Subgroup analysesSubgroup analyses by dose of BHT suggested that higher doses of BHT may be associated with more effectiveness but also higher risk of adverse effects .
There was low to moderate quality evidence that BHT in various forms and doses is more effective than placebo for treating moderate to severe menopausal hot flushes .
There was some evidence to suggest that higher doses of BHT are associated with greater effectiveness but also with higher risk of adverse effects .
No data are yet available about the safety of BHT with regard to long-term outcomes such as heart attack , stroke and breast cancer .
BACKGROUND Various hormone therapies ( HT ) are available to treat  menopausal vasomotor symptoms .
Bioidentical hormones are chemically identical to those produced by the human body , and several types are well-tested and available on prescription .
Many women have opted for bioidentical hormone therapy ( BHT ) on the assumption that it is safer than other forms of HT .
We evaluated the evidence .
OBJECTIVES To determine the effectiveness and safety of bioidentical hormones compared to placebo or non-bioidentical hormones for the relief of vasomotor symptoms .
Preserved forearm endothelial responses with acute exposure to progesterone: A randomized cross-over trial of 17-beta estradiol, progesterone, and 17-beta estradiol with progesterone in healthy menopausal women.
Regularly menstruating women are relatively protected from cardiovascular disease . Epidemiological and endothelial function studies attribute this protection to estradiol ( E(2 ) ) , but both progesterone ( P ) and E(2 ) are normally present . A range of vascular effects of added progestins have been described , from neutral to detrimental , but the effects of P per se on endothelial function in humans have not been reported . We therefore investigated the acute effects of E(2 ) , P , and E(2 ) combined with P , on endothelium-dependent and -independent forearm blood flow responses . Using venous occlusion plethysmography , forearm blood flow ( FBF ) was measured during acute brachial artery infusions , achieving physiologic levels of 17-beta-E(2 ) , P , and 17-beta-E(2 ) with P in healthy menopausal women with no cardiovascular disease risk factors . Vehicle or hormones were infused , in r and om order , on 4 days , 1 week apart . Flow responses were measured during coinfusions of hormone with the endothelium-dependent vasodilator acetylcholine and the endothelium-independent vasodilator sodium nitroprusside . Twenty-seven healthy menopausal women were studied , and all had normal baseline endothelial responses . Small ( approximately 15 % ) , statistically nonsignificant increases in endothelium-dependent flow responses were seen after all acute hormone treatments . No impairment in response was seen with P alone or in combination with 17-beta-E(2 ) . In healthy menopausal women without cardiovascular disease risk factors and without baseline defects in endothelial function , acute exposure to physiologic levels of 17-beta-E(2 ) , P , and 17-beta-E(2 ) with P produced equivalent endothelium-dependent responses . These data suggest that P does not have detrimental vascular effects in humans
Subgroup analysesSubgroup analyses by dose of BHT suggested that higher doses of BHT may be associated with more effectiveness but also higher risk of adverse effects .
There was low to moderate quality evidence that BHT in various forms and doses is more effective than placebo for treating moderate to severe menopausal hot flushes .
There was some evidence to suggest that higher doses of BHT are associated with greater effectiveness but also with higher risk of adverse effects .
No data are yet available about the safety of BHT with regard to long-term outcomes such as heart attack , stroke and breast cancer .
BACKGROUND Various hormone therapies ( HT ) are available to treat  menopausal vasomotor symptoms .
Bioidentical hormones are chemically identical to those produced by the human body , and several types are well-tested and available on prescription .
Many women have opted for bioidentical hormone therapy ( BHT ) on the assumption that it is safer than other forms of HT .
We evaluated the evidence .
OBJECTIVES To determine the effectiveness and safety of bioidentical hormones compared to placebo or non-bioidentical hormones for the relief of vasomotor symptoms .