What are Bio-Identical Hormones?

Bio-identical hormones offer an effective and safe alternative to commercially produced hormones as well as numerous health benefits. Bioidentical hormones are identical to those produced by your own body and are individually dosed to replicate your own specific symptoms and lab tested deficiencies.

Bio indentical Hormones
Conventional HRT vs. bio-identical hormone replacement therapy

If you have heard of the controversies surrounding conventional hormone replacement therapy (HRT) and the billion dollar commercial menopausal industry, and if you’re unsure what it all means, Calgary physician Dr. Bruce Hoffman can help. Dr. Hoffman is board certified in Anti-Aging, Regenerative and Functional Medicine, and a certified fellow in the same disciplines. He specializes in advising women and men regarding bio-identical hormone replacement treatment. He understands this medical minefield and can explain the complexities of the debate surrounding menopausal hormone therapies. With his unique insights Dr. Hoffman will bring you up-to-date and advise you concerning alternatives to HRT. Above all, he will explain that one size does not fit all with hormone therapy.

Conventional hormone replacement therapy (HRT) uses animal and synthetic hormones. In the last few decades HRT was heavily marketed; millions of women were prescribed synthetic estrogen and progesterone. In July 2002, there was a major reversal in thinking among the medical profession and women following the release of data from the Women’s Health Initiative (WHI) study.

We now have many studies, which show that these mass produced hormones are associated with significant adverse side effects, including cancer, heart disease and other health problems.

Biologically identical hormone replacement is an emerging therapy that is gradually winning more and more converts in the medical profession and among the public. Bio-identical hormones offer an effective and safe alternative to commercially produced hormones as well as numerous health benefits.

They alleviate the symptoms caused by a natural decrease in the production of hormones in the body during menopause and andropause. They re-establish a hormonal balance and provide protective benefits. For example, natural estrogen and progesterone protect against heart disease, stroke, osteoporosis and Alzheimer’s disease. Natural progesterone protects against breast cancer.

If you’ve heard the “buzz” about bio-identical natural hormone therapy offering an alternative to synthetic hormones but you are unsure if natural hormones are the answer for you, Dr. Hoffman can help. He will explain the real issues and assist you to figure out the risks and benefits of HRT, as well as the ins and outs of natural HRT.

Dr. Hoffman will look at your options given your family history, health status, and menopause experience, and help you make a choice about whether natural hormone therapy is right for you.

If you would like to learn more about bio-identical hormone replacement therapy in Calgary and southern Alberta, please contact
The Hoffman Centre for Integrative Medicine at (403) 206-2333 or schedule an appointment online.

Frequently Asked Questions

What are hormones?

Hormones are critical to our health. Produced by the endocrine glands, hormones are natural substances that act as the brain’s messengers. They tell the body’s internal organs how to function. When we reach middle-age we start to produce fewer hormones. Hormone production continues to decline as we grow older. Researchers now believe that hormonal decline is actually a major cause of aging.

What is a "bio-identical" hormone?

When people talk about “bio-identical” hormones I don’t understand what they mean. Bio-identical hormones are biologically identical (have an identical molecular structure) to the hormones naturally produced in the body and function in the body the same way as the body’s own hormones.

Natural progesterone and natural estrogen are processed from botanical plants (soy, wild yam) and are made into either a cream for use on the skin or an oral supplement.

What is "natural" HRT?

Natural hormone replacement therapy is another name for bio-identical hormone replacement therapy.

Why should I try bio-identical hormones instead of conventional HRT?

Biologically identical hormone replacement is an emerging therapy that is gradually winning more and more converts in the medical profession and among the public. Bio-identical hormones offer an effective and safe alternative to animal or synthetic treatment.

Conventional hormone replacement therapy (HRT) uses synthetic hormones that are produced in a laboratory and patented by pharmaceutical companies. Premarin, for instance, is an estrogen obtained from pregnant horses. In the last few decades HRT was heavily marketed by these drug companies. Millions of women took HRT although neither they nor their physicians understood the full risks and benefits associated with synthetic hormones.

In July 2002, there was a major reversal in thinking among the medical profession and women following the release of data from the Women’s Health Institute (WHI) Study in the Journal of the American Medical Association (JAMA).

The WHI was a 15-year national health study involving over 161,000 women, ages 50-79, in the US. This study investigated the risks and benefits of synthetic estrogen plus progestin in healthy postmenopausal women.

The arm of the study using Premarin and Provera was discontinued early when an increased risk of breast cancer was detected in study participants. The arm of the study using Premarin was discontinued, because of an increased incidence of strokes in older women.
Bio-Identical Hormone Optimization Alberta

Following the release of the results of the WHI in 2002, women were devastated. Women and doctors became anxious about HRT. Many women listened to the bad press and decided it was no longer safe to take Premarin and Provera.

Later studies of hormone replacement therapy published more positive results but these studies have received less publicity and much confusion remains. The media have not widely publicized reliable data showing natural hormones are protective against many conditions.

Natural estrogen and natural progesterone protect against heart disease, stroke, osteoporosis and Alzheimer’s disease. Natural progesterone is the only treatment found to protect against breast cancer (whereas synthetic hormones promote cancer).

