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 of biorhythmic transdermal combined hormone treatment in relieving climacteric symptoms: a pilot study
Objective : To evaluate the efficacy of a combination of bioidentical combined 17β-estradiol and progesterone transdermal delivery system ( lipophilic emulsion-type base ) to relieve  climacteric symptoms . The hormonal replacement was given during a period of 6 months at four different cyclic doses to mimic the normal ovary secretory pattern . Design : An open , r and omized , comparative , between-patient trial conducted over 6 months in 29 menopausal women with climacteric symptoms assessed with the Kupperman index at baseline and during treatments . Saliva and serum values of 17β-estradiol and progesterone were quantitated before treatment and after 3 and 6 months . Pharmacokinetic data following transdermal administration of 17β-estradiol ( 0.3 mg , daily ) and progesterone ( 100 mg , daily ) were calculated from saliva levels using high-performance liquid chromatography analysis . Results : Improvement in climacteric symptoms was reported in 93 % of women evaluated before and after 3 and 6 months of treatment . Values of saliva 17β-estradiol increased after 6 months from 0.6 ± 0.3 pg/mL to 14.1 ± 3.3 pg/mL , and the values of serum 17β-estradiol increased from 3.3 ± 2.8 pg/mL to 80.6 ± 21.9 pg/mL. Of responders , 88 % characterized symptom relief as complete . No adverse health-related events were attributed to the bioidentical hormone therapy . Time to maximum saliva concentrations ( Tmax ) , in all experimental cases , was observed after 6 hours . Baseline values were reached within 24 hours , indicating a diurnal rhythm of 17β-estradiol seen in normally cyclic women over the 24-hour period , ie , its daily biological rhythm . Conclusion : Percutaneous absorption of 17β-estradiol , as well as the absorption of progesterone , was associated with relief of climacteric symptoms . The cyclical transdermal delivery of combined bioidentical hormones may be advantageous because it mimics the secretory profiles of 17β-estradiol and progesterone in normally cyclic women over a 28-day period . Larger studies are needed to determine the long-term effects of our 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 .