5507353pubmedA Comprehensive Review of the
Safety and Efficacy of Bioidentical Hormones for
the Management of Menopause
and Related Health Risks
Deborah Moskowitz, ND


Numerous forms of estrogens and progestins
are utilized for the treatment of menopausal
complaints and associated conditions that
occur temporally. Although known to be different
with respect to molecular structure, receptor
affinity, metabolism, and other physiological
traits, most have been treated as if they were
clinically identical. The majority of these hormone
preparations, commonly referred to as hormone
replacement therapy (HRT), should perhaps be
more aptly referred to as hormone substitution
therapy, as most of the therapies utilized do
not exactly match those produced in the body.
Research indicates these synthetic hormones
vary clinically in safety and efficacy. As such,
women and their physicians have, in increasing
numbers, been opting for the use of bioidentical
hormones; i.e., those that match the structure
and function of hormones produced in the body.
With greater utilization and research surrounding
bioidentical hormones, the differences can now
begin to be fully assessed and appreciated. This
article reviews the disparities between synthetic
and bioidentical estrogens and progestins/
progesterone with respect to safety and efficacy;
special attention is devoted to clinical outcomes
in the breast, endometrium, bone, cardiovascular
system, and brain. The studies reviewed suggest
bioidentical progesterone does not have a negative
effect on blood lipids or vasculature as do many
synthetic progestins, and may carry less risk with
respect to breast cancer incidence. Studies of both
bioidentical estrogens and progesterone suggest
a reduced risk of blood clots compared to nonbioidentical
preparations. Bioidentical hormone
preparations have demonstrated effectiveness in addressing menopausal symptoms. The
author advocates for continued research on
bioidentical hormones and concludes there is
currently sufficient evidence to support their
preferred use over that of their synthetic cousins.
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