Bioidentical menopausal hormone therapy: registered hormones (non-oral estradiol ± progesterone) are optimal.
Level 5 - mechanism / opinion, no new human data
Narrative review and expert commentary without systematic review methodology or primary data.
PubMed 28301216 · doi:10.1080/13697137.2017.1291607
What was done
This narrative review evaluated existing evidence on the clinical profiles of registered bioidentical menopausal hormone therapies, specifically transdermal estradiol and oral micronized progesterone, compared to conventional non-bioidentical formulations and custom-compounded products.
What was found
No numerical data, effect estimates, or statistical values are reported in the abstract. The review qualitatively describes that transdermal estrogen avoids excess risk of venous thromboembolism and ischemic stroke, conjugated equine estrogens carry higher thrombogenic and hypertensive potential, and combining estrogen with synthetic progestogens is associated with an increased incidence of breast cancer relative to regimens using micronized progesterone.
Why it matters
It outlines clinical reasoning favoring commercially approved transdermal estradiol plus oral micronized progesterone over conventional oral synthetic regimens and unregulated custom-compounded products.
Limits
The paper is a narrative review without a systematic search, risk-of-bias assessment, or meta-analysis. The abstract explicitly notes that the superiority of the combined transdermal estradiol and oral micronized progesterone regimen has not yet been proven in a randomized controlled trial.
Cited by
- supports Standard pharmacy brand-name estradiol and micronized progesterone are bioidentical, whereas equine estrogens and synthetic progestins are not bioidentical.