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Bioidentical hormone therapy: a review
Lisa A Boothby1, Paul L Doering, Simon Kipersztok
1Columbus Regional Drug Information Center, Columbus, GA, USA. lisa.boothby@crhs.net
Menopause (New York, N.Y.)
|May 29, 2004
Summary
Natural hormone therapy (NHT) uses compounded steroids to treat symptoms. However, current evidence does not support its use over conventional therapies due to a lack of proven safety and efficacy.
Area of Science:
- Endocrinology and Pharmacology
- Women's Health
- Evidence-Based Medicine
Background:
- Natural or bioidentical hormone therapy (NHT) involves individually compounded steroid formulations.
- Proponents claim NHT is better tolerated than manufactured hormone products.
- NHT composition is based on individual salivary hormone level results.
Purpose of the Study:
- To review the concept of NHT.
- To determine if scientific evidence supports the use of NHT.
Main Methods:
- Literature search conducted using Medline, Current Contents, and other databases.
- MeSH terms included hormone replacement therapy, menopause, and specific hormones like estradiol and progesterone.
- Searched for drug combinations, drug monitoring, and drug compounding.
Main Results:
- Few observational studies and clinical trials exist comparing NHT with conventional hormone therapy.
- Studies often lack adequate design, including small sample sizes and inequivalent doses.
- Limited evidence supports individualized dosing based on saliva hormone concentrations.
Conclusions:
- Individualized hormonal products may alleviate some menopause symptoms.
- NHT shows no proven advantage over conventional hormone therapies.
- Evidence regarding pharmacokinetics, safety, and efficacy of NHT is lacking.