Bioidentical Hormone Use High Among Women

Fifteen percent of Rose respondents obtained menopausal hormone therapy at their physician’s office, although most compounded bioidentical hormone therapy users in both surveys filled their prescriptions at local pharmacies.

Among Harris respondents, 76% did not know whether their compounded bioidentical hormone therapy obtained from a specialty pharmacy was FDA-approved, while 10% incorrectly believed it was.

“This important knowledge gap represents a substantial educational opportunity on the part of clinicians, who these surveys show play a significant role in guiding women’s choice of menopausal hormone therapy,” the researchers wrote.