Bioidentical hormones: Are they better than standard HRT?

There is a lot of interest in bioidentical — or so called "natural" — hormone therapy for menopause symptoms. However, there is no evidence that bioidentical hormones are safer or more effective than standard hormone replacement therapy.

Bioidentical hormones are custom-mixed formulas containing various hormones that are chemically identical to those naturally made by your body. These over-the-counter products are marketed as being tailored to a woman's individual hormone needs, typically determined through saliva hormone testing. Manufacturers claim that bioidentical hormones are safer than standard, FDA-approved hormone therapy.

According to the North American Menopause Society (NAMS), custom compounds may provide certain benefits, such as individualized doses and mixtures of products and dosage forms that are not available commercially. However, they may also pose risks to consumers. These compounds have not been approved by the Food and Drug Administration (FDA) and as a result have not been tested for purity, potency, efficacy or safety. These products may even contain unknown contaminants. For this reason, NAMS does not recommend these custom-mixed products over well-tested, government-approved commercial products for the majority of women.

Also, bioidentical estrogen and progesterone are available in FDA-approved hormone therapy products, including:

• Estradiol, derived from soy or yam sources, such as Estrace, Climara patch and Vivelle-Dot patch
• Natural progesterone (Prometrium)

These products come in many different doses and forms. So, you don't need to turn to unregulated, individually compounded products as your only source of "natural" hormones.