Increasing numbers of peri- and post-menopausal women request “bioidentical” rather than synthetic hormones. Although there is a tendency to think of bioidentical hormones as “all-natural”, they, like synthetic hormones, are manufactured in the laboratory. In contrast to synthetic hormones, they are chemically identical to the hormones produced by the human body; synthetic hormones are structurally different yet are designed to have similar biological effects as naturally produced hormones.
Rather than using FDA-approved hormone replacement preparations, many women are given prescriptions for compounded hormone therapy, which are custom-blended by pharmacists.
In the media, women are often given the message that bioidentical hormones are safer and more effective than synthetic hormones; however, the bottom line is that we have no information to suggest that bioidentical hormones are any safer or more advantageous for women than traditional hormone treatments. A recent study indicates that these compounded preparations often contain doses of hormones which differ from the actual prescribed dose.
Without FDA oversight and regulation, there is no guarantee that these custom-made compounded preparations contain active ingredients that provide predictable therapeutic levels. The North American Menopause Society (NAMS) and other medical organizations have cautioned against the use of bioidentical hormones: “Little or no scientific or medical evidence supports claims that bioidentical hormones are safer or more effective than more traditional FDA-approved therapies. In addition, many custom-compounded “bioidentical hormone” formulations are not subject to FDA oversight and can be inconsistent in dose and purity.”
Ruta Nonacs, MD PhD
Custom Menopause Hormones Have Unpredictable Ingredient Mix (Medscape – free subscription)
Compounded Bioidentical Hormone Replacement Scrutinized by Panel (Medscape – free subscription)