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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
PubMed
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.

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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.

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