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Q: What's the best natural hormone replacement?

A: In the strictest sense, natural means a product that you can pretty much use as is. Many people assume plant-based hormone replacements are natural, but in fact, the material has to go through multiple chemical processes before it's useful to humans. That's not really natural. On the other hand, one of the first commercially approved estrogens, Premarin, is considered natural. Premarin, which came out more than 70 years ago and is still on the market, is derived from horses, but it doesn't have to go through the chemical changes that plants do. Keep in mind, though, that taking a natural hormone has no known advantages over synthesized estrogen; both are similarly effective and safe so long as you're using products that are well regulated by the FDA. — Margery Gass, MD, executive director of the North American Menopause Society