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 .
Bioidentical compounded hormones: a pharmacokinetic evaluation in a randomized clinical trial.
OBJECTIVE Bioidentical compounded hormone therapy is popular among patients , but providers do not have pharmacokinetic information or dosing guidelines for these preparations . Our objective was to compare the pharmacokinetics of the commonly used compounded preparations with conventional hormonal preparations that are considered bioequivalent in practice . METHODS We conducted a r and omized , blinded , four-arm 16-day clinical trial of forty postmenopausal women assigned to one of three doses of a compounded estrogen cream ( Bi-est ( 80:20 ) ; 2.0 , 2.5 , or 3.0 mg)+compounded oral progesterone 100 mg , or to a conventional estradiol patch ( Vivelle-Dot ™ 0.05 mg)+Prometrium ™ 100 mg . Serum levels of estrone , estradiol , estriol , and progesterone were obtained at multiple time intervals during the first 24-h , and at steady-state . RESULTS Results were analyzable for 37/40 women .  Study medications were well tolerated . The AUC at 24h and at steady-state for estrogens remained consistently lower for all doses of Bi-est tested relative to the patch . The difference was statistically significant for Bi-est 2.0 mg ( AUC-estradiol=181 vs. 956 ; p<0.001 ) and 2.5 mg ( AUC-estradiol=286 vs. 917 ; p<0.001 ) . Estriol levels remained low in all study arms . Serum progesterone levels were comparable in conventional vs. compounded groups . CONCLUSIONS This pharmacokinetic trial showed that the currently used doses of compounded hormones yield lower levels of estrogen compared to the st and ard-dose estradiol patch . To find comparable doses , further studies are needed . This successfully conducted r and omized controlled study attests to the feasibility of using a similar design in the setting of a larger clinical trial
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 .