Bioidentical Hormone Therapy in Ottawa and Across Ontario
By Dr. Harsimranjeet Singh Bhatia, ND · Last reviewed November 2026
Hormones shape far more than your cycle. They affect sleep, mood, energy, bone health and, for many people we see, the hope of a pregnancy. Dr. Harsimranjeet Singh Bhatia, ND offers bioidentical hormone therapy in two situations: easing the symptoms of perimenopause and menopause, and looking carefully at progesterone when you are trying to conceive. In both, the approach is the same. A thorough and personalized assessment comes first, and treatment is suggested using an approach tailored to your needs with careful monitoring for tolerance and safety. Your care works alongside your family doctor, obstetrician or fertility clinic.
What are Bioidentical Hormones?
Bioidentical hormones have the same molecular structure as the hormones your body makes. The two used most often are estradiol, the main estrogen your ovaries produce before menopause, and progesterone, which rises after ovulation and helps prepare the uterine lining for pregnancy. Because the structure matches, your body processes them the way it processes its own hormones.
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"Bioidentical" describes the structure of a hormone, not its safety. The dose, the form, the timing and your own health history matter far more than the label.
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Can a Naturopathic Doctor Prescribe Hormones in Ontario?
Yes, within a clear scope of practice. Naturopathic Doctors in Ontario who have completed the province's prescribing requirements can prescribe bioidentical estrogen and progesterone in topical and vaginal forms, and Dr. Harsimranjeet Singh Bhatia, ND has completed these requirements. Oral progesterone is not currently within naturopathic scope in Ontario. If an oral form would serve you better, we will say so and work with your family doctor or OB to review if this can be included in your care.
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Conditions Where Hormone Therapies May Be Considered
Bioidentical hormone therapies may be considered in clinical contexts such as:
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Symptoms related to progesterone or estrogen imbalance
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Certain hormone-related reproductive conditions identified through clinical assessment and testing
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Hormone Therapy for Perimenopause and Menopause
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For hot flashes, night sweats and the broken sleep that often comes with them, hormone therapy remains the most effective treatment studied. It also helps with vaginal dryness and protects bone density. The Menopause Society and the Society of Obstetricians and Gynaecologists of Canada both support hormone therapy for healthy people with bothersome symptoms who are under 60 or within ten years of their last period, with each decision made individually.
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Within naturopathic scope, bioidentical estradiol is prescribed as a compounded topical or vaginal preparation, made by a pharmacy for your individual prescription. When estrogen is used and you still have a uterus, the lining needs protection, which usually means adding progesterone. The progesterone forms available within naturopathic scope are a Health Canada approved vaginal product or a compounded topical preparation, and the evidence that they protect the lining as reliably as oral progesterone is limited. We discuss this openly and decide together, with your family doctor or OB, how that protection is best managed.
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You will find more about symptoms, testing and the wider treatment plan on our menopause care page.
Progesterone Support and Fertility
Progesterone is the hormone of the second half of the cycle. After ovulation it helps the uterine lining become receptive, and it supports an early pregnancy until the placenta takes over. Because of that role, many people trying to conceive ask whether extra progesterone could help. Depending on each particular case, the use of progesterone may help reduce risk of miscarriages as well as support a pregnancy where there is a concern around short cervix.
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During IVF and Frozen Embryo Transfer
This is where the evidence is strongest. A Cochrane review of luteal phase support in assisted reproduction found that progesterone given after egg retrieval was associated with more live births and ongoing pregnancies. It is part of standard IVF protocols, and it is prescribed and adjusted by your fertility clinic. Our role is supportive: helping you understand your protocol, looking at the wider picture of your health, and never changing or adding to clinic hormones without your clinic's agreement.
