Compounded Bioidentical Menopausal Hormone Therapy

Conventional hormone therapy is preferred over compounded hormone therapy given the available data.


American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and American Society for Reproductive Medicine Practice Committee

Vol 98, Issue 2, Pages 308-312


While improvement in long-term health is no longer an indication for menopausal hormone therapy, evidence supporting fewer adverse events in younger women, combined with its high overall effectiveness, has reinforced its usefulness for short-term treatment of menopausal symptoms. Menopausal therapy has been provided not only by commercially available products but also by compounding, or creation of an individualized preparation in response to a physician's prescription to create a medication tailored to the specialized needs of an individual patient. The Women's Health Initiative findings, coupled with an increase in the direct-to-consumer marketing and media promotion of compounded bioidentical hormonal preparations as safe and effective alternatives to conventional menopausal hormone therapy, have led to a recent rise in the popularity of compounded bioidentical hormones as well as questions about the use of these preparations. Not only is evidence lacking to support superiority claims of compounded "bioidentical" hormones over conventional menopausal hormone therapy, but they also pose the additional risks of variable purity and potency, and a lack of efficacy and safety data. The Committee on Gynecologic Practice of the American College of Obstetricians and Gynecologists and the Practice Committee of the American Society for Reproductive Medicine provide an overview of the major issues of concern surrounding compounded bioidentical menopausal hormone therapy and provide recommendations for patient counseling.

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