Are they safe?
Bio‐identical hormones, specifically estrogen and progesterone, are hormones with are chemically identical to the hormones that your ovaries produce during your reproductive years. They are often called “natural” hormones because of this and thought to be safer. Interestingly, these hormones are not necessarily “natural” in that they are synthesized in a laboratory and then sent to various pharmacies, called Compounding Pharmacies, for formulation into gels, creams, capsules, or vaginal inserts.
There are 2 kinds of bio‐identical hormone products. The first is the type that has been approved by the Food and Drug Administration (FDA). This means that the manufacturing process is overseen by the manufacturer to ensure a consistent product.
The second kind of bio‐identical hormone has been the source of much media attention. These hormones are formulated by Compounding Pharmacies that mix the medications according to a physician’s prescription. The estrogen component usually contains 2 ‐3 types of naturally occurring estrogen. The FDA does not regulate compounded hormones so it is very important that Compounding Pharmacies being used by your doctor have strict quality control to ensure highest quality and consistency of dosage.
Bio-identical hormones compounded by a Compounding Pharmacy have not been shown to be any “safer” than a bio‐identical formulation synthesized by a pharmaceutical company.
Bottom line, there are risks and benefits to hormone therapy. Your individual risk factors, timing of initiation, dosage and route of administration need to discussed in depth with your physician.