‘Bioidentical’ hormones: Are they better?

Doctors who prescribe bioidentical hormones often use salivary (spit) testing to “tailor” the amount of bioidentical hormones you supposedly need. But hormone levels vary tremendously by the hour, throughout the day and from woman to woman. Comprehensive studies have yet to show the correlation between these hormones and a woman’s clinical status or response to various preparations, and until there is scientific documentation of their validity, I would not recommend this type of testing. If I want to check to see how much of a hormone a woman is absorbing or the level of active hormone in her body, I draw the appropriate blood test.

A recent position statement issued by the North American Menopause Society stated quite clearly that whatever risks or benefits are thought to apply to pharmaceutically produced hormones should also apply to bioidentical hormones. There is no “free” hormone.

It’s important to understand that commercial pharmaceutical products are FDA-regulated and tested for their purity, potency and safety, whereas products made by compounding pharmacies are not subject to the same strict guidelines and may vary considerably in all these parameters. Indeed, they may even contain contaminants that both you and your doctor are unaware of.

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Dr. Reichman’s Bottom Line: Bioidentical does not mean safer or better. If your doctor feels comfortable in prescribing compounded products, is familiar with the manufacturing company, and knows that the type of product you are seeking is not available through an FDA-regulated source (products such as certain forms of testosterone, estrogen skin creams and DHEA), then this type of hormone may be a viable option for you. But please remember that a hormone is a hormone and it works on hormone receptors found in nearly every cell in your body. If you have menopausal symptoms and you decide that you would like to begin or continue hormone therapy, discuss the pros and cons of known and tested medications with your doctor. You may also want to consult another doctor for a second opinion. No matter what you take, your physician should closely monitor its positive and possible negative effects.

Dr. Judith Reichman, the “Today” show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," which is now available in paperback. It is published by William Morrow, a division of HarperCollins.

PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.

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