Doctors are starting to warn women against an unsafe, costly, and potentially cancer-causing form of hormone replacement therapy, which is supposedly “more natural” than the therapy from NHS doctors.
Compounded bioidentical hormone replacement therapy (cBHRT) is uniquely designed for each individual, using identical hormones to the ones made in a female’s body. The hormone amalgamations are typically formed into a cream or type of gel by pharmacists operating in private clinics. The required dosage of the hormones is different for each particular woman.
Women have been advised against the use of the increasingly favoured products by the British Menopause Society (BMS) and the Royal College of Obstetricians and Gynaecologists (RCOG). Experts suggest that women should rather go for the pre-packaged regulated bioidentical hormone replacement therapy (rBHRT). Although they’re also duplicates of female hormones, these therapies are in set dosages and are licensed by the medicines regulator.
HRT is the primary method of treatment for intense symptoms of menopause, like sleeping problems, hot flushes, and mood swings. It normally comes in the form of gels, pills, patches, or implants, and it works by replacing the estrogen and progesterone.
What do the experts have to say?
Next month, several top international menopause institutes will announce a global statement opposing the use of compounded bioidentical testosterone therapy for men over the same concerns as cBHRT.
“Every expert in the field shares the same view and concerns about compounded hormones: it’s unsafe, untested, and unnecessary. We are concerned by its purity, potency, and safety,” said Haitham Hamoda, the chair of the BMS, spokesperson for the RCOG, and consultant gynaecologist at King’s College hospital foundation trust. “You can get bioidentical HRT on the NHS: 95 percent of my 2,500 patients at King’s are on it. But the key thing is that it’s not compounded: rBHRT is prescribed and manufactured under very strict regulations. In contrast, there is no medical evidence to support cBHRT.”
Estrogen levels in cBHRT might be too high or too low than required in order to manage symptoms, and the progesterone dosage might not always be adequate to protect the womb. “If the womb is not sufficiently protected, there is a cancer risk,” said Hamoda.
A lot of cBHRT applications administer progesterone through the skin. “Absorption is variable with fluctuating tissue availability and as a result, may not provide sufficient protection for wombs,” Hamoda said. “Again, that’s a cancer risk.”