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 on climacteric symptoms and safety of low dose estradiol transdermal matrix patches. A randomized, double-blind placebo-controlled study.
Two estradiol ( E2 ) transdermal patches releasing 25 micrograms/day E2 ( D-25 ) or 37.5 micrograms/day E2 ( D-37.5 ) were compared to a placebo patch on 156 patients in natural or surgical menopause suffering from at least 5 hot flushes per day , r and omly and blindly assigned to three parallel groups of 52 patients each , to be treated continuously for 12 weeks , without progestin opposition . " Responders " ( patients with less than 3 hot flushes per day at the end of treatment ) , were 82 % and 90 % under D-25 or D-37.5 , respectively , both significantly ( p < 0.001 ) more than under placebo ( 44 % ) . Comparable efficacy was observed on severity of hot flushes , Kupperman Index and on the self-rated efficacy . Systemic adverse events occurred in 10 % , 10 % and 8 % of patients , respectively , under D-25 , D-37.5 or placebo . Occasional mild and transient itching and /or erythema on the site of application was reported by few patients and did never require discontinuation of application . In conclusion D-25 and D-37.5 were significantly more effective than placebo in relieving climacteric symptoms and were systemically and locally as well tolerated as placebo . D-25 ( Demestril 25 ) releasing 25 micrograms/day E2 can therefore be recommended for low-dosed estrogen replacement 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 .