It takes just a few minutes on social media, a wellness podcast, or a conversation among friends to come across the topic of “bioidentical hormones.” They are often described as a “natural,” “personalized,” and even “safer” route compared with conventional hormone therapies, especially by those going through menopause, andropause, or a period of fatigue and low energy. Behind these promises, however, the clinical reality is more nuanced than the headlines suggest.

At the Sorengo Medical Center, we believe that clear, accurate information is an integral part of care. So let us try to distinguish what is supported by scientific evidence from what belongs, instead, to the language of marketing.

A correct definition: what “bioidentical” means

The term “bioidentical” refers to hormones with a chemical structure identical to those naturally produced by the body, such as estradiol or progesterone. One widespread misconception, however, needs clearing up: bioidentical is not the same as “natural” in the sense of “not made in a laboratory.” These hormones too are synthesized, generally from plant sources, and then processed to make them structurally identical to human ones.

There is also a distinction that completely changes the perspective:

• Regulator-approved bioidentical hormones, such as estradiol and micronized progesterone: standardized products, tested in clinical trials, with controlled dosage and purity.
• Compounded preparations, prepared by a pharmacy on an individual prescription, often personalized on the basis of saliva tests.

Why so much talk about them right now?

The growing interest stems from the meeting of two trends: the desire for an increasingly personalized approach to health, and the now widespread attention to longevity and hormonal balance. A recent development has made the topic even more current: in November 2025, the U.S. FDA initiated the removal of the black box warning from menopausal hormone therapies, calling it a “course correction” in light of evolving evidence. The news reignited public debate and, predictably, also fuelled expectations that are not always realistic.

What they do and which benefits they may offer

When indicated and properly monitored, hormone therapy can be an effective tool to:

• relieve menopausal symptoms (hot flashes, night sweats, sleep disturbances, dryness)
• contribute to the prevention of osteoporosis
• improve quality of life during phases of hormonal transition

One clarification is essential, however: it is the approved, standardized bioidentical hormones that have demonstrated these benefits in clinical trials. For personalized compounded preparations, on the other hand, there is no scientific evidence demonstrating greater safety or effectiveness compared with standardized therapies.

The aspects not to underestimate

The leading international scientific societies agree on several critical points regarding compounded preparations:

• dosage variability from one preparation to another
• the absence of standardized controls for purity and quality
• saliva tests, often used to “personalize” therapy, do not reliably reflect hormone levels in the blood
• the “natural” label does not eliminate the risks inherent in any hormone therapy, which must always be assessed individually

In short: “personalized” and “natural” are not synonyms for “safer.”

The Sorengo Medical Center approach

Hormonal health is not managed on hearsay, but through a serious, individual clinical assessment. That is why our pathway always begins with an accurate diagnosis: through our Gynecology unit and our Laboratory, in particular with endocrinology and hormone profiling, we build a real, objective picture of each patient’s situation.

Only on the basis of concrete data is it possible to establish whether, when, and how hormone therapy is indicated, choosing the most appropriate, evidence-based option within a broader vision of precision medicine and longevity.

An informed, tailor-made choice

Bioidentical hormones are neither a trend to chase nor a threat to fear: they are a clinical tool that, like any therapy, requires expertise, data, and genuine personalization, the kind grounded in science rather than in promises.

Taking care of your hormonal balance means relying on a pathway built on dialogue, listening, and evidence-based medicine.

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Recent references

Arnautu AM, Nimigean VR, Nacea-Radu CA, Tilici DM, Paun DL. Menopausal Hormone Therapy—Risks, Benefits and Emerging Options: A Narrative Review. International Journal of Molecular Sciences. 2025;26(22):11098. https://doi.org/10.3390/ijms262211098

Platt O, Bateman J, Bakour S. Impact of menopause hormone therapy, exercise, and their combination on bone mineral density and mental wellbeing in menopausal women: a scoping review. Frontiers in Reproductive Health. 2025;7:1542746. https://doi.org/10.3389/frph.2025.1542746

American College of Obstetricians and Gynecologists. Compounded Bioidentical Menopausal Hormone Therapy. Clinical Consensus No. 6. Obstetrics & Gynecology. 2023;142(5):1266–1273. https://doi.org/10.1097/AOG.0000000000005395

Liu Y, Yuan Y, Day AJ, et al. Safety and efficacy of compounded bioidentical hormone therapy (cBHT) in perimenopausal and postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Menopause. 2022;29(4):465–482. https://doi.org/10.1097/GME.0000000000001937