As women age, the natural levels of hormones in their bodies – estrogen, progesterone and testosterone, to name a few – decline. In some women, this process can be more dramatic than in others and can result in a variety of symptoms including hot flashes, night sweats, difficulty sleeping, fatigue, mood symptoms, poor concentration and low sex drive.
To lessen the more severe symptoms, some women can consider hormone therapy. There has been a great deal of press over the past 10 years about “bioidentical hormone therapy” (BHT), which has been promoted as a “natural” hormone option. BHT refers to compounds that have the same structure as hormones produced in the body. Providers who prescribe BHT compounds often conduct hormone testing with blood or saliva samples and then recommend “custom-compounded” hormone recipes of one or more hormones in varying amounts. A compounding pharmacist then prepares these.
BHT Compounds: What You Should Know
While BHT compounds may sound ideal, there are some concerns most patients and many providers may not be aware of. In particular, BHT compounds have not been vetted by the FDA. They have not been studied the way FDA-approved conventional hormones that are currently available in the United States and Canada have been.
The North American Menopause Society (NAMS), International Menopause Society, The American College of Obstetricians and Gynecologists, Society of Obstetricians and Gynaecologists of Canada, The Endocrine Society, The FDA, American Association of Clinical Endocrinologists, American Medical Association, American Cancer Society, and the Mayo Clinic have released statements that there is a lack of evidence of any difference in either the benefits or risks of custom-compounded bioidentical hormones compared to well-studied, conventional counterparts.
What is the right treatment for my menopause or perimenopause symptoms?
If you are having menopause symptoms that are affecting your quality of life, please see a clinician who can help you find the right treatment during this time of transition. The good news is that there are many options, hormonal and non-hormonal, available to help with menopause symptoms. If you and your clinician determine that hormone treatment is the best option for you, know that there are many well-tested, FDA-approved bioidentical hormones that do not have to be custom-compounded (meaning custom mixed). They have the same chemical and molecular structure as hormones produced in the body, are commercially available from retail pharmacies, produced with monitored quality control and are likely covered by your health insurance plan.