Q. My daughter insists that bio-identical hormones are superior to horse-derived hormones, and that they are safe to use over the long term. Every doctor I’ve asked says this is not so. Apparently bio-identical hormones are made in compounding pharmacies that are not FDA regulated. Dosages may be inconsistent. Do you have more information?
A. Bio-identical hormones have been promoted as safer than synthetic or equine-derived compounds, but this topic is extremely controversial. The FDA doesn’t always monitor the compounding pharmacies that make them.
Dr. Susan Love has suggested that taking any type of hormone for a long time is more problematic than the specific type of hormone (natural or synthetic) used.
We are sending you our Guide to Menopause, with ways to relieve hot flashes as well as a discussion of bio-identical hormones. Your daughter may also be interested in a CD of our one-hour radio interview with Dr. Love.
A new NIH-funded study may help to resolve this controversy in part. The investigators compared low-dose 17-beta estradiol, a bio-identical hormone (though one that is available through standard manufacturers) to low-dose venlafaxine (Effexor) and to placebo. The estradiol and venlafaxine both cut the number of hot flashes per day nearly in half. Nonetheless, expert advice remains to use the lowest effective dose for the shortest possible time if treatment for hot flashes is needed.
