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 .
A randomized, open-label, crossover study comparing the effects of oral versus transdermal estrogen therapy on serum androgens, thyroid hormones, and adrenal hormones in naturally menopausal women
Objective : To compare the changes induced by oral versus transdermal estrogen therapy on the total and free serum concentrations of testosterone ( T ) , thyroxine ( T4 ) , and cortisol ( C ) and the concentrations of their serum binding globulins sex hormone-binding globulin , thyroxine-binding globulin , and cortisol-binding globulin in naturally menopausal women . Design : R and omized , open-label , crossover . Interventions included a 6-week withdrawal from previous hormone therapy ( baseline ) , followed in r and omized order by 12 weeks of oral conjugated equine estrogens ( CEE ) ( 0.625 mg/d ) and 12 weeks of transdermal estradiol ( TD E2 ) ( 0.05 mg/d ) , with oral micronized progesterone ( 100 mg/d ) given continuously during both transdermal estrogen therapy regimens . Results : Twenty-seven women were enrolled in the study , and 25 completed both treatment periods . The mean(SD ) percentage changes from baseline of sex hormone-binding globulin , total T , and free T with oral CEE were + 132.1 % ( 74.5 % ) , + 16.4 % ( 43.8 % ) , and −32.7 % ( 25.9 % ) , respectively , versus + 12.0 % ( 25.1 % ) , + 1.2 % ( 43.7 % ) , and + 1.0 % ( 45.0 % ) with TD E2 . The mean ( SD ) percentage changes of thyroxine-binding globulin , total T4 , and free T4 with oral CEE were + 39.9 % ( 20.1 % ) , + 28.4 % ( 29.2 % ) , and −10.4 % ( 22.3 % ) , respectively , versus + 0.4 % ( 11.1 % ) , −0.7 % ( 16.5 % ) , and + 0.2 % ( 26.6 % ) with TD E2 . The mean ( SD ) percentage changes of cortisol-binding globulin , total C , and free C with oral CEE were + 18.0 % ( 19.5 % ) , + 29.2 % ( 46.3 % ) , and + 50.4 % ( 126.5 % ) , respectively , versus −2.2 % ( 11.3 % ) , −6.7 % ( 30.8 % ) , and + 1.8 % ( 77.1 % ) with TD E2 . Concentrations of all hormones and binding globulins were significantly different ( P ≤ 0.003 ) during administration of oral versus transdermal estrogen therapy , except for free T4 and free C. Conclusions : Compared with oral CEE , TD E2 exerts minimal effects on the total and free concentrations of T , T4 , and C and their binding proteins
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 .