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 .
Comparison of transdermal to oral estradiol administration on hormonal and hepatic parameters in women with premature ovarian failure.
Five women with premature ovarian failure were studied in a r and omized cross-over design to compare the biochemical effects of transdermal to oral estradiol administration when used in doses appropriate for endometrial preparation in a donor oocyte program . Patients r and omly received increasing dosages of oral micronized or transdermal estradiol for 4 week , with progesterone added in the last 2 weeks , to mimic a normal hormonal cycle . Serum sample s were assayed throughout treatment and compared to those from normally cycling premenopausal controls . In general , serum estradiol remained within the normal range in both treatment groups , whereas peak serum estrone levels were 10-fold higher in the orally treated group than those in the transdermally treated group . Serum levels of sex hormone-binding globulin , thyroid binding globulin , and renin substrate were all significantly elevated by day 14 in the orally treated patients and unchanged in the transdermal subjects . While plasminogen was unaltered by either route of administration , antithrombin-III levels fell with both treatments . Changes in gonadotropin levels were similar in both groups , with suppression of FSH by the end of the simulated cycles , but not into the normal premenopausal range . In conclusion , both estrogen replacement regimens provided near-normal serum estradiol profiles . However , despite the relatively high doses necessary to mimic a hormonally normal cycle , the transdermal route did not significantly alter the hepatic parameters studied , suggesting that this route of administration may have less adverse hepatic effects
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 .