Estrogen Myths Debunked By A Naturopathic Doctor: The Truth About Bioidentical Hormones
- Madison Fandel
- Nov 17
- 4 min read
By: Dr. Madison Fandel, ND, MSCP | Menopause Practitioner
Follow me on socials @drmadisonfandel
Hey there, it’s Dr. Madison Fandel Menopause Society Certified Practitioner.
Let’s talk about estrogen.
When it comes to hormone replacement therapy (HRT), confusion and controversy abound. You may have heard that estrogen therapy can increase your risk of breast cancer, or that hormones should be avoided altogether. The truth is more nuanced than that, and today I want to clear up some of the most common misconceptions about estrogen and hormone therapy.
Disclaimer:
This content is for informational and educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, naturopathic doctor, or other qualified healthcare provider with any questions you may have regarding a medical condition or health concern. Never disregard professional medical advice or delay seeking it because of something you have read here.
Why Estrogen Has Been Misunderstood
Yes, there is always some risk associated with hormone replacement therapy. But it’s critical to understand that not all hormone therapy is created equal.
Traditional or synthetic hormone therapies—like birth control pills or Premarin (which is derived from pregnant mare’s urine)—contain hormones that look similar to those your body produces, but they are not an exact match.
Premarin, for instance, contains 39 different types of estrogens. When your body metabolizes these conjugated equine estrogens, they can take less favorable pathways that may increase certain risks.
By contrast, bioidentical hormone replacement therapy (BHRT) uses compounds made from soy or yams that are chemically identical to the hormones your body naturally produces. Because of this, your body recognizes them and knows exactly how to metabolize and use them.
Estrogen and Progesterone: The Balancing Act
We can’t talk about estrogen without talking about progesterone—its natural counterpart and protective partner.
Progesterone receptors are found throughout the body: in the uterus, breasts, brain, blood vessels, and vagina. Natural progesterone helps balance estrogen and offers protection against:
Breast cancer
Cardiovascular disease
Fluid retention and bloating
Headaches
Irregular bleeding
Fibroids
However, synthetic progesterone, called progestin (such as medroxyprogesterone acetate), is not the same thing. Progestins can actually cause or worsen many of the symptoms women hope to avoid, including:
Depression
Weight gain and fluid retention
Breast tenderness
Irregular bleeding
Increased risk of breast cancer and cardiovascular disease
This is one of the major reasons why synthetic hormone replacement therapy developed such a poor reputation.
What the Women’s Health Initiative Really Found
The fear surrounding estrogen therapy largely stems from the Women’s Health Initiative (WHI) study, a massive research program launched in 1991 to evaluate health outcomes in postmenopausal women.
The hormone therapy portion included two groups:
Estrogen + Progestin (synthetic) in women with a uterus
Estrogen alone in women without a uterus
The study was halted early because the estrogen-plus-progestin group showed an increased risk of breast cancer, coronary artery disease, stroke, and blood clots.
However, it’s essential to note that the hormones used in that study were synthetic and animal-derived, not bioidentical.
In fact, the women receiving estrogen alone (without synthetic progestin) did not experience an increased breast cancer risk. The absolute increase in risk is generally small, based on the WHI data, a woman with 1.3% breast cancer risk without HRT would see the risk increase to 1.6% with HRT, that translates to an additional 3 cases of breast cancer per 1000 women over a 5 year period of time. Later research even suggests that bioidentical progesterone may reduce the risk of breast cancer, improve cardiovascular health, and support better overall outcomes.
Regarding the cardiovascular risk the WHI revealed for women who initiated HRT more than 10 years after menopause when older than age 60 had a slight increase risk in women with established cardiovascular disease. But when started younger (less than 60) and within 10 years of menopause, adding HRT is likely protective and may prevent heart disease and other related issues.
This difference is crucial—and it’s why BHRT should not be confused with conventional hormone therapy.
Who Might Benefit from Estrogen Support?
While hormone replacement is often associated with menopause, estrogen deficiency can affect women of many ages.
Younger women can experience low estrogen from:
Surgical menopause (total hysterectomy with ovary removal)
Premature ovarian failure
Chemotherapy or radiation
Autoimmune or metabolic disorders
Chronic stress or over-exercising
Nutrient deficiencies or low-calorie diets
Thyroid dysfunction
Common symptoms of low estrogen include:
Hot flashes or night sweats
Vaginal dryness or pain during intercourse
Low libido
Mood changes and irritability
poor concentration or brain fog
Fatigue and sleep disturbances
If you’re experiencing these symptoms, it may be worth exploring whether bioidentical hormone therapy is right for you.
The Bottom Line: Hormone Nuance Is Key, Especially With Bioidentical Hormones
The key takeaway is this: 👉 Not all hormone therapy is the same.
Bioidentical hormones, when prescribed appropriately, monitored carefully, and supported with lifestyle medicine can help restore balance, protect your long-term health, and help you feel like yourself again.
If you’re struggling with symptoms of hormone imbalance or want to better understand your options, I’d love to help. Together, we can determine whether HRT is a safe and beneficial choice for you.
Your Tomorrow Starts Today
Don’t let fear or confusion prevent you from feeling your best. If you’re experiencing symptoms of low estrogen or menopause-related changes, schedule a consultation using the button below.
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