A pioneer in the field of hormone therapy (HT), Marla Ahlgrimm has helped more than 300,000 women manage their symptoms of premenstrual syndrome (PMS), perimenopause, and menopause. Marla Ahlgrimm, founder and CEO of Women’s Health America, receives many questions from women and will answer several of the most common ones.

Q: What is a natural or bioidentical hormone?

Marla Ahlgrimm: When choosing between hormonal medications, a woman and her doctor must select between hormones that are natural or bioidentical and those that are synthetic. A natural or bioidentical hormone is identical – has the same chemical structure – to those hormones naturally produced by a woman. These may include estradiol, estrone, estriol, progesterone, and testosterone. In contrast, synthetic hormones are similar to, but not identical chemically to those produced naturally by a woman. These include oral contraceptives, Provera, Premarin, and Estratest to name a few. A woman doesn’t naturally produce the hormones found in oral contraceptives for example, explains women’s health expert, Marla Ahlgrimm.

“A ‘natural’ hormone does not mean that it is an unregulated, organic product purchased in a health food store either,” Marla Ahlgrimm, co-founder of Madison Pharmacy Associates in Madison, Wisconsin, says. “In fact, ‘natural’ prescription hormones are manufactured by FDA approved pharmaceutical companies.”

Slight chemical differences between natural and synthetic hormones can have substantially different effects in a woman’s body. Pharmacist Marla Ahlgrimm tells her patients, “it‘s more important than ever to understand the differences before beginning hormone therapy”.

Q: What Does Micronized Progesterone Mean?

Marla Ahlgrimm: Progesterone is the hormone of pregnancy and the word means “for gestation.” Progesterone is produced cyclically, 2 weeks out of every month. If pregnancy doesn’t occur, the progesterone level falls and menstruation begins. Micronized describes the size of the particles of progesterone found in pharmaceutical progesterone capsules or tablets. Pharmaceutical companies micronize progesterone particles for better oral absorption. Pharmacists use micronized progesterone powder to formulate customized progesterone dosages for women.

Q: How is Hormone Therapy administered?

Marla Ahlgrimm: Hormones can be administered in a variety of ways. Depending on the hormone, options include transdermal skin patches like Climara or Vivelle for estradiol, transdermal creams, vaginal tablets or creams, oral capsules and sustained release progesterone tablets. Each route of administration is specifically selected by a woman and her physician, according to Marla Ahlgrimm, a licensed pharmacist.

Q: What types of natural estrogen are there?

Marla Ahlgrimm: Estrogen is a general term referring to a category of hormones which include estradiol, estrone, and estriol.   Marla Ahlgrimm has found that many women are surprised to learn there are natural estradiol preparations commercially manufactured and readily available. Brand names include Estrace tablets, Climara, Vivelle patches and Estraderm cream. When hormone therapy is needed, your doctor will likely prescribe a specific hormone or combination that works best for your particular situation, Marla Ahlgrimm, founder of Women’s Health America, concludes.