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When a Short Luteal Phase or Low Progesterone is Suspected​
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Many people are told their luteal phase is too short or their progesterone too low. The American Society for Reproductive Medicine (ASRM) has concluded that there is no reliable test to determine luteal phase deficiency, but rather is a clinical diagnosis. This means that understanding overall context of a patient's medical history which may include evaluating serum progesterone and luteal phase length may help provide insight to diagnosing this condition, but no single test on its own can diagnose it. That does not mean your concern is unfounded. It means the first step is understanding why your cycle looks the way it does, through well timed testing and a look at ovulation, thyroid function and other factors, before deciding whether progesterone has a place.​​
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Bleeding in Early Pregnancy after Previous Losses
The large PRISM trial found that vaginal progesterone may improve live birth rates for people with bleeding in early pregnancy and had a history of miscarriage, with the clearest benefit after three or more losses. An earlier trial, PROMISE, found no benefit when progesterone was given to people with unexplained recurrent miscarriage who were not bleeding. Use of progesterone is made on a case-by-case basis carefully evaluating risk factors and where there may be benefit treatment can be offered.
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How we Help
Our part is thorough and personalized assessment with careful consideration and respect for patient preferences in every conversation. We review your cycle history and any testing, time bloodwork so the results mean something, look at contributing factors such as thyroid function, and discuss whether bioidentical progesterone is a reasonable option for you. When it is, it is prescribed in topical or vaginal form and coordinated with your physician or fertility clinic. When it is not, we will tell you that too. You can read more on our recurrent pregnancy loss and IVF support pages.
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Regulated or Compounded: what the Research Shows
Regulated products, approved by Health Canada, are tested for consistent strength and quality. Compounded hormones are mixed by a pharmacy for one person's prescription. A 2020 review by the US National Academies of Sciences, Engineering, and Medicine found no good evidence that compounded hormones are safer or more effective than regulated ones. Within naturopathic scope in Ontario, the estradiol and estriol we prescribe are compounded. For progesterone, we use Health Canada approved and regulated products for vaginal use, and compounded progesterone for topical use. We support Health Canada approved products wherever they are available within our scope, and work with trusted pharmacies for any compounding, and we monitor your response closely.
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Is Hormone Therapy Safe for Me?
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Hormone therapy is not the right fit for everyone. People with a history of breast or endometrial cancer, blood clots, stroke, heart disease, active liver disease or unexplained vaginal bleeding usually need a gynecologist's input before hormone therapy is considered, and in some cases it is not recommended. We review your history carefully at the first visit and review if this would be an appropriate treatment or if another path is safer for you. Once treatment begins, follow up visits review how you are feeling, any side effects and your dosing.
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Serving Ottawa and Across Ontario
In-person consultations are available in Ottawa. Secure virtual consultations are available for patients across Ontario and Quebec including Toronto, Kingston, Hamilton, London, Kitchener WaterÂloo, Guelph, Barrie, Durham Region, Windsor and Niagara.
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Frequently Asked Questions
What to expect at your first visit
Your first appointment reviews your symptoms, cycle and reproductive history, current medications and any previous testing. If bloodwork would change the decision, we explain what to test and when. For most people over 45, perimenopause is recognized by symptoms and cycle changes rather than a single blood test, while fertility questions usually call for testing timed to your cycle. You leave with a clear explanation of your options, including whether hormone therapy makes sense at all. Appointments are available in person in Ottawa and by secure video for patients anywhere in Ontario.
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Can progesterone help me get pregnant?
It depends on each individual case. In IVF, progesterone support after retrieval is standard care. For people who experienced bleed in early pregnancy with a previous medical history of miscarriages, one large trial found a benefit. For a suspected short luteal phase in natural cycles, the current guideline from the ASRM has not identified any benefit with progesterone supplementation and instead recommends reviewing for causes of the short luteal phase (i.e. thyroid disorder, hyperprolactinemia, hypothalamic disorder, etc.).
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Are bioidentical hormones safer than conventional hormone therapy?
"Bioidentical" describes structure, not safety. Regulated bioidentical estradiol and progesterone have the strongest research behind them. There is no good evidence that compounded hormones are safer or more natural. Within naturopathic scope in Ontario, estradiol is compounded, progesterone for vaginal use is a Health Canada approved and regulated product, and topical progesterone is compounded.
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How soon might I notice a difference with menopause hormone therapy?
