Bioidentical Hormones, Compounding, and Evidence-Based Medicine: What Women's Health Practitioners Need to Know

For many years, hormone therapy (HT), administered as estrogen alone (for hysterectomized women) or combined estrogen/progestin (for nonhysterectomized women), has been an effective treatment for menopausal symptoms and osteoporosis prevention. Questions regarding the benefit–risk profile of HT have prompted some women to seek alternative therapies. Compounded bioidentical HT has been promoted as a potentially safer option than conventional HT; however, there are a lack of sufficient data from well-designed comparative trials to support the safety or efficacy of this approach. Compounded bioidentical hormone formulations may be associated with additional risks for variability in quality, purity, and batch-to-batch consistency.