MedQuest Pharmacy compounds products for hormone replacement therapy for both men and women. Over the years there has been significant confusion over certain words used to describe bio identical hormones and they include ‘natural’, ‘synthetic’ and ‘bio identical’. We hope this clarification of word definitions provided by The Compact Oxford English Dictionary, Copyright Oxford University Press, 2008, helps in your understanding of the different hormones that are available in the market today. For a printable version of this White Paper including references please refer to the home page of this website.

natural

adjective: existing in or derived from nature; not made, caused by, or processed by humankind.

The use of the word “Natural” in relation to HRT may be misleading since the word might imply that hormone components of HRT are naturally occurring, unaltered hormones which are incorporated into HRT preparations like topical creams, sublingual tablets, capsules, etc. Natural hormones include the estrogens derived from pregnant mare’s urine found in Premarin Tablets (Estrone, Equilin, 17, Dihydroequilin, 17 Estradiol, 17 Dihydroequilenin etc)

synthetic/sinthettik

adjective: made by chemical synthesis, especially to imitate a natural product.

The term “synthetic” has also been used to designate hormone replacement products containing hormone ingredients not found in human tissues. Examples of synthetic hormones would include progestins (medroxyprogesterone, morethindrone, norgestimate, levonorgestrel, desogestrel, etc.) and estrogen analogs (ethinyl estradiol, diethylstilbestrol, etc.).

biological (bio)

adjective: relating to biology or living organisms
(DERIVATIVES biologically adverb)

identical

adjective: exactly a like or the same
(DERIVATIVES identically adverb)

hormone replacement therapy

noun: treatment with certain hormones to alleviate menopausal symptoms or osteoporosis.

bio identical hormone replacement therapy

Relating to biology or living organisms exactly alike or the same pertaining to treatment with certain hormones to alleviate menopausal symptoms or osteoporosis.

The term “bio identical” has been used in recent years to attempt to clarify hormone replacement products which are chemically identical to human hormones. This designation has been applied to 17 – Estradiol, Estrone, Estriol, Testosterone, Dehydroepiandrosterone, Melatonin, Pregnenolone and Progesterone. All of which are found in human tissues. Strictly speaking, hormones referenced in bio identical HRT are chemically synthesized from precursor compounds found in nature. These naturally occurring base compounds are similar but not identical to human hormones.

In 1941, Russell E. Marker, a Pennsylvania State College biochemist, discovered a practical method of synthesizing progesterone beginning with diosgenin, a sapogenin molecule closely related to all of the human steroid sex hormones. The marker Degradation provided a commercially viable source for progesterone, namely the diosgenin molecule found in Mexican yams (Dioscorea). This diosgenin molecule is not a human hormone molecule, but is similar in structure to many human hormone molecules. Human steroid hormones can now be easily and economically synthesized from these readily available precursor compounds found in nature.

Chemical manufacturers of bio identical hormones utilize diosgenin from dioscorea in the Marker Degration to synthesize progesterone and other hormones. Diosgenin may also be obtained from other plant sources (agave, grape, ginger, soy etc.). The majority of commercially available bio identical steroid hormones are produced with this process. Chemical manufacturing companies utilize United States Pharmacopeia-National Formulary (USP-NF) monographs to test each hormone for which USP-NF monographs are available. Reputable chemical manufacturers and distributors can provide compounding pharmacies with Certificates of Analysis based on USP-NF standards certifying that hormone ingredients are not adulterated or misbranded and that the hormone meets or exceeds a rigid set of monograph specifications, which vary by molecule.