What You Need to Know About Bioidentical Hormone Therapy for Menopausal Symptoms

Allan I. Fleming

Expanding quantities of peri- and post-menopausal girls ask for “bioidentical” hormones alternatively than the hormones out there in normally employed Fda-permitted hormone substitution therapies.  

What Specifically is a Bioidentiacal Hormone?

The phrase “bioidentical” suggests that a hormone is chemically and structurally identical to the hormone that the entire body obviously makes. Bioidentical hormone treatment applied to take care of menopausal signs or symptoms normally consists of estradiol which is, in fact, similar to the estradiol utilized in common hormone treatment. As a result, the expression bioidentical hormone therapy can be perplexing there are bioidentical hormones authorised by the Fda, but there are also compounded bioidentical hormone therapies.  

Food and drug administration-accredited bioidentical hormones involve estradiol, estrone, and micronized progesterone, which are controlled and monitored for purity and efficacy according to Food and drug administration recommendations. The efficacy and safety of these products and solutions have been recognized via rigorous tests in randomized controlled trials. These goods have to have a prescription. 

Compounded bioidentical hormone therapies are prepared by a compounding pharmacy according to a provider’s technical specs. These therapies are personalized-blended and typically merge a number of hormones together with estradiol, estrone, estriol, DHEA, testosterone, and progesterone. The efficacy of these preparations have not been assessed in randomized controlled trials and generally incorporate untested combinations and dosages of hormones. These formulations may also be administered by nonstandard or untested routes, this kind of as topical lotions, subdermal implants or pellets, injections, or oral lozenges. Bioidentical hormone treatment is most generally encouraged by naturopathic medical practitioners.  

Is Bioidentical Hormone Therapy Safer or A lot more Productive?

In the media, females are frequently provided the message that bioidentical hormones are safer and a lot more successful than artificial hormones even so, the bottom line is that we have no proof to suggest that bioidentical hormones are any safer or far more useful for females than classic hormone remedies. 

Whilst there is a tendency to think of bioidentical hormones as “all-natural”, they, like the hormones utilized in conventional hormone therapies, are made in the laboratory. Consequently, bioidentical hormone therapy carries quite a few of the similar hazards as classic estrogen replacement treatment, which include improved threat of blood clots, stroke, endometrial cancer and breast cancer. Since there is not constant deal labeling for these compounded items, shoppers may well not be fully mindful of the opportunity for serious side results.

To date, there have been no randomized, managed trials evaluating compounded bioidentical hormone therapy with placebo or Fda-accepted hormone therapies for menopausal signs and symptoms. On top of that, there is no scientific evidence to assistance the idea that bioidentical hormone treatment has much less challenges than Fda-authorised hormone therapies. In point,  numerous specialist companies are worried that these compounded preparations may well have additional threats. There is the potential for dose variability (possibly overdosing or underdosing), inconsistent bioavailability, and contamination. Even though compounding pharmacies are envisioned to comply with USP Criteria for the preparing of these hormone therapies, compounded merchandise are not routinely examined, and pharmacies are not demanded to gather info on adverse activities.

With no Fda oversight and regulation, there is no ensure that custom-produced compounded preparations made up of bioidentical hormones provide predictable therapeutic amounts of hormones. 

Not plenty of Info, Oversight for the Use of Bioidentical Hormone Treatment

 The North American Menopause Society (NAMS) and other medical corporations have cautioned towards the use of bioidentical hormones: “Little or no scientific or professional medical evidence supports statements that bioidentical hormones are safer or extra productive than a lot more conventional Food and drug administration-authorized therapies. In addition, lots of custom-compounded “bioidentical hormone” formulations are not subject to Fda oversight and can be inconsistent in dose and purity.”  

We concur. We do not have enough details to assist the use of these bioidentical preparations for the treatment method of menopausal symptoms.  

Ruta Nonacs, MD PhD

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