Compounded and BioIdentical Hormone Therapy Challenged
In a breaking news story a physician has gotten reprimanded for biodentical hormone therapy claims that are unsubstantiated. You can read the news story here. For good references regarding hormone therapy in general refer to Menopause.org. Some physicians feel that most of the prescribing of bioidentical hormone therapy is based on faulty research, overstated claims, and the prescription of unsafe medications. However, that too is overstating the risks and there are some women that need unique therapies that cannot be gotten other than by bioidentical therapies. For most women needing hormonal treatment, standard prescription of pharmaceutical medication is the safest, most researched, effective treatment. Many of these women could be treated by bioidentical therapies should they choose. Consultation and alternative choices is what is best for each woman.
Here are a few of the challenges of bioidentical therapy to remember:
1. The compounds prescribed have to be made individually each time you receive them, thus there are inevitable variances in what you are receiving that have been shown by research to have greater fluctuations than standard pharmaceutical preparations..
2. Not all variations of hormones are available by compounding. Prescription therapy has a wider variety of types of medications, delivery systems, and combinations than are available through compounding. Prescriptions have hormonal medications that aren't even hormones but act on the hormone receptors. Some uniqueness in dosing, particularly with testosterone for women, however, is available only through compounding.
3. No long term studies on compounding have been done.
4. Compounding hormones therapy is often paired with laboratory testing that has not been validated. That testing can lead to confusing results. Testing cannot always determine dosing because bio-effectiveness varies based on many factors in your physiology. It is important to remember a lot of hormone testing, whether you are doing blood, saliva, or urinary testing is just a snapshot of your levels, not always the whole picture.
5. The same risks for side effects and complications exist whether hormone therapy is compounded or not. These risks should be reviewed on an ongoing basis.
6. Many women's health organizations do not endorse compounded therapy. While off label medication is commonly prescribed in medicine, it's good to understand that if you are taking compounded therapy, it likely is an off label use not specifically FDA approved for the indication you are using medicine. This too is very complicated and should be discussed with your provider.