Bioidentical Hormones Work Better for Premature Ovarian Failure (POF)

A small study from Scotland shows natural hormones are safer than oral contraceptives for young women with ovarian failure.

premature ovarian failureA great little study out of Scotland will help women with premature ovarian failure get the natural hormones they need to be healthy and balanced.

Premature ovarian failure (POF) is a catch-all term to describe non-working ovaries in women under the age of 40. When the ovaries aren’t working, few or no hormones are being made. The result is infertility, absent or irregular periods, and menopause-like symptoms such as hot flashes, night sweats and vaginal dryness. Women with POF have a higher risk of osteoporosis, heart disease and cognitive impairment (memory loss, foggy thinking) and a higher risk of premature death.

It’s estimated that as many as a million women in the U.S. suffer from POF. As if all of the above symptoms aren’t bad enough, women with POF are often put on either oral contraceptives (birth control pills) or conventional hormone replacement drugs (HRT) such as PremPro, and then suffer from their unpleasant side effects as well as an increased risk of stroke, heart disease and breast cancer.

The Scottish study on POF was small—only 18 out of 34 women completed it. They spent a year taking a “standard” oral contraceptive, followed by a year of using what the authors call a “physiological treatment,” an estradiol (natural estrogen) patch and either vaginal or oral progesterone—in other words, bioidentical or natural hormones. In spite of the huge doses of progesterone (200 mg twice daily), and large doses of estradiol (0.10 mg daily) in the natural hormone regimen, when the women switched over to the natural hormones, their blood pressure went down and their kidney function improved significantly.

The authors attribute much of the success of the natural hormone treatment to the transdermal (through the skin) delivery of the hormones, rather than the fact that these were bioidentical hormones without the side effects of the synthetic hormones. Had they used progesterone cream in true physiologic doses (what the body would make) of 15 to 30 mg daily, and lower doses of estradiol, the results would likely have been even better.

Although symptoms were relieved on both hormone regimens, it’s important to remember that women using oral contraceptives do not have the bone-building benefit of natural progesterone and estradiol, and have a higher risk of stroke. In fact, bone loss is a risk factor for oral contraceptives.

There are likely millions of women worldwide with POF who could be happier and healthier using bioidentical hormones. Let’s hope that this small study is a seed for bigger and better studies.

For an excellent article on POF, its symptoms, causes and treatments, please visit the Women to Women website and read Premature Ovarian Failure—You Haven’t Failed by Marcelle Pick, OB/GYN NP. Dr. Pick's articles are informed by science, her clinical practice, and her compassion for her patients.

You might also be interested in an article by Dr. John Lee, What Your Doctor May Not Tell You about Your Ovaries.


Langrish JP et al, “Cardiovascular effects of physiological and standard sex steroid replacement regimens in premature ovarian failure,” Hypertension 2009 May; 53:805.

Fatemi HM, Bourgain C, Donoso P et al, “Effect of oral administration of dydrogestrone versus vaginal administration of natural micronized progesterone on the secretory transformation of endometrium and luteal endocrine profile in patients with premature ovarian failure: a proof of concept,” Hum Reprod. 2007 May;22(5):1260-3.

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