Hormone replacement therapies are designed to restore that balance. Both Hormone Replacement Therapy (HRT) and Bioidentical Hormone Replacement Therapy (BHRT) can provide meaningful relief for people experiencing hormone-related symptoms. While they share the same goal, the way they work, the type of hormones they use, and how they are prescribed differ in important ways.
In this guide, we'll explain how HRT and BHRT work, highlight their key differences, and review potential benefits and risks. We also outline how Onus IV Therapy + Longevity approaches hormone therapy with precision and care.
Written by:
Dr. Ben Wilks
Published: August 27, 2025
BHRT vs HRT: Hormone Replacement Options
Compare BHRT vs HRT to understand key differences in hormone replacement options, benefits, risks, and how Onus personalizes hormone replacement therapy for balance.
Hormones are powerful messengers that regulate vital functions such as energy, mood, sleep, metabolism, and sexual health. When hormone levels decline or become imbalanced—whether due to aging, lifestyle factors, or medical conditions—everyday life can feel disrupted. Fatigue, mood changes, sleep disturbances, and other symptoms often signal that the body’s natural balance has shifted.
What Is HRT?
Hormone Replacement Therapy (HRT) is the traditional, widely used approach to restoring hormone levels. It typically involves estrogen and progesterone therapy for women going through menopause, and testosterone therapy for men experiencing age-related decline.
HRT uses synthetic hormones designed to mimic, though not exactly replicate, the hormones naturally produced by the body.
Delivery methods: Pills, patches, creams, and gels are the most common options.
Who it’s for: Often prescribed for women navigating menopause, and also for men and women facing hormone decline or recovering from surgical removal of reproductive organs.
HRT’s strengths lie in its broad availability, FDA-approved options, and decades of clinical research supporting its effectiveness. It remains an important treatment option for many patients.
However, potential side effects, such as bloating, headaches, mood changes, and in some cases increased risk of blood clots or stroke, are important factors to consider in consultation with a qualified provider.
What Is BHRT?
Bioidentical Hormone Replacement Therapy (BHRT) presents a more individualized approach. Unlike synthetic hormones, bioidentical hormones are chemically identical to those naturally produced in the body. This molecular similarity allows the body to recognize and respond to them as if they were its own.
BHRT uses plant-derived, pharmaceutical-grade compounds that are structurally matched to human hormones at the molecular level.
Customization: Treatment is based on comprehensive lab testing. Dosages are adjusted to each individual’s hormone levels and health needs, making BHRT a more personalized therapy than standardized HRT protocols.
Delivery methods: BHRT may be prescribed in creams, gels, lozenges, or capsules. One of the most widely used and reliable options is pellet therapy, in which small pellets are inserted under the skin to release hormones steadily over several months.
This steady delivery is often valued by patients, as it avoids the fluctuations in hormone levels that can occur with oral or patch-based therapies. For many patients, this makes BHRT both effective and sustainable in the long term.
The Key Differences That Actually Matter
While both HRT and BHRT work toward the same goal of restoring hormonal balance, there are important distinctions that influence how each therapy is experienced.
- Molecular structure: Synthetic hormones used in HRT are designed to mimic natural hormones but are not identical. Bioidentical hormones, by contrast, are structurally the same as the hormones produced by the human body.
- Dosing: HRT generally follows standardized dosing protocols. BHRT is customized, with doses calibrated through lab testing and adjusted over time as hormone levels shift.
- Source: Synthetic hormones are created through laboratory processes, while bioidentical hormones are derived from plant sources that are modified to match human hormones at the molecular level.
- Regulation: Many HRT medications are FDA-approved and available as standardized prescriptions. BHRT may include FDA-approved options, but compounded formulations are also common, created by specialized pharmacies to meet individual needs.
Knowing these differences can help patients evaluate which therapy better aligns with their health goals, lifestyle, and comfort with regulation.
Share this post
Written by:
Dr. Ben Wilks
Dr. Ben Wilks
Co-Founder, Medical Director
Wayne State Masters in Medical Science, Michigan State Med School, Baystate / Tufts Residency. Part time ER doctor, full-time adventure enthusiast. Lover of all things adrenaline. Current loves include kite surfing, cycling, skiing and kicking it with my Irish Wolfhound Grace. Spend a lot of free time exploring life's mysteries along the path less traveled.
Connect on LinkedIn: https://www.linkedin.com/in/benjamin-wilks-md-93267111a/