Many women have embraced “natural” or “bioidentical” hormones to treat their hot flashes, night sweats and other menopausal symptoms over the more traditional hormone replacement therapy (HRT) offered by pharmaceutical companies. But bioidentical treatments are not without controversy.
The idea of bioidentical hormones is to create compounds from natural sources that are chemically matched to a woman’s own hormones. Bioidentical hormones are made, or “compounded” by specialized pharmacists using plant products such as soy or yam. The hormones are incorporated into various forms including creams, lotions, patches and pills.
Proponents believe these compounds are more safe and effective than the man-made hormones provided in standard HRT. These claims are largely countered in a recent on line article published on the EndocrineToday website that summarizes the history of bioidentical hormones and reviews the published scientific evidence.
“What women want is individualized care. What bioidentical hormones promise is tailored hormone therapy,” according to JoAnn V. Pinkerton, MD of the Midlife Health Center at the University of Virginia who is quoted in the article. Most scientific experts believe that bioidentical hormones may be effective in some cases but are no better than standard HRT and may present their own unique sets of health risks, according to the article.
There have been no large-scale studies comparing bioidentical hormones to standard HRT, so it’s difficult to know the benefits or pitfalls of these hormones. “My mottos is, ‘In God we trust.’ In everyone else, show me the data,” adds Michael Cirigliano, M.D. from the University of Pennsylvania.
In his own review of the scientific literature on bioidentical hormones, Dr. Cirigliano found little evidence to support the use of bioidentical hormones. He concluded in an article published in the Journal of Women’s Health that the current “scientific uncertainties associated with compounded bioidentical hormone therapy (BHT) make their use less preferable to that conventional hormone therapy.”
Experts explain that bioidentical hormones may be riskier than standard therapies because the individualized compound recipes are not pretested for safety or efficacy. Bioidentical hormones are not approved by the FDA, and there is no regulation to confirm that the treatments are pure or contain the advertised concentration of active ingredients.
In addition, “natural” or not, bioidentical hormones are still hormones and come with the same set of risks as traditional HRT products. Safety of hormones like estrogen to treat menopausal symptoms has become a concern since the highly publicized results of the Women’s Health Initiative of 2002 that found HRT increased the risk of heart disease and some cancers in certain women on long-term hormone therapy.
Alternative treatments are appealing, but should be approached with caution and fully examined before broadly prescribed to women eager to address their menopausal symptoms, the authors conclude.
Article Links:
Kalvaitis, K., Mar 2008. “Compounded Hormone Therapies: unproven, untested and popular,” EndocrineToday website article
http://www.endocrinetoday.com/view.aspx?rid=27231
Cirigliano, M. 2007. “Bioidentical Hormone Therapy: a Review of the Literature,” http://www.liebertonline.com/doi/abs/10.1089/jwh.2006.0311
Related Links:
Bracy, K., Apr 2008. “What are Bioidentical Hormones?” About.com article.
http://menopause.about.com/od/alternativetreatments/f/BioidenticalFAQ.htm
US Food and Drug Adminstration, 2008. “Bio-Identicals: Sorting Myths from Fact,”
http://www.fda.gov/consumer/updates/bioidenticals040808.pdf