Which menopause treatment’s best for me?

Ellie Cox

Marion Gluck

Dr Marion Gluck, Hormone Expert, and Founder of The Marion Gluck Clinic explores the different treatment options available for anyone experiencing menopause or perimenopause symptoms.

With October being Menopause Awareness Month, and many women experiencing debilitating symptoms that make carrying out everyday tasks difficult, it’s important that women know there are treatment options available, and they needn’t suffer in silence.

Synthetic HRTs made from estrogens derived from horse urine, or synthetic oral estrogens are still available on the NHS but are not the optimal choices. The British Menopause Society recognises that bioidentical HRT is the gold standard form of HRT, which is derived from plant sterols such as beta-sitosterol and diosgenin from Mexican yams. Bioidentical and body identical hormones are exactly the same but body identical refers to the regulated standard dose treatments available on the NHS, and bioidentical refers to the personalised HRT from a compounding pharmacy. 

As a menopause doctor, I prefer to prescribe compounded Bioidentical Hormone Replacement Therapy (BHRT) and regulated body identical HRT where appropriate, depending on each individual client. BHRT differs from synthetic HRT as bioidentical hormones have an identical molecular structure to the naturally occurring hormones which are produced in the body. Whereas synthetic hormones are structurally different and do not have the same physiological reaction. 

Comparing body identical and bioidentical hormones

Although body identical and bioidentical hormones are made with similar ‘ingredients’ there are differences between the two. Including the manufacturing process, dosage, delivery, and which hormones are available in terms of estradiol, progesterone, DHEA, and testosterone. For example, body identical progesterone is only available as utrogestan which is an oral capsule rather than a cream. The availability of suitable testosterone preparations for women is also limited. 

Body identical hormones are produced by large pharmaceutical companies in regulated, set doses and application methods, and while this one-size-fits-all approach works for some patients, the dosage and application of body identical hormones cannot be altered to cater to those with more specific needs. 

On the other hand, BHRT can be compounded into a personalised dosage and in different application methods, creating a better solution, with fewer side effects, for many women. Women can choose to have their medication as a cream, sublingual drop, or lozenge, making the treatment fit with their lifestyle and preferences. BHRT is also usually prescribed in much lower dosages than regulated hormones, meaning women experience fewer side effects and can enjoy feeling themselves again in a much shorter timeframe. With BHRT, shortages are rarely faced as individual prescriptions are made in the compounding pharmacy. 

BHRT is prescribed in personalised dosages, based on thorough testing, and produced to order. This means that the pharmacy (which must meet industry standards for purity of Active Pharmaceutical Ingredients and Good Manufacturing Practice) is able to prepare custom doses and application methods to address the individual needs of a patient.  

“Women around the world face an ongoing needless struggle with hormonal issues. I have made it my life’s work to raise awareness about the treatment and holistic changes that can help them feel themselves again”

As we’re living longer and working later in life, menopause is something that needs to be discussed and women need to feel they have choices in their treatment plans and control of their wellbeing. For too long we have suffered in silence, and it doesn’t need to be this way. There are effective and safe treatments available to women who are experiencing debilitating symptoms such as brain fog, palpitations, anxiety, and sleep deprivation. Whether a woman chooses HRT, body identical HRT or my pioneering method of BHRT, I am on a mission to raise awareness, champion getting life-changing treatment, and offering women choice.