Criticisms
The primary difference between the popular promotions of CHRT and compounded BHRT involves BHRT advocates' use of regular testing of blood or saliva-bound hormone levels, use of individualized compounding rather than standard doses, dosing to attain certain levels in the body rather than for symptom relief, and the use of hormones for purposes other than relief of menopausal symptoms. Proponents of compounded BHRT have been criticized by many mainstream medical sources for making unsubstantiated claims about its effectiveness for a variety of purposes, and for promoting it as more safe and "natural" than CHRT.
Advocates for BHRT have claimed that commonly-compounded BHRT preparations are not commercially available; this is false, as there are many FDA-approved hormone preparations containing bioidentical molecules available both as proprietary or generic brands. The exception is estriol, used in the compounded bioidentical preparations Triest and Biest—in 2008, the FDA banned estriol until a New Drug Application had been completed; these preparations are not approved by either the FDA, or Health Canada. Some advocates of compounding have also falsely claimed that customized compounding provides customized results; this is incorrect since it is aimed at producing a single hormone profile with absolute blood or saliva levels—which has not been demonstrated to be better than CHRT—and does not consider the rate at which individuals will differ in the activity, metabolism and excretion of the hormones. There have been no clinical trials directly comparing the effectiveness or efficacy of bioidentical versus nonbioidentical compounds.
A 2010 article published in The Medical Letter on Drugs and Therapeutics concluded "There is no acceptable evidence that 'bioidentical' hormones are safe or effective. Patients should be discouraged from taking them."
Read more about this topic: Bioidentical Hormone Replacement Therapy
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