Compounding
Compounding for menopause and andropause
Where a prescriber wants a strength or a form that is not commercially manufactured — and an honest account of where the evidence sits.
What this covers
Hormone therapy for menopause and perimenopause, and testosterone therapy for andropause, are ordinary prescribed treatments. Most of the time a commercially manufactured product is the right answer, and that is what we would expect a prescriber to reach for first.
Compounding has a place where it genuinely does not fit: a strength between the manufactured ones, a form somebody cannot tolerate, or an allergy to something in the commercial preparation.
About the word “bioidentical”
“Bioidentical” describes a molecule’s structure. It is not a measure of safety, and it does not mean natural, gentler or better tested.
Plenty of commercially manufactured hormone products are bioidentical in exactly the same sense — and they carry something a compounded preparation does not: batch consistency, regulatory review, and published evidence.
The word has been used to market compounded preparations as a premium natural alternative. That marketing runs ahead of the evidence, and professional bodies have said so. We would rather tell you that than sell into it.
What that means practically
If a prescriber has a clinical reason for a compounded preparation, we will make it properly and carefully. If the reason is that compounded sounds more natural, the honest answer is that a manufactured product is likely the better choice — more consistent, better studied, and usually better covered.
If you are looking for gender-affirming hormone therapy
This page is not about that, and the distinction matters.
Gender-affirming hormone therapy in Ontario is provided with commercially manufactured products, and that is what the guidance supports. Compounded preparations are not the standard of care for it, whatever the internet suggests.
Common questions
Is compounded hormone therapy covered?
Usually less well than the manufactured equivalent, and sometimes not at all. Worth checking before you start rather than at the counter.
My prescriber recommended a compounded cream. Is that wrong?
Not at all — there are good clinical reasons for one, and your prescriber knows your history. The caution on this page is about compounding marketed as inherently superior, not about a specific prescription written for a specific reason.
Can I ask for a compounded version of something?
The conversation is with your prescriber, since it needs a prescription that specifies what and why. We are happy to be part of that conversation.