This excerpt comes from an article entitled What are bioidentical hormones? first printed in the August 2006 issue of the Harvard Women’s Health Watch
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Much of the confusion about bioidentical hormones comes from the mistaken notion that they must be custom-mixed at a compounding pharmacy. But custom compounding is necessary only when a clinician wants to prescribe hormones in combinations, doses, or preparations (such as lozenges or suppositories) not routinely available — or to order hormones not approved for women, such as testosterone and DHEA. Compounding pharmacies use some of the same ingredients that are made into FDA-approved products, but their products are not FDA-approved or regulated.
One size doesn’t fit all in women’s health. Compounded hormones can certainly help to individualize treatment, but if you’re considering them, be aware of the following:
•Compounded drugs are mixed to order, so there are no tests of their safety, effectiveness, or dosing consistency.
•There is no proof that compounded hormones have fewer side effects or are more effective than FDA-approved hormone preparations.
•Some clinicians who prescribe compounded hormones order saliva tests to monitor hormone levels. Most experts say these tests are of little use because there’s no evidence that hormone levels in saliva correlate with response to treatment in postmenopausal women.
•There is no scientific evidence that the compounded preparations Biest and Triest, which are largely estriol, are safer or more effective than other bioidentical and FDA-approved formulations. Some proponents claim that estriol decreases breast cancer risk and doesn’t increase endometrial cancer risk. Both claims are unproven.
•Heath insurers don’t always cover compounded drugs.
This doesn’t mean that you shouldn’t consider compounded hormones. Just realize that, in a real sense, you’re going to be an experiment of one. Unless your clinician has considerable experience with bioidentical hormones and a particular compounding pharmacy, you’re better off with a prescription for commercially available hormones, many of which are bioidentical.
See the whole article at http://www.health.harvard.edu/womens-health/what-are-bioidentical-hormones
HCS: We do have doctors in Singapore who have “considerable experience with bioidentical hormones” but their ability to help us is being curtailed.