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The Risks of Prescribing Bioidentical Hormones for Menopause


Core Concepts
Prescribing compounded bioidentical hormone therapy for menopause poses legal risks and lacks scientific backing.
Abstract
The content discusses the risks associated with prescribing compounded bioidentical hormone therapy (cBHT) for menopause. It highlights the lack of FDA approval, quality issues, and unsubstantiated marketing claims surrounding cBHT. The article emphasizes the importance of evidence-based practice and informed decision-making in hormone therapy for menopausal symptoms. Highlights: Legal risks for physicians prescribing cBHT Lack of scientific evidence supporting cBHT Quality problems and variations in cBHT ingredients Higher side effects in cBHT compared to FDA-approved HRT Financial implications for patients due to lack of insurance coverage Importance of informed consent and documentation for prescribing cBHT
Stats
Clinicians write an estimated 26 to 33 million prescriptions for compounded bioidentical hormone therapy (cBHT) every year. Side effects were significantly higher in the cBHT group (57.6% vs 14.8%; P < .0001).
Quotes
"There is a public perception that this is natural, safer, and anti-aging." "They're being hyped as safer and more effective when in reality, we don't have any studies that show that information."

Key Insights Distilled From

by Karen Blum at www.medscape.com 05-24-2023

https://www.medscape.com/viewarticle/992412
Should You Prescribe Bioidentical Hormones for Menopause?

Deeper Inquiries

How can physicians navigate the balance between patient preferences and evidence-based practice in hormone therapy?

Physicians can navigate the balance between patient preferences and evidence-based practice in hormone therapy by engaging in open and transparent discussions with patients. It is crucial for healthcare providers to educate patients about the risks and benefits of different treatment options, including compounded bioidentical hormone therapy (cBHT), and to emphasize the importance of evidence-based practices. By providing patients with accurate information and involving them in shared decision-making, physicians can help patients make informed choices that align with their preferences while also considering the scientific evidence supporting various treatment modalities.

What are the potential implications of widespread use of cBHT on public health outcomes?

The widespread use of compounded bioidentical hormone therapy (cBHT) can have significant implications on public health outcomes. Since cBHT lacks FDA approval and scientific backing, there is a risk of patients experiencing adverse effects or not receiving the intended therapeutic benefits. Studies have shown quality issues with the compounding process of cBHT, leading to variations in the actual ingredients and potentially higher rates of side effects compared to FDA-approved hormone replacement therapy (HRT). Additionally, the unsubstantiated marketing claims made by cBHT manufacturers, such as preventing cardiovascular disease and Alzheimer's disease, can mislead patients and healthcare providers, potentially leading to inappropriate treatment decisions. The financial burden on patients due to the lack of insurance coverage for cBHT products is another concern, as it may limit access to more affordable and proven treatment options, ultimately impacting public health outcomes.

How can the medical community address the gap in education and awareness regarding hormone replacement therapy?

To address the gap in education and awareness regarding hormone replacement therapy (HRT), the medical community can take several proactive steps. Medical schools and residency programs should prioritize teaching evidence-based information on HRT, including the benefits, risks, and appropriate indications for use. Continuing medical education programs can also play a crucial role in updating healthcare providers on the latest research and guidelines related to hormone therapy. Professional organizations like the American College of Obstetricians and Gynecologists (ACOG) and the North American Menopause Society (NAMS) can provide resources and guidelines to support evidence-based practice in hormone therapy. Moreover, healthcare providers should engage in discussions with patients about the importance of FDA-approved therapies and the potential risks associated with non-approved treatments like cBHT. By promoting education, awareness, and evidence-based decision-making, the medical community can ensure that patients receive safe and effective hormone replacement therapy options.
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