Compounded hormones vs regulated HRT
"Bioidentical" describes a chemical structure, not a regulatory status, and that gap is where confusion sits. Regulated, licensed HRT already includes body-identical forms of oestrogen and progesterone. Compounded bioidentical HRT is a different thing entirely — custom-mixed to an individual prescription outside the licensing process — and the British Menopause Society advises against it.
Two products, one overlapping name
Regulated HRT (patches, gels, sprays, tablets, and micronized progesterone capsules) goes through the same licensing, manufacturing quality control, and dose-consistency testing as any other medicine. Many of these products already use hormones structurally identical to what the body produces — this is sometimes described as "body-identical," and it's the mainstream, guideline-recommended option.
Compounded bioidentical HRT (cBHRT) is mixed to an individual prescription by a compounding pharmacy, often marketed as more "natural" or personalized through saliva-testing dose adjustments. It uses the same category of hormone but skips the standard licensing pathway.
What the British Menopause Society actually says
Its consensus statement states directly: "the BMS does not recommend the prescribing of cBHRT." The stated reasons are specific, not vague brand preference:
- Compounded products haven't been evaluated in controlled trials against placebo or against standard HRT for either effectiveness or safety.
- There's no requirement to demonstrate purity, potency, or batch-to-batch consistency the way a licensed product must.
- Critically, there's no evidence the progestogen dose in compounded preparations reliably protects the womb lining — a specific safety gap, since under-dosed progestogen alongside oestrogen is the exact combination that increases endometrial risk.
What to log if you're offered one
Whichever category your prescription falls into, the log entry is the same shape: what you're taking, at what dose, from what source, and since when. If a product is compounded, note that specifically — it's a materially different fact about your regimen than "I'm on a patch," and worth being able to say clearly at a review appointment.
This is general information, not medical advice, and not an evaluation of any specific product or prescriber. HormoneLog does not recommend a source, formulation, or dose for HRT of any kind. Questions about a specific product's safety belong with a prescriber or pharmacist.
HRT formulations explained. · How to log an HRT dose change. · What to ask before starting HRT.
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About HormoneLog
HormoneLog is an iOS app from Baker Ventures LLC for tracking perimenopause and menopause symptoms and keeping an HRT record: what you took, at what dose, from when, and what changed afterwards. It is built for the appointment, where "it has been bad lately" is worth far less than a dated record of frequency and severity. The app is in development.
HormoneLog is a record-keeping tool. It does not diagnose, does not score you, and makes no claim about symptom relief. The guides on this site link to NICE, the NHS, the Menopause Society and peer-reviewed sources, and say plainly where the evidence is thin. Everything here is free and needs no account.
Questions and answers
Is "bioidentical HRT" the same as regular HRT?
Often, yes — many standard, regulated HRT products (estradiol patches, gels and micronized progesterone) are chemically identical to the hormones the body makes, and are sometimes marketed as "body-identical." That's different from custom-compounded products made to an individual prescription outside standard regulatory testing.
What does the British Menopause Society say about compounded bioidentical hormones?
Its consensus statement is direct: "the BMS does not recommend the prescribing of cBHRT" — compounded bioidentical HRT — citing a lack of the same regulatory testing, evidence base, and quality control that licensed products go through.
What's the actual concern with compounded products?
They don't go through the same evaluation for effectiveness, safety, purity or potency as licensed medicines, and there's no requirement they be tested for how well they protect the womb lining when a progestogen component is involved — a specific, stated safety gap, not just a paperwork difference.
Can HormoneLog tell me whether a compounded product is safe?
No. HormoneLog logs what you're taking, however it's sourced. It doesn't evaluate a specific product's safety or endorse compounding pharmacies over licensed prescribing.
HormoneLog. “Compounded hormones vs regulated HRT.” Baker Ventures LLC, September 8, 2026. https://hormonelog.bakerventuresstudio.com/guides/compounded-bioidentical-hormones-what-the-difference-is/