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 .
Efficacy and tolerability of a new 7-day transdermal estradiol patch versus placebo in hysterectomized women with postmenopausal complaints.
OBJECTIVES To investigate the efficacy and tolerability of a continuously applied 7-day-Estradiol patch ( Fem7 , Merck KGaA , Germany ) delivering 50 microg estradiol per day in the treatment of hysterectomized women with postmenopausal complaints compared with placebo . DESIGN A multicentre , r and omized , double-blind study with an initial screening phase ( phase I ) , a 3-month double-blind placebo-controlled phase ( phase II ) and a 3-month open follow-up phase ( phase III ) . METHODS 186 patients were r and omized for a 3-cycle  placebo-controlled  study followed by a 3-cycle open follow-up ( total duration ; 6 months ) . The changes in Kupperman Index ( primary efficacy variable ) , hot flushes and urogenital symptom score were studied from baseline to the end of the study . In addition , skin tolerability was assessed and patients were also asked to grade the subjective acceptance of therapy . RESULTS A reduction in Kupperman Index was observed in both groups , and at each cycle of the placebo-controlled treatment phase the 7-day-Estradiol patch was superior compared with placebo ( last value vs. baseline P = 0.0006 ) . From the second treatment week onwards a distinct difference was noted in the reduction of hot flushes from baseline between the 7-day-Estradiol patch group and the placebo group . The difference between the groups was statistically significant for each cycle and at the end of the controlled treatment phase ( mean weekly hot flush reduction at the end of the placebo-controlled treatment phase : -32.5 for the 7-day-Estradiol patch vs. -22.0 for placebo , P = 0.0025 ) . The efficacy of the 7-day-Estradiol patch within the application period did not show any difference between days 1 - 3 and 4 - 7 . Subjective acceptance of the 7-day-Estradiol patch was good and 72.4 % of patients who took active medication throughout the study were willing to consider continuing its use . CONCLUSIONS The 7-day-Estradiol patch is well tolerated and provides effective relief of moderate to severe vasomotor symptoms in hysterectomized women , with a rapid onset of action and 7-day duration of therapeutic effect . Although a placebo effect was observed , the 7-day-Estradiol patch significantly reduced hot flushes and other menopausal symptoms throughout the application period
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 .