequently bundled with BHRT programmes to justify dosing, is not a validated basis for titration. There is no clinical trial evidence that any bioidentical hormone regimen, compounded or pharmaceutical, extends lifespan, slows biological ageing, or improves a hard healthspan endpoint in people without a hormone deficiency. The gap between what is sold and what is shown is wide, which is why this grades commercial rather than clinical.

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Common questions

What is Bioidentical hormone therapy?

"Bioidentical" is a marketing term, not a regulatory or pharmacological category, and this is the central thing to understand about it. Regulator-approved body-identical products (transdermal estradiol, micronised progesterone, testosterone) have genuine randomised evidence, but for symptom control in menopause and for treating diagnosed hypogonadism, not for extending healthspan or lifespan. Custom compounded bioidentical preparations are a separate case: the 2020 US National Academies review found a lack of rigorous safety and effectiveness evidence from well-designed or properly controlled studies, and recommended their use be restricted. The Australasian Menopause Society states it cannot endorse compounded bioidentical therapy, noting there are no data on the efficacy of compounded oestrogen for maintaining bone density, that compounded progesterone delivery has been documented as inadequate for endometrial protection with associated endometrial cancer risk, and that excipients in the preparations are unknowable. Salivary hormone testing, frequently bundled with BHRT programmes to justify dosing, is not a validated basis for titration. There is no clinical trial evidence that any bioidentical hormone regimen, compounded or pharmaceutical, extends lifespan, slows biological ageing, or improves a hard healthspan endpoint in people without a hormone deficiency. The gap between what is sold and what is shown is wide, which is why this grades commercial rather than clinical.

How strong is the evidence for Bioidentical hormone therapy?

Commercial. It is offered and sold, which is a statement about availability, not about efficacy.

Is Bioidentical hormone therapy approved in Singapore?

Health Sciences Authority position on record: "Bioidentical hormone therapy" is not an HSA approval category. Individual body-identical hormone medicines (estradiol, micronised progesterone, testosterone) are HSA-registered prescription therapeutic products, indicated for menopausal symptoms and male hypogonadism respectively; use for general "longevity" or anti-ageing purposes is off-label. Custom compounded bioidentical preparations are not HSA-registered and have not been evaluated by HSA for quality, safety or efficacy. HSA permits licensed healthcare institutions and retail pharmacies to compound without a manufacturer's licence only under specific conditions: the final compounded product must not be commercially available in Singapore, compounding must occur on the licensed premise under a pharmacist or qualified practitioner, an appropriate expiry date must be documented, and prescription-only ingredients require a valid prescription. So compounded BHRT is lawful in narrow circumstances but carries no regulatory assessment.. An evidence grade and a regulatory approval are different questions.

Is Bioidentical hormone therapy approved in Australia?

Therapeutic Goods Administration position on record: "Bioidentical hormone therapy" is not a TGA approval category. Pharmaceutical body-identical hormones are TGA-registered on the ARTG (estradiol patches, gels and tablets; micronised progesterone as Prometrium/Utrogestan; testosterone products) and several are PBS-listed, approved for menopausal symptoms and male hypogonadism; longevity or anti-ageing use is off-label. Compounded bioidentical preparations are a different matter: they are exempt from ARTG inclusion under the extemporaneous compounding provisions of the Therapeutic Goods Regulations 1990, where a medicine is compounded for a particular person for therapeutic application to that person and not held as routine stock. Compounding in anticipation of demand is prohibited outside hospital settings. The exemption means the TGA has not evaluated these preparations for quality, safety or efficacy. The Australasian Menopause Society does not recommend compounded bioidentical hormone therapy in any form.. An evidence grade and a regulatory approval are different questions.

Which clinics offer Bioidentical hormone therapy?

2 clinics in the variis directory across Singapore and Australia have Bioidentical hormone therapy on record. Each is listed on this page with its own sourced profile.

What else is Bioidentical hormone therapy called?

Also known as BHRT, cBHT, compounded bioidentical hormones, bio-identical hormone support, body-identical hormone therapy.