You may have noticed that in recent months on the Balance app, on social media and on my podcast, we’ve made some subtle but important changes to the language we use when talking about hormone health.

For example:

* Instead of HRT, we now often use the term ‘hormone treatments’

* Instead of estrogen, we use the term ‘estradiol’ (the most beneficial form of estrogen)

* We are using the term ‘bioidentical treatments’ to describe all hormone treatments that are the same structure as your own hormones (progesterone, estradiol and testosterone)

* We make a clear distinction between bioidentical hormone treatments and synthetic ‘hormones’.

So why does this matter?

Hormone health can feel overwhelming. There are dozens of symptoms, multiple diagnostic labels and an ever-growing range of treatment options. You might find yourself asking: do I have PMS or PMDD? Am I perimenopausal or menopausal? Which hormone treatment is right for me?

That’s why clarity around language is so important. Understanding the words we use helps you better understand what’s happening in your body, make informed decisions and feel more confident in managing your health.

Why ‘hormone treatments’ rather than HRT?

HRT is not a one-size-fits-all treatment.

Using HRT as a catch-all term can imply that all hormone treatments are interchangeable, when in reality they are not. There are many different formulations, including patches, gels, sprays and creams, and different products contain different hormones, doses and ingredients.

You may have noticed that changing from one patch brand to another, or switching formulations, can make you feel different. You’re not imagining it. Even when the active hormone is the same, manufacturers use different adhesives, oils, fillers, cream bases and delivery systems, all of which can affect how the hormone is absorbed and works in your body.

The hormone may be identical, but the formulation is not.

Every woman’s hormone treatment regimen is different. Some women use estradiol alone, while others use progesterone, testosterone, vaginal hormones, or a combination of these hormone treatments. That’s why we increasingly use the term ‘hormone treatments’ and specify the exact hormone and how it’s delivered, such as transdermal (through the skin).

Natural versus synthetic hormones

Another important distinction is between natural and synthetic hormones.

Synthetic hormones, found in older hormone treatments and all hormonal contraceptives (other than Zoely with contains estradiol and a synthetic progestogen), are designed to mimic your body’s hormones but have a different chemical structure, so they are not actually hormones. This affects how they work in your body and are associated with risks (including increased risk of clot, heart attacks and some cancers).

In contrast, natural, bioidentical hormone treatments have the same chemical structure as the hormones produced by your body. They are usually derived from plant sources such as soy or yams and are safer and better tolerated.

Why we say estradiol, not estrogen

Estrogen isn’t a single hormone. It’s actually a family of hormones.

The most important of these is estradiol – the form of estrogen that is the most beneficial to your body. This is why declining estradiol levels have such widespread effects on both your physical and mental health.

When we talk about hormone treatments, we often refer specifically to estradiol because it’s more precise and helps avoid confusion.

Progesterone, progestogens and progestins

Progesterone is probably one of the most confusing hormones because different terms are often used interchangeably.

Progesterone refers to the hormone naturally produced by your ovaries, brain and other tissues, and also to hormone treatments that have the same chemical structure as the progesterone made in your body.

Progestogens and progestins refer to synthetic ‘hormones’ used in hormonal contraception. ‘Progestin’ is a term used more commonly in countries such as the United States.

Understanding these differences matters because these synthetic ‘hormones’ are not actually hormones nor are they identical to your own hormone and have different effects in your body.

Body identical or bioidentical hormones?

These terms often also cause confusion.

In the UK, ‘body identical’ has traditionally referred to hormone treatments with the same chemical structure as the hormones produced naturally in your body and are made by pharmaceutical companies. The term ‘bioidentical’ has often been used to describe hormone treatments with the same chemical structure as the hormones produced naturally in your body made specifically for an individual by a compounding pharmacy.

Compounded hormone treatments are more commonly used in countries such as the United States but are becoming increasingly available in the UK. They can provide additional options for women who don’t tolerate standard preparations (they may be sensitive to certain ingredients, for example) or need a different delivery method.

If you’re considering compounded hormone treatments, it’s important to ensure that your provider is appropriately regulated and licensed.

Globally, the term ‘bioidentical’ is used to describe all hormones that have the same chemical structure as those produced by your body, regardless of who makes them. For this reason, we are increasingly using the term ‘natural, bioidentical hormone treatments’.

Ultimately, the words we use matter because greater clarity about hormones and hormone treatments can help reduce confusion, support better decisions and enable women to feel more informed, empowered and confident about their health.

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