# Body-Identical Hormone Therapy in Antalya > Body-identical hormone therapy in Antalya: difference from synthetic, who it suits, when it works, side effects, breast cancer risk, compounding warning. Body-identical hormones have **a chemical structure similar to the hormones the ovaries produce**. The most important distinction on this page is this: **regulated (prescription) body-identical hormones and compounded preparations made up individually in a pharmacy are not the same thing.** In Antalya, menopausal symptoms are assessed and body-identical hormone therapy is planned at Op. Dr. Murat Alpay's clinic in Lara. **In short:** Body-identical hormones are hormones with a chemical structure similar to those the ovaries produce. For menopausal symptoms, oestrogen is given by mouth or through the skin; people whose womb is intact also take progesterone to protect the lining of the womb. Hormones compounded individually in a pharmacy are not subject to the same rigorous oversight, and the guideline advises avoiding them. The decision to treat is made individually, after the benefits and risks, including breast cancer risk, have been discussed. ## What are body-identical hormones? Body-identical hormones have **a chemical structure similar to** the hormones produced by the human ovary. Two advantages over synthetic, non-body-identical options have been described: - A more neutral effect on **the risk of blood clots** - A more neutral effect on **the risk of breast cancer** **The most critical information on this page:** regulated (licensed, prescription) body-identical hormones must be distinguished from body-identical hormones **compounded individually** in a pharmacy. Compounded preparations are not subject to the same rigorous oversight, and **there are concerns about their purity and safety.** The source guideline recommends that people who wish to use body-identical hormones **obtain a prescription for a regulated preparation from their doctor** and **avoid** compounded body-identical hormones. The American College of Obstetricians and Gynecologists (ACOG), in its 2023 consensus statement, likewise advises that compounded hormones **should not be prescribed routinely** when approved medicines exist, and notes that the word "bioidentical" is often used for these products as a marketing term. ## Which hormones are used? ### Oestrogen This is the main component of hormone therapy and is effective in controlling menopausal symptoms. It can be given in two ways: - **By mouth** (tablet) - **Through the skin** (transdermal): patch, gel or spray Oestrogen given through the skin has **a very neutral effect** on the way the body breaks hormones down, and **does not increase the risk of clots** compared with not being on treatment. For people at higher risk of clots — for example those who are overweight or who have a high background risk — the skin route is therefore the one to prefer. Because absorption varies from person to person, the dose is adjusted until the right level is reached. Three questions guide that: how much oestrogen is being given, how much of it is being absorbed, and how much the person needs for their symptoms to be controlled. ### Progesterone / progestogen For people whose womb has not been removed, this is always given to **protect the lining of the womb** from the effect of oestrogen. It can be given in two ways: so as to produce a monthly bleed (for people in perimenopause who are still having periods), or continuously without a monthly bleed (for people who have reached the menopause). **Micronised progesterone** is plant-derived and similar in chemical structure to the progesterone the human ovary produces — that is, it is body-identical. Its advantages over synthetic progestogens are **a neutral effect on clot risk** and, in theory, **a slightly lower breast cancer risk**. Synthetic progestogens are available as a tablet, a patch or an intrauterine device. ### Testosterone At replacement doses appropriate for women, testosterone is effective in improving **low sexual desire**. At physiological doses for women, unwanted effects are not expected, and it may be considered when oestrogen does not resolve this symptom. Its use is supported by the 2019 international consensus statement and by the British Menopause Society. The licensing of testosterone preparations for women differs from country to country. Please ask your doctor about your own situation. ## Why does hormone therapy matter? Hormone therapy is the approach **most often used and shown to be most effective** in managing menopausal symptoms. It has been shown to produce clear improvement in symptom control and in quality of life. Beyond that it has two long-term effects: ### Bone health It has been shown to improve bone density appreciably and to **protect against osteoporosis and the fractures that follow from it**. This matters because hot flushes or vaginal dryness are noticeable symptoms, whereas **osteoporosis has no clear symptom** — the first sign may be a fracture. ### Heart health and timing Hormone therapy started **under the age of 60 or within the first 10 years after the menopause** has been shown to produce a **clear reduction** in the risk of heart disease and in deaths from cardiovascular disease. This is where the idea that the timing of treatment affects the outcome comes from. The reverse also holds: when treatment is started **more than 10 years after the menopause or after the age of 60**, the absolute risks of heart disease, stroke, blood clots and dementia are higher, so the balance of benefit and risk is less favourable. Hormone therapy is also **not started solely to prevent heart disease**; its main uses are relieving symptoms and preventing bone loss. ## How large is the breast cancer risk really? This is the heading that causes the most concern, so it matters that the numbers are understood in context. - **Combined treatment containing oestrogen and a progestogen** is associated with **a small increase** in breast cancer risk. That increase is low both medically and statistically. - For **oestrogen-only treatment** (in people whose womb has been removed), **little or no increase** in breast cancer risk has been shown. - **A family history of breast cancer** may raise a person's background risk but **is not a barrier to taking hormone therapy.