What hormones do I need to replace?

Natural hormone therapy replaces the hormones (e.g. bio-identical estrogen and progesterone) that the ovaries stop making as women age.

Conventional HRT uses synthetic estrogen (Premarin) and progestins (Provera) to mimic the hormones the body makes, usually either estrogen alone or an estrogen-progestin combination. Premarin and Provera are NOT the same as bio-identical estrogen and progesterone.

Premarin is a molecule that has been modified from horse’s urine. Premarin contains 9 molecules unrecognizable by the human body, including a hormone called equilinin, which we know is dangerous, as opposed to bioidentical estrogen, which is derived from yam or soy, which is exactly the same molecular structure as the human body produces.

According to a US National Institutes of Health study, the risks of blood clotting and strokes that arise with Premarin and PremPro are sharply lower or nonexistent with bioidentical estrogens.

When should I begin bio-identical hrt?

You should commence natural hormone therapy replacement when you are perimenopausal (anywhere from ages 35-55). The age you start is very individual and based on risk factors. The sooner you start after the decline of hormones the better the protection for your heart, brain, and bones.

What about the risk of breast cancer with natural hormones?

If you look at the literature there is no evidence to suggest that bio-identical estrogen increases the risk of breast cancer. In fact, there is ample evidence that suggests that bio-identical progesterone has an anti-cancer effect.

Will my family physician prescribe bio-identical hormones for me?

Currently Canadian medical schools do not teach medical students about the role of natural hormones as an alternative to synthetic hormones. In fact, many physicians do not understand the difference between natural progesterone and synthetic progestin, or the difference between transdermally applied estrogen versus oral dosing.

Although more and more doctors are beginning to research this emerging therapy, those well informed on the issues are still a minority. Perhaps your doctor is one of them. If not, Dr. Bruce Hoffman will discuss the issues with you.

Is bio-identical HRT controversial?

Bioidentical hormone replacement therapy is used to help treat the symptoms of menopause, perimenopause, and post-menopause.

The patient’s individual hormone deficiencies are identified following saliva, blood or 24 hour urine testing. Then a prescription based on the individual’s specific deficiencies, is compounded by a compounding pharmacist.

The pharmaceutical industry has billions of dollars invested in profits from the commercially available synthetic hormones that are prescribed for menopausal symptoms. Some commercial drug companies have challenged those who have promoted bio-identical hormones as an alternative to patented hormone therapies.

For instance, Wyeth Pharmaceuticals submitted a citizen petition to the US Food and Drug Administration (FDA) asking the FDA to take regulatory action against compounding pharmacy operations that produce compounded bio-identical hormone replacement therapy drugs.

In January 2008, the FDA sent a warning letter to a small number (7) of compounding pharmacies that compound prescriptions for natural hormones. Some bio-identical hormones are FDA approved, but the FDA has not approved estriol, saying its safety and effectiveness is unknown.

The FDA recommends: “All patients who use compounded hormone therapy drugs should discuss menopausal hormone therapy options with their health care provider to determine if compounded drugs are the best option for their specific medical needs.” Women’s groups, led by advocates such as Suzanne Somers, are fighting for women’s right to choose.

The Function of each Hormone


Cortisol is produced by the adrenal gland and plays an important role in helping the body deal with stress. Low cortisol levels contribute to “adrenal fatigue” and crippling fatigue. High levels contribute to anxiety and insomnia

DHEA - Dehydroepiandrosterone

DHEA is a precursor to the sex hormones and is important for the production of these hormones. DHEA, which is produced by the adrenal glands, declines markedly as we age. Low levels of DHEA have been associated with premature aging. When you replace DHEA, you enhance the immune system and overall sense of wellbeing. Studies have shown that when levels of DHEA remain high into middle age, there is a dramatic decline in the incidence of all chronic diseases.


Estrogen is secreted by the ovaries. When estrogen levels are low women experience menopausal symptoms, such as hot flashes and mood swings. When you replace declining levels of estrogen in women with natural estrogen there is a protective effect against heart disease, stroke, Alzheimer’s disease, and osteoporosis.

Growth hormone (GH)

Human growth hormone stimulates growth and cell reproduction. Secreted by the pituitary gland, it also contributes to tissue repair. Various studies have suggested that growth hormone is an effective anti-aging agent, helping to increase muscle mass and decrease body fat.


Melatonin helps with sleep. Produced by the pineal gland, it plays an important role in the regulation of the circadian rhythm. Melatonin levels decline as we age. Melatonin supplements are marketed as a natural aid to better sleep but this hormone also offers powerful antioxidant effects.


Pregnenolone, which declines after age 30, plays a role in cerebral function and may have the potential to improve cognitive and memory function.


Progesterone is secreted by the ovaries. Studies suggest that natural progesterone reduces the symptoms of menopause and has a protective effect against breast cancer.


Testosterone is best known as a male hormone but it is also present in women and plays an important role in women’s health and well being. Testosterone production declines after age 30.

Thyroid Hormone

Thyroid hormone production also declines with age. A thyroid deficiency causes a number of symptoms, including fatigue, weight gain, constipation, hair loss, cold intolerance, and dry skin.