How Much Do You Know about "Bioidentical" Hormones?

By Jane Farrell

Although many menopausal women are taking so-called “bioidentical hormones,” they may not understand the risk of these unapproved treatments, according to the North American Menopause Society.

An analysis to be published in the Society’s journal Menopause found that between 28% to 68% of women using hormones take the “bioidentical” substances without understanding that they are not approved by the federal Food and Drug Administration (FDA). Prescriptions for “compounded” hormones, as they’re also known aren’t tracked, unlike those for FDA-approved drugs.

According to a news release from the society, nearly 3,000 women completed surveys, and the researchers used their feedback and US Census data to estimate national use of bioidentical hormones.

The investigators estimated that from 57 million to 75 million prescriptions for hormone therapies are filled each year. Just 36 million are written for FDA-approved hormone therapy.

However, many women don’t necessarily know what they’re getting into. When asked if they thought the bioidentical hormones were FDA-approved, 76 percent weren’t sure.

The risks of bioidentical hormones aren’t known because they are not tested in clinical trials and there’s no mechanism for reporting problems. An investigation by More magazine showed that compounded hormone prescriptions didn’t always contain what they were supposed to contain. That is risky, the Society’s news release said, especially if a woman takes estrogen without enough progesterone. That puts women at increased risk of endometrial cancer.

“These results indicate a general lack of understanding about key differences between compounded and FDA-approved hormone therapy. This publication establishes the need for better education on this topic,” commented Dr. Margery Gass, executive director of The North American Menopause Society.

The analysis, “Compounded bioidentical hormone therapy: identifying use trends and knowledge gaps among US women,” was funded by Therapeutics MD and will be published in the September 2015 print edition of Menopause.