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 .
National use of postmenopausal hormone therapy: annual trends and response to recent evidence
CONTEXT  Postmenopausal hormone therapy use increased dramatically during the past 2 decades because of a prevailing belief in its health benefits . Recent evidence from r and omized trials published in July 2002 demonstrated adverse cardiovascular disease events and other risks with hormone therapy in the form of oral estrogen combined with progestin . OBJECTIVE To describe patterns of hormone therapy use from 1995 until July 2003 , including the impact of recent evidence . DESIGN , SETTING , AND POPULATION Two data bases were used to describe national trends in  hormone therapy use from January 1995 to July 2003 . The National Prescription Audit data base provided data on the number of hormone therapy prescriptions filled by retail pharmacies and the National Disease and Therapeutic Index data base provided data on patient visits to office-based physicians during which hormone therapy was prescribed . MAIN OUTCOME MEASURES Annual number of hormone therapy prescriptions and characteristics of visits to physicians during which hormone therapy was prescribed . RESULTS Annual hormone therapy prescriptions increased from 58 million in 1995 to 90 million in 1999 , representing approximately 15 million women per year , then remained stable through June 2002 . Adoption of new oral estrogen/progestin combinations , primarily Prempro , accounted for most of this growth . Obstetrician/gynecologists provided more than 70 % of hormone therapy prescriptions , and more than one third of patients were older than 60 years . Following the publication of trial results in July 2002 ,  hormone therapy prescriptions declined in successive months . Relative to January-June 2002 , prescriptions from January-June 2003 declined by 66 % for Prempro and 33 % for Premarin . Small increases were observed in vaginal formulations and in new prescriptions for low-dose Premarin . If prescription rates observed through July 2003 remain stable , a decline to 57 million prescriptions for 2003 , similar to the rate in 1995 , is projected . CONCLUSIONS Clinical practice responded rapidly to recent evidence of harms associated with hormone therapy . Since July 2002 , many patients have discontinued hormone therapy or are tapering to lower doses
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 .