advertisement



Q & A Library


Print this page | Sign up for free e-bulletins
 | Bookmark This Page

Q
Are Bioidentical Hormones Better?

What do you think of the FDA’s move against bioidentical hormones for treatment of menopausal symptoms? I understand that the manufacturer of Premarin petitioned for this action. Is it an attempt to eliminate competition since so many women have given up on Premarin and other hormone replacement drugs?

A
Answer (Published 3/10/2008)

Bioidentical hormones are supposedly chemically identical to those made by the human body and are often described as "natural." Many of those available today are custom-mixed – "compounded," in pharmacy parlance - to a woman's specific needs at the direction of her physician. However, "bioidentical" is more of a marketing term than a medical one (the FDA doesn't recognize it), and different medical groups define it differently.

Related Weil Products
Dr. Weil on Healthy Aging for Women's Health Issues - If you are going through menopause, a support group can be helpful. The Dr. Weil on Healthy Aging online guide has a vibrant, active community of supportive members, and a dedicated moderator to help guide you along. Start your 14-day free trial now!

The FDA has warned seven pharmacies that sell these compounded "bioidentical" hormones over the Internet against making misleading claims about safety and efficacy of their products. In letters to the pharmacies sent on Jan. 9, 2008, the FDA said that the compounded products are no safer than conventional forms of hormone replacement therapy. (Premarin and most other FDA-approved hormone therapy contain synthetic hormones.) It also described as "misleading" claims by some pharmacies that their compounded hormones could prevent or treat such diseases as Alzheimer's, stroke, and some cancers, and said that no credible evidence to supports those claims. However, the agency stopped short of prohibiting the pharmacies from filling doctors' prescriptions for these products.

For the record, Wyeth, the manufacturer of Premarin and Prempro, petitioned the FDA in 2005 to restrict the availability of compounded "bio-identical" hormones. According to the Wall Street Journal, sales of Premarin and Prempro have dropped by about half since 2002 when two big government-sponsored studies found that the drugs raised the risks of breast cancer, stroke, and heart attack.

I've never supported universal hormone replacement therapy (HRT) for peri- or post-menopausal women, but some do need reliable short-term relief from intractable symptoms, such as frequent and intense hot flashes, vaginal dryness that makes sex uncomfortable, or overwhelming fatigue and mood changes. HRT is the most effective treatment for these discomforts, but because of the risks involved, it is now recommended only for treatment of severe menopausal symptoms or for women at high risk of osteoporosis who can't take other medications available to preserve bone strength. When HRT is necessary, I have always recommended using bioidentical (in the sense of hormones that are similar or identical in molecular structure to the hormones women make in their bodies) estrogen /progesterone for women who need treatment, specifically Estrace and oral micronized progesterone, both FDA-approved prescription drugs.

Concerns about the "bioidentical" hormones dispensed by compounding pharmacies have been raised by the North American Menopause Society and the American College of Obstetricians and Gynecologists. Both groups have questioned whether the hormones have been adequately tested and maintain that there is no evidence showing that compounded hormones are better or safer than the pharmaceutical drugs. My belief is that they have the same risks as synthetic hormones like Premarin and Prempro, but better side effect profiles. I would like to see them remain available, but I also support the FDA's effort to curtail unfounded claims for their therapeutic benefits.

Andrew Weil, M.D.

Creative Commons License Some Rights Reserved Creative Commons Copyright Notice
A portion of the original material created by Weil Lifestyle, LLC on DrWeil.com (specifically, all question and answer-type articles in the Dr. Weil Q&A Library) is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.

The Weil Vitamin Advisor
Get your FREE personalized vitamin recommendation & supplement plan today!

Dr. Weil on Healthy Aging
Your Online Guide to the Anti-Inflammatory Diet. Start eating for your health - begin your free trial now.

Dr. Weil's Spontaneous Happiness
Achieve emotional well-being
in just eight weeks!
Start your 10-day free trial now!

Vitamin Library
Supplement your knowledge with Dr. Weil's essential vitamin facts. Learn why they are necessary and more.

Dr. Weil's Optimum Health Plan
Your 8-week plan to wellness.
Begin your journey today!
 

Dr. Weil's Head-to-Toe
Wellness Guide

Your guide to natural health.
Use the Wellness Guide today!

Dr. Weil's Anti-Inflammatory Diet Food Pyramid
Our interactive tool can help improve overall health through diet.

Condition Care Guide
Learn about health conditions from acne to vertigo, and Dr. Weil's view of the best treatment options for each.

Healthy Recipes
Discover a treasure trove of healthy, healing foods and creative, delicious ways to prepare them.

Q&A Library
Over 2,000 questions from you
and their corresponding answers
from Dr. Weil.

 
Copyright © 2014 Weil Lifestyle, LLC
Information on this web site is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. You should not use the information on this web site for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment.

Ad Choice
Advertising Notice

This Site and third parties who place advertisements on this Site may collect and use information about your visits to this Site and other websites in order to provide advertisements about goods and services of interest to you. If you would like to obtain more information about these advertising practices and to make choices about online behavioral advertising, please click here