TRT vs BHRT — what's the difference?
TRT replaces testosterone in men; BHRT optimizes estradiol and progesterone (and sometimes testosterone) in women using bioidentical molecules. Different markers, different cadences, same authority spine.
Full answer
TRT (testosterone replacement therapy) and BHRT (bioidentical hormone optimization) are distinct pathways. TRT addresses confirmed low testosterone in men, restoring serum testosterone toward an optimization band through injectable, transdermal, or oral testosterone. BHRT addresses perimenopause and menopause in women using bioidentical estradiol, progesterone, and (when indicated) testosterone matched to the body's native molecules. Different biomarker sets anchor each — total/free testosterone, estradiol, SHBG, hematocrit, PSA for TRT; estradiol, progesterone, FSH, SHBG, TSH for BHRT. The authority spine and monitoring cadence are shared.
Educational. Not a substitute for individualized provider review.
- BHRT pathway — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-05-29