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 .
Estradiol in micellar nanoparticles: the efficacy and safety of a novel transdermal drug-delivery technology in the management of moderate to severe vasomotor symptoms
Objective : To assess the efficacy and safety of topical micellar nanoparticle estradiol emulsion ( MNPEE ; Estrasorb ; Novavax , Inc. , Malvern , PA ) in postmenopausal women with moderate to severe vasomotor symptoms . Design : A multicenter , r and omized , double-blind , placebo-controlled study was conducted in 200 postmenopausal women with seven or more moderate to severe hot flushes per day . The study consisted of a 3-week screening period followed by a 1-week placebo emulsion run-in period and a 12-week active or placebo treatment period . Women were r and omized ( 1:1 ) to receive MNPEE ( 3.45 g daily dose of emulsion containing 8.6 mg estradiol ) or matching placebo emulsion . The primary efficacy variable was the change from baseline in the frequency of moderate and severe hot flushes at weeks 4 and 12 . Adverse events were monitored throughout the trial . Results : Topical micellar nanoparticle estradiol emulsion was statistically significantly superior to placebo emulsion in reducing the mean frequency of moderate to severe vasomotor symptoms by week 3 ( P = 0.003 ) , with superiority to placebo maintained from weeks 4 to 12 ( P < 0.001 ) . At week 12 ( peak benefit ) , MNPEE reduced mean daily frequency of hot flush count by 11.1 ( P < 0.001 vs placebo ) . MNPEE significantly reduced mean symptom severity from weeks 4 to 12 ( P < 0.001 ) compared with placebo . At endpoint , mean serum concentrations of estradiol and estrone were 63 and 89 pg/mL , respectively , in the MNPEE group . The mean endpoint ratio of estradiol to estrone in these patients was 0.774 . MNPEE was safe and well tolerated . Conclusion : Once-daily application of 3.45 g of micellar nanoparticle estradiol emulsion containing 8.6 mg of estradiol was safe and effective in providing significant relief of vasomotor symptom frequency and severity in postmenopausal women
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 .