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 .
Pulsed estrogen therapy in prevention of postmenopausal osteoporosis. A 2-year randomized, double blind, placebo-controlled study
The aim of this study was to evaluate the efficacy of pulsed estrogen therapy ( intranasal 17β-estradiol ) in the prevention of  postmenopausal bone loss . A total of 386 women ( 40–65 years old ) , less than 5 years past menopause , were r and omized to intranasal placebo , 17β-estradiol 150 µg , or 300 µg daily for 2 years . Women with an intact uterus received micronised progesterone 200 mg per day , 14 days of each 28-day cycle . Women r and omised to placebo-treatment received placebo progesterone . The primary endpoints were changes in BMD at the spine ( L2–L4 ) and femoral neck . Secondary endpoints were changes in bone turnover markers : serum osteocalcin ( sOC ) as a marker of bone formation and urinary C-terminal telopeptides ( uCTX ) as a marker of bone resorption . BMD increased at all measured sites in women receiving active treatment in a dose-related manner , the difference compared to placebo being 5.2 % and 6.7 % at the spine , and 3.2 % and 4.7 % at the hip , respectively , with 150 μg and 300 μg ( P<0.001 ) . On the other h and , a decrease versus baseline of −3.2 % and −3.3 % at the spine and hip , respectively , was observed in women receiving placebo ( P<0.001 ) . In the patients with at least one risk factor for osteoporotic fracture , the difference between placebo and 150 μg or 300 µg was even higher at the spine ( 5.4 % and 7.4 % , respectively ) , and at the femoral neck ( 4.0 % and 5.2 % , respectively ) . Correspondingly , uCTX decreased from baseline by 39 % and 46 % , and sOC by 22 % and 27 % , in the 150 µg group and 300 µg group ( all P<0.001 versus placebo ) . A strong correlation was found between variations of bone turnover markers after 1 year and BMD after 2 years , emphasizing that bone markers can predict BMD response during hormonal treatment . Acceptability and general tolerance were good . This study demonstrates that pulsed estrogen therapy at the dose of 150 μg and 300-μg per day prevents bone loss in a dose-dependant manner at each site studied , and normalizes bone turnover markers to premenopausal levels
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 .