Why Should I Choose Bioidentical Hormones?

By: Dr. Thomas M. Basch


Why should I  choose bioidentical hormones? And why haven’t I heard about these before?

Quite simply, bioidentical hormone replacement therapy (BHRT) enhances your life and improves your health by restoring youthful levels of hormones. The literature and clinical experience support these claims, yet many doctors are unaware of just how beneficial BHRT can be. Most physicians lump BHRT in with synthetic hormone therapy and conclude that BHRT is dangerous. Nothing could be further from the truth. I had to learn this for myself when I trained in BHRT. 

While there are reasons for concern with synthetic hormone therapies, study after study has shown that BHRT is an entirely different treatment, and yet, most of us in medical fields never learn the truth. 

Why this disconnect? I have my theories.  As a product of 1990’s era medical schooling, I never learned about bioidentical hormone replacement therapy (BHRT) or how important it could be to health in middle age and beyond. I was taught to equate “hormone therapy” with “birth control pills”, and of course there was not even a mention of testosterone therapy, bioidentical or otherwise. 

By the time I completed my training and entered private practice, doctors were being warned away from all hormone therapy (aside from thyroid supplementation) with the release of a study on POSSIBLE risks associated with peri menopausal hormone supplementation. Understand, doctors are trained to always error on the side of caution, and so most of us read “possible” risks as “probable” risks. The fact that this study was never intended to be definitive made no difference. Millions of women (as well as men) who could have benefitted from hormone supplementation never even had the chance to try it, and worse yet, women who had been doing well on it for years abruptly lost access to the treatment. 

Meanwhile, the data supporting BHRT as safe and effective in both women and men had been quietly accumulating, but unfortunately, it received little coverage, even inside of the medical profession. Looking back, this is no surprise, because even the alarming drop in male testosterone levels in North America, which had become abundantly apparent by the mid 1980’s, seemed to barely warranted a discussion in the medical journals. When it became apparent that men, as a group, were losing roughly 1% of their testosterone every year, it was as if no one even batted an eye. Knowing what I now know, I find this shocking. 

Do the math. By 2020, men on average had lost 40 percent or more of their normal testosterone levels. Did you know that? I didn’t, at least not until I studied BHRT. And how could I have known? As with all physicians, my attention is trained to focus immediately upon test results that are outside the accepted normal ranges without questioning the ranges themselves.  Most lab report sheets have a special column for “outside normal” numbers. Trust me, if a doctor scanning results sees nothing in that column, his/her focus quickly moves on. Perhaps this is why the unprecedented drop in male testosterone over my adult lifetime has been minimized. Like so many of my colleagues, I just did not realize that the national testing laboratories, used by most doctors and many hospitals, had simply and quietly moved the “normal range” for male testosterone DOWNWARDS to accommodate this 40% decline. In no other instance have I seen a major decline in ANY human health parameter seemingly swept under the rug like this. 

Back to BHRT. Compounding pharmacists and chemists have been using plant and animal extracts to make EXACT replicas of human gonadal hormones for decades. These are not “chemical equivalents” to the testosterone, estrogen, and progesterone made by healthy human glands. These are IDENTICAL. Perhaps it is because they are not produced inside the big pharmaceutical industry that they get very little press, and when they do receive commentary from physicians, things typically begin with a warning that these exact copies of our natural hormones are NOT approved by the federal government’s regulatory agencies. Even today, many Revive patients are warned by their primary doctors that our therapies are “not FDA approved”. 

However, what our patients are NOT told is that the individual ingredients that we use at Revive are, in fact, FDA approved.  It is the DELIVERY system of these ingredients, the implantable pellets and the topical creams, that have not undergone the extraordinarily lengthy and expensive FDA process that would allow for approval, which in turn would allow our BHRT to be advertised in magazines or journals or on TV or on the internet. But fact is, likely, BHRT will NEVER receive FDA approval, which is why you will never hear about it though the usual channels.  Allow me to explain. 

In the United States, we have a very strict and stringent FDA trial and approval process. On average, it costs over a billion dollars to bring a drug from conception to prescription. It takes years of animal studies, human studies, clinical trials, packaging testing, and so forth before a medication gets onto the pharmacist’s shelf. That is an enormous investment cost, and somehow, it must be recaptured. Typically, that is done via very high brand name drug prices and patent protections. 

We all complain about high brand name drug costs, just as we all gripe about side effects, but let’s at least acknowledge that many of these medications are absolutely and miraculously lifesaving. Ever had a child diagnosed with a crippling or deadly disease? If you have, then you know what it is like to pray, with all your might, to hear these four magical words: WE CAN TREAT THIS. Until roughly 100 years ago, most parents could never hope to hear those words. By today’s standards, the good old days sucked. Losing one or more children to illness was considered a normal part of life, even more so if you were not rich. I always try to remember this little fact when I pick up a prescription and have to part with the co-pay that seems larger every year. Had I lived a century ago, statistically at least, I would already be dead.  

Back to BHRT. Put to case that a major pharmaceutical firm decides to get into BHRT so that it can bring this treatment modality to market. After spending a fortune, said firm would have to recover that fortune through premium brand name prices which would be patent- protected for 8 years.  Now, would YOU, as a patient-consumer, pay that premium price for a brand name FDA- approved BHRT product when you could just as easily get the same product in a privately compounded, non-brand name, non-FDA approved version that millions of people have been using safely and effectively for years at a FRACTION of that price??????

Do you see the conundrum here? 

I doubt that you will you ever see FDA approval, much less insurance coverage, for BHRT, but as I hope I have explained, this has nothing to do with the safety and efficacy of the treatment. One of the main reasons for Revive is that I myself have used BHRT since 2017, and I can tell you that it has absolutely changed my life. I feel better now than I did twenty years ago. Fact is, if you had told me back then that I could be feeling as good as I feel now, I would never have believed you. Not possible, I’d have said. 


To conclude, I suggest to my potential patients that they take the time to simply educate themselves via the internet, and then decide if moving forward with BHRT makes sense.  While the internet is no longer as open and as unbiased as it was ten years ago, when it comes to BHRT, it is still a remarkable tool, and it can point the way to a different and better sort of future. 

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.