Initiating Discussions, Dispelling Myths, and Finding Solutions
Menopausal women often present with a list of complaints, questions and worries. While they seek effective treatment to alleviate their symptoms, they express their concerns regarding the potential adverse effects associated with conventional hormone treatment-namely, coronary heart disease, stroke and breast cancer. As a result, many women ask their clinicians about alternative options. They come armed with anecdotal stories, advice from friends, and information from television and internet sources.
One such alternative women inquire about is bioidentical hormones. Bioidentical hormones have been around for years, but have only recently gained public favor. While the interest in these products have increased, confusion continues to plague women as they try to better understand such concepts as custom-compounding, “natural” versus bioidentical, and FDA approvals and safety issues. So how can a clinician best counsel their patients?
We’ve invited Dr. Richa Sood, instructor of medicine at the Mayo Clinic and clinician at the Mayo’s Women Health Clinic, to help answer this question. Dr. Sood recently published an article discussing the available research evidence on BCHT, including myths about the use of compounded hormones and tips for clinicians in answering commonly asked questions.
Abstract: Sood R, Shuster L, Smith R, et al. Counseling postmenopausal women about bioidentical hormones: ten discussion points for practicing physicians. J Am Board Fam Med. 2011; 24(2):202-210.
Bioidentical hormones are compounds that have exactly the same chemical and molecular structure as endogenous human hormones. In contrast, nonbioidentical, or synthetic, hormones are structurally dissimilar from endogenous hormones. Although available for years, bioidentical compounded hormone therapy (BCHT) has gained popularity in the United States only recently. This popularity has paralleled women's rising fears of conventional hormone therapy, especially since the publication of the Women's Health Initiative clinical trials. Although BCHT offers advantages, it is not the panacea of hormone therapy. The claims that BCHT lowers the risk of breast cancer, coronary artery disease, stroke, or thromboembolism are not supported by scientific research. The goal of this review is to present an overview of the available research evidence on BCHT, dispel myths about the use of compounded hormones, and provide helpful tips to answer commonly asked questions about BCHT.