Bioidentical hormones: Are they safer?

No, they aren't. The term "bioidentical" means the hormones in the product are chemically identical to those your body produces. In fact, they are — but so are the hormones used in many FDA-approved hormone replacement products.

According to the Food and Drug Administration (FDA) and several medical specialty groups, bioidentical hormones may be riskier than are hormones used in standard hormone therapy, and there's no evidence they're any more effective.

Marketers of bioidentical hormones say their products have these advantages over standard hormone therapy:

• They're derived from plant chemicals, not synthesized in a laboratory. Even though they come from plants, bioidentical hormones still need to be commercially processed to become bioidentical. Some FDA-approved products — such as Estrace, Climara patch and Vivelle-Dot patch, which contain estrogens, and Prometrium, a natural progesterone — also are derived from plants.
• They're produced in doses and forms that differ from those in FDA-approved products. For many nonstandard combinations, you need to go through a compounding pharmacy — one that specializes in making medications customized for your individual needs. However, products from compounding pharmacies haven't been subject to the same rigorous quality assurance standards that standard commercially available hormonal preparations have to meet.
• They're custom made for you, based on a test of your saliva to assess your unique hormonal needs. Unfortunately, however, the hormone levels in your saliva don't reflect the levels in your blood or correspond to menopause symptoms.

Some women may benefit from nonstandard doses and forms of hormones in bioidentical hormone preparations, but there is almost no scientific support for an advantage of these compounds over common commercially produced preparations.