What are Bioidentical Hormones?
Bioidentical hormones are hormones marketed as being similar to those produced by your own body. They are often compounded in pharmacies that dose medication based on salivary or blood hormone levels. While intuitively this seems to make sense, hormone levels are not consistent from day to day, and vary quite a bit. Hormone levels can be useful to diagnose menopause, but not necessarily to guide therapy. They can also be quite expensive to obtain. Because compounded hormones are not FDA approved, these pharmacies are also not required to track and report problems that may arise from taking these medications.
Compounded hormones have not been studied as well as FDA approved “bioidentical” hormones. These include both estradiol, a natural, plant based estrogen, and prometrium, a natural form of progesterone. It may be important to note that the Women’s Health Initiative, the large study which helped clarify some of the risks associated with hormone replacement therapy, did not use either of these natural hormones.
Hormones have benefits and risks, and are not safe for everyone. There is no evidence that compounded hormones are more safe or more effective than traditionally prescribed hormone replacement therapy. While there are likely benefits to these medicines, there are surely risks as well, and these are largely unknown. As your physician, our job is to support you through this time of transition, to help you make educated decisions that are based on science, and above all, keep you safe. There may be some circumstances in which we decide trying bioidenticals may be the best option for you, but please make an appointment to discuss this with your physician before making any decisions regarding hormones.