** For context, the guideline offers these comparisons: the breast cancer risk from **two units of alcohol every evening** is **higher** than the risk from hormone therapy. The risk from **being overweight** is **markedly higher** than that from hormone therapy. For most people the improvement in quality of life, the reduction in osteoporosis risk and the reduction in heart disease risk outweigh the small increase in breast cancer risk. **A lower death rate** has been reported in people taking hormone therapy compared with those who are not. Even so, the decision whether to take it and for how long should be made **individually**, after the benefits and risks have been discussed. ## Who is body-identical hormone therapy suitable for? Hormone therapy is considered for women who have menopausal symptoms that affect their quality of life (such as hot flushes, night sweats, and sleep or mood problems) and who have no condition that rules treatment out. According to guidelines, the period when benefit is greatest and risk is lowest is starting **before the age of 60 or within the first 10 years after the last period** (the "window of opportunity"). For women who reach the menopause before the age of 45, continuing treatment at least until the average age of menopause (about 51) is recommended. For situations in which treatment is not used, see [who should not have body-identical hormone therapy?](https://www.muratalpay.com.tr/en/blog/biyoesdeger-hormon-tedavisi-kimlere-uygulanmaz/) ## The course of treatment: when does it work, and what are the side effects? - **Time to effect:** relief from hot flushes and night sweats usually begins within the first **1–3 weeks**; the full effect is seen at **8–12 weeks**. For this reason, whether the treatment is working is assessed at around the third month. - **Side effects at the start:** breast tenderness, spotting (light bleeding), headache, nausea and temporary bloating may occur. These mostly ease within the first 1–3 months as the body adjusts; spotting in the first 6 months is expected. Bleeding that starts or increases after 6 months needs an examination. - **Weight:** research shows that menopausal hormone therapy does not cause weight gain. Weight gain in midlife is more closely linked to the metabolism (the way the body uses energy) slowing with age; a slight rise on the scales noticed at the start of treatment is usually temporary fluid retention. - **Duration of use:** current guidelines set no fixed time limit such as "5 years at most"; whether to continue is decided each year by reviewing symptoms and the balance of benefit and risk. When stopping, the dose can be reduced gradually over a few months; in a considerable proportion of women who stop, symptoms may come back. - **Check-ups:** the first check-up is usually 3 months after starting, and once a year after that — see [menopause treatment](https://www.muratalpay.com.tr/en/tedaviler/menopoz-tedavisi/). ## Options other than hormone therapy **Lifestyle:** regular exercise, a diet low in saturated fat and salt and rich in calcium and vitamin D, stopping smoking and cutting down alcohol improve both symptoms and heart and bone health. Smoking has been shown to bring the menopause on earlier and to trigger hot flushes. **Cognitive behavioural therapy:** an effective option for improving hot flushes, night sweats and other symptoms; it can be considered for people who do not want, or cannot take, hormone therapy. **Complementary methods:** acupuncture, aromatherapy, herbal treatments, homeopathy, yoga and reflexology may help with symptoms; but **most are less effective than hormone therapy at controlling symptoms** and are not expected to have a clear effect on bone strength or heart health. Some herbal or "natural" products may contain substances with **oestrogen-like activity**. For that reason they are also unsuitable for people for whom hormone therapy would be inadvisable. ## Frequently Asked Questions ### Which doctor should I see for body-identical hormone therapy? Hormone therapy in the menopause is planned by an **obstetrician-gynaecologist**. Before starting, the health history, breast and womb screening and individual risks are assessed. ### Where are body-identical hormones obtained? Approved body-identical hormones (oestradiol gel or patch, micronised progesterone) are medicines dispensed by a pharmacy on a doctor's prescription. Individually mixed (compounded) pharmacy preparations do not go through standard quality control and are therefore not recommended by guidelines. ### How long does body-identical hormone therapy take to work? Relief from hot flushes and night sweats usually begins within the first 1–3 weeks; the full effect is seen at 8–12 weeks. For this reason, whether the treatment suits you is assessed at around the third month. ### Do body-identical hormones cause weight gain? Research shows that menopausal hormone therapy does not cause weight gain. A slight rise on the scales that may be seen at the start of treatment is usually temporary fluid retention and settles with time. ### What are the side effects of body-identical hormone therapy? At the start there may be breast tenderness, spotting (light bleeding), headache, nausea and temporary bloating. These complaints mostly ease within the first 1–3 months. Bleeding that starts or increases after 6 months needs an examination. ### Which hospitals offer body-identical hormone therapy? It does not require a separate