Scenario

Pharmacy team member Priya is approached by customer Denise, asking about ‘natural’ HRT for her perimenopause symptoms.

Denise: Hi, I wonder if you can help. A friend told me about something called bioidentical HRT. She says it’s completely natural and much safer than the normal stuff. She’s been buying it online and says it’s changed her life. I’m really struggling at the moment and I’d like to try it.

Priya: That’s a really common thing we’re hearing from our customers because there’s been a lot of talk about it on social media.

It’s completely understandable that ‘natural’ sounds more reassuring, especially with so much online about HRT risks, but it’s worth unpacking what that word actually means here, because it can be a little misleading. Would that be okay?

Denise: Yes please. I want to understand it properly.

Priya: So the term ‘bioidentical’ just means the hormone has the same chemical structure as the ones your body makes. The oestrogen patches and gels, and the progesterone capsules that are prescribed on the NHS – what you might think of as ‘normal HRT’ products – those contain bioidentical hormones too.

But unlike these ‘natural’ products, they are licensed, approved, tested and regulated for safety by the UK medicines regulator, the MHRA.

Denise: Oh, I didn’t know that. So, what’s the difference with what my friend is using?

Priya: What’s often being sold online and promoted as ‘natural’ tends to contain what’s known as compounded bioidentical HRT. That means it’s mixed up in a specialist pharmacy, often without the same safety checks as properly licensed medicines.

The issue is that no major medical body, including the MHRA and the British Menopause Society, recommends these products because they haven’t been through the same testing to show they’re safe or that the dose is consistent. So you could be getting much more or much less hormone than you think.

Denise: That does sound a bit worrying. Do you think I should try a licensed product rather than just ordering something online?

Priya: I would really encourage that, yes. Our pharmacist can look at your full picture and discuss the licensed options with you, including whether HRT is right for you, which type might suit you, and what the actual risks and benefits are for you personally.

There are also non-hormonal options if you’d prefer to explore those. You deserve proper advice tailored to you, not something potentially unknown bought online. I’ll see if they’re available now if you would like to have a chat with them and find out more.

Denise: Yes, that would be really helpful. I feel a bit silly now for nearly just ordering it online.

Priya: Please don’t. You were trying to find something that would help you feel better, and that’s completely understandable.

The online world makes it very easy to come across this kind of thing, especially when you’re not struggling with symptoms and just want answers. 

The important thing is that you’ve got a clearer picture now and our pharmacist will be more than happy to help you.