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 .
Quality of life and costs associated with micronized progesterone and medroxyprogesterone acetate in hormone replacement therapy for nonhysterectomized, postmenopausal women.
BACKGROUND Because natural progesterone is poorly absorbed and rapidly metabolized , synthetic derivatives of progesterone , such as medroxyprogesterone acetate ( MPA ) , are used in combination with estrogen in hormone replacement therapy . A micronized form of natural progesterone is available that is readily absorbed and reaches peak serum concentrations from 1 to 4 hours after administration . OBJECTIVE The purpose of this study was to compare the quality of life ( QOL ) , menopausal symptoms , and costs associated with a natural micronized progesterone ( MP ) formulation versus MPA as add-on therapy to estrogen in hormone replacement for post-menopausal women . METHODS This prospect i ve , multicenter , r and omized , fixed-dose , open-label , parallel-group study enrolled postmenopausal , otherwise healthy , nonhysterectomized women 45 to 65 years of age who had been amenorrheic for > or = 6 months and exhibited symptoms of estrogen deficiency . All women received 0.625 mg conjugated equine estrogens on days 1 to 25 of a 30-day cycle ; on days 12 to 25 , women were r and omized to receive either MP 200 mg or MPA 5 mg ; patients were followed for 9 months . QOL , the primary end point , was measured at baseline and months 3 , 6 , and 9 using the 36-Item Short-Form Health Survey ( SF-36 ) , the Nottingham Health Profile ( NHP ) , and the condition-specific Women 's Health Question naire ( WHQ ) . Bleeding pattern , compliance , menopausal symptoms , and cost were evaluated as secondary end points . Costs ( in 1997 Canadian dollars ) were assessed from the societal perspective and included costs of study medication , hormone therapy monitoring , concomitant medication , outpatient re sources , out-of-pocket expenses , and patient and caregiver time loss . RESULTS A total of 182 women were enrolled ; 89 received MP and 93 received MPA . Improvements in climacteric symptoms were observed from baseline to month 9 for both treatments . Mean scores on all domains of the SF-36 at month 9 were greater than scores at baseline in both treatment groups but the increases were not statistically significant . All domains within the NHP and WHQ improved significantly over this period for both groups ( P < or = 0.008 ) . Only patients receiving MP showed specific improvements in the menstrual problems and cognitive domains of the WHQ . The difference in average 9-month cost per patient was not statistically significant , at Can 367 dollars + /- 120 dollars and Can 360 dollars + /- 369 dollars for patients receiving MP and MPA , respectively . CONCLUSIONS MP is a clinical ly effective , well-tolerated , and cost-comparable alternative to MPA
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 .