centre or procedure. Treatment is planned after an examination by an obstetrician-gynaecologist, and approved medicines are dispensed by a pharmacy on prescription. This assessment can be done in the obstetrics and gynaecology outpatient clinics of hospitals or in private clinics. ### How long are body-identical hormones used for? Guidelines set no fixed time limit; the decision to continue is made each year based on symptoms and the balance of benefit and risk. When stopping, the dose can be reduced gradually over a few months; in some women who stop, symptoms may come back. ### What is the difference between body-identical and synthetic hormones? Body-identical hormones have **a chemical structure similar to** the hormones the human ovary produces. Compared with synthetic options they have been described as having more neutral effects on clot risk and on breast cancer risk. Micronised progesterone, for example, is plant-derived and similar in structure to ovarian progesterone. ### Are compounded body-identical hormones from a pharmacy better? No — this is an important misunderstanding. **Compounded body-identical hormones are not subject to the same rigorous oversight as regulated (licensed) ones**; there are concerns about purity and safety. The source guideline recommends **avoiding** these preparations and obtaining a prescription for a regulated preparation from your doctor. ### Tablet, or patch and gel? Oestrogen given through the skin has a very neutral effect on the way the body breaks hormones down and **does not increase clot risk compared with not being on treatment**. For people at higher risk of clots — for example those who are overweight — the skin route is the one to prefer. The decision is individual. ### My womb is intact — can I take oestrogen alone? No. For people whose womb has not been removed, progesterone or a progestogen is always given as well, to **protect the lining of the womb** from the effect of oestrogen. If you are still having periods it can be given so as to produce a monthly bleed; if you have reached the menopause it can be given continuously without a bleed. ### Does hormone therapy cause breast cancer? Combined (oestrogen + progestogen) treatment is associated with **a small increase** in breast cancer risk, low both medically and statistically. With oestrogen-only treatment, **little or no increase** has been shown. For context: the risk from two units of alcohol every evening is higher than that from hormone therapy, and the risk from being overweight is markedly higher. ### When should treatment be started? Timing affects the outcome. Hormone therapy started **under the age of 60 or within the first 10 years after the menopause** has been shown to produce a clear reduction in the risk of heart disease and in deaths from cardiovascular disease. ### Do I need a blood test to diagnose the menopause? **Usually not, over the age of 45.** The diagnosis is made by assessing symptoms together with the change in the pattern of periods. Because the FSH level fluctuates from month to month it can be misleading in this age group. Under 40, FSH is measured if premature ovarian insufficiency is suspected and repeated if unclear; between 40 and 45 it may help. A single test may not give the diagnosis. ### Can herbal products replace hormone therapy? Complementary methods may help with symptoms, but **most are less effective than hormone therapy at controlling them** and are not expected to have a clear effect on bone strength or heart health. Some herbal products may also contain substances with oestrogen-like activity, so they are unsuitable for people for whom hormone therapy would be inadvisable. Cognitive behavioural therapy, by contrast, is an effective option for hot flushes and night sweats. ## Sources 1. British Menopause Society (BMS) — Tool for Clinicians: "What is the menopause?". Reviewed January 2026. The benefits of hormone therapy, routes of administration, choice of progesterone, the context of breast cancer risk and the distinction between regulated and compounded body-identical hormones are taken from this source. 2. Global Consensus Position Statement on the Use of Testosterone Therapy for Women (2019). 3. The North American Menopause Society. The 2022 hormone therapy position statement. Menopause 2022;29(7):767–794. doi:10.1097/GME.0000000000002028 — favourable benefit-risk balance under 60 or within 10 years of the menopause, less favourable after. 4. Stuenkel CA et al. Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2015;100(11):3975–4011. doi:10.1210/jc.2015-2236 — hormone therapy is not used to prevent heart disease. 5. ACOG Clinical Consensus No. 6: Compounded Bioidentical Menopausal Hormone Therapy. Obstet Gynecol 2023;142(5):1266–1273. doi:10.1097/AOG.0000000000005395 — compounded body-identical hormones. The information on this page is based on the national and international guidelines listed above. The page is reviewed whenever those guidelines are updated. ## Practice and Contact Details The information on this page is general. Please speak to your doctor about your own situation. - **Doctor**Op. Dr. Murat Alpay — Specialist in Obstetrics and Gynaecology - **Address**Op. Dr. Murat Alpay Practice, Tekelioğlu Cd. No:51 B Kat:2, Filo Apt., 07160 Muratpaşa / Antalya - **Telephone**0505 351 77 88 - **Hours**Monday – Saturday 09:00 – 18:00 · Closed on Sunday [← All treatments](https://www.muratalpay.com.tr/en/tedaviler/) --- Original page: https://www.muratalpay.com.tr/en/tedaviler/biyoesdeger-hormon-tedavisi/ Last updated: 2026-10-22 Op. Dr. Murat Alpay — Specialist in Obstetrics and Gynaecology Op. Dr. Murat Alpay Practice, Tekelioğlu Cd. No:51 B Kat:2, Filo Apt., 07160 Muratpaşa / Antalya 0505 351 77 88 · Monday – Saturday 09:00 – 18:00 · Closed on Sunday *This information is for general guidance only and does not replace examination, diagnosis or treatment.*