10/04/2025
A menopause 3 minutes on hormone terminology (small mistake, most hormones are made by semi synthesis from soybeans, not yams)
Natural = found in nature. Only Premarin is natural
We don’t typically use the term natural when describing estradiol or progesterone, unless we mean it has come from human ovaries or another animal’s ovaries. So in your body it’s your natural estradiol, in a prescription it’s just estradiol. Estradiol can’t be synthetic because it’s estradiol!
Semi-synthesis is how all other hormones are made (from soybeans). Hormones can also be made by synthesis, which means assembling them from small molecules.
Synthetic means a hormone not found in nature. They are usually tweaked in a lab to give them special properties. It doesn’t mean bad or a Frankenhormone! For some women, a progestin (which is synthetic) will be superior. Progestins are more portent at suppressing the endometrium, so they are better at preventing endometrial cancer. They tend not to be sedating like progesterone. And they can be used transdermally in the right formulation. But observational studies tell us they may have a higher risk of breast cancer than progesterone. This is where individualization comes in. We believe starting with progesterone is best on average based on observational studies, but there are absolutely times when a progestin (a synthetic hormone) is the better option for an individual patient.
What is most important from is how these hormones perform in clinical settings (the real world), not whether they are natural or synthetic or made by semi-synthesis. Also, people confuse natural with phytoestrogens and the world natural has been co-opted to mean safety, and that is not the case.
I love biochemical terminology and wanted to share!
