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 .
Vaginal ring delivering estradiol and progesterone: a possible alternative to relieve climacteric symptoms.
BACKGROUND Relief of climacteric symptoms is currently the main role of hormone therapy . However , vaginal bleeding complicating this therapy is among the leading causes for its early discontinuation . OBJECTIVES To assess the effect of a vaginal ring delivering estradiol and progesterone in postmenopausal women and to determine whether continuous administration can relieve climacteric symptoms , produce an acceptable pattern of vaginal bleeding and control endometrial proliferation . METHODS Twenty-nine postmenopausal women with an intact uterus were studied . All had climacteric symptoms . The vaginal rings contained 0.36 g estradiol and either 3.6 g progesterone ( high dose progesterone ) or 1.8 g ( low dose progesterone ) , and were kept in place for 4 - 6 months . Serum progesterone , estradiol and estrone were measured and endometrial thickness determined . All women kept a daily diary of bleeding/spotting and completed a question naire on climacteric symptoms at monthly intervals . The low dose progesterone group comprised 14 women and the high dose progesterone group 15 women . RESULTS A total of 18 patients ( 9 in each group ) completed the study .  Mean levels of estradiol , estrone and progesterone were at their peak after 2 to 4 weeks . All rings were effective in alleviating vasomotor symptoms , although there was evidence of " escape from effect " in month 6 . Endometrial thickness increased in 6 of the 29 women but biopsy in each case showed no evidence of hyperplasia . Of the 18 women who completed the study , 5 had amenorrhea throughout , 7 had amenorrhea after 3 months , and the remainder had one or two bleeding episodes after 3 months . Therapy was discontinued in 11 women . CONCLUSIONS A vaginal ring delivering estradiol and progesterone controlled climacteric symptoms , prevented endometrial proliferation , and provided an acceptable bleeding pattern . It should be viewed as a possible alternative for short-term estrogen-progesterone therapy
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 .