Harvard Women's Health Watch

Survey finds wide use of compounded postmenopausal hormones

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A national survey published Sept. 30, 2015, in Menopause indicates almost a third of women who take hormones at menopause are using compounded hormones—estrogen, progesterone, or testosterone prepared by a pharmacist according to a prescription. Such preparations aren't FDA-approved.

The survey, conducted by the North American Menopause Society, asked 3,700 women ages 40 to 84 about their hormone use at menopause. They were queried about the benefits they expected, the benefits they actually received, the side effects they experienced, and their health histories.

Of the roughly 1,000 respondents who reported using hormone therapy at menopause, 31% said they were taking or had taken compounded hormones.

The women who used compounded hormones reported higher rates of vaginal bleeding and acne than women who used FDA-approved hormone formulations, and four women who used compounded hormones reported they had endometrial (uterine lining) cancer, compared with no cases among those who used approved hormones.

Almost half of the women who took compounded hormones said they believed "natural" or "bioidentical" hormones to be safer than FDA-approved hormone drugs, and were more likely to report that they expected benefits like improved mood, greater muscle mass, better memory, and increased sexual desire.

Compounded hormones haven't been tested in clinical trials, so their risks and benefits are largely unknown. For symptom relief, FDA-approved products containing estradiol or progesterone—which are chemically identical to the hormones produced by the ovaries—are worth discussing with your doctor.