Many people notice changes in hot flashes, night sweats and sleep within a few weeks, with fuller benefits often seen over about three months. Vaginal dryness can take a little longer to improve.
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Is this covered by insurance?
Many extended health plans in Ontario cover visits with a Naturopathic Doctor up to a yearly amount. Coverage for prescriptions written by a Naturopathic Doctor depends on your plan, so it is worth checking both your naturopathic and drug benefits before your first visit. Receipts are provided for every appointment.
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About Dr. Harsimranjeet Singh Bhatia, ND
Dr. Harsimranjeet Singh Bhatia is a licensed Naturopathic Doctor in Ontario with over 10 years of clinical experience and a focused interest in fertility, reproductive health and hormone-related concerns. His approach to bioidentical hormone therapy is evidence informed and individualized, taking into account symptoms, medical history, laboratory findings, reproductive goals, potential contraindications and ongoing monitoring. He has presented grand rounds to physicians at The Ottawa Hospital and to physicians at the largest fertility clinic in Eastern Ontario, and collaborates with fertility clinics and other healthcare providers when appropriate. He is the recipient of the 2026 Emerging Leader Award from the OAND and Faces Magazine Naturopath of the Year four years in a row (2021 to 2024).
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If you are weighing hormone therapy, or wondering whether progesterone has a place in your fertility or menopause/perimenopause care, a consultation is a good place to sort through the options together.
Medical disclaimer: This page is for general education and does not replace individual medical advice, diagnosis or treatment. Please speak with your physician or a qualified healthcare provider about your own situation before starting or changing any treatment, supplement or medication.
References
1. College of Naturopaths of Ontario. Briefing Note: Oral Micronized Progesterone (Council Meeting, Part 2, Item 6.03). Toronto: College of Naturopaths of Ontario; December 10, 2025. https://www.collegeofnaturopaths.on.ca/wp-content/uploads/2025/12/Part-2-Item-6.03.pdf
2. Government of Ontario. O. Reg. 168/15: General, under the Naturopathy Act, 2007, S.O. 2007, c. 10, Sched. P. https://www.ontario.ca/laws/regulation/150168
3. The 2022 Hormone Therapy Position Statement of The North American Menopause Society Advisory Panel. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7):767–794. doi: 10.1097/GME.0000000000002028.
4. Yuksel N, Evaniuk D, Huang L, Malhotra U, Blake J, Wolfman W, et al. Guideline No. 422a: Menopause: Vasomotor Symptoms, Prescription Therapeutic Agents, Complementary and Alternative Medicine, Nutrition, and Lifestyle. J Obstet Gynaecol Can. 2021;43(10):1188–1204.e1. doi: 10.1016/j.jogc.2021.08.003.
5. van der Linden M, Buckingham K, Farquhar C, Kremer JA, Metwally M. Luteal phase support for assisted reproduction cycles. Cochrane Database Syst Rev. 2015;2015(7):CD009154. doi: 10.1002/14651858.CD009154.pub3.
6. Practice Committee of the American Society for Reproductive Medicine and Practice Committee of the Society for Reproductive Endocrinology and Infertility. Diagnosis and treatment of luteal phase deficiency: a Committee Opinion. Fertil Steril. 2026;126(4):633–639. doi: 10.1016/j.fertnstert.2026.06.014.
7. Coomarasamy A, Devall AJ, Cheed V, Harb H, Middleton LJ, Gallos ID, et al. A randomized trial of progesterone in women with bleeding in early pregnancy. N Engl J Med. 2019;380(19):1815–1824. doi: 10.1056/NEJMoa1813730.
8. Coomarasamy A, Williams H, Truchanowicz E, Seed PT, Small R, Quenby S, et al. A randomized trial of progesterone in women with recurrent miscarriages. N Engl J Med. 2015;373(22):2141–2148. doi: 10.1056/NEJMoa1504927.
9. National Academies of Sciences, Engineering, and Medicine. The Clinical Utility of Compounded Bioidentical Hormone Therapy: A Review of Safety, Effectiveness, and Use. Washington (DC): National Academies Press; 2020. doi: 10.17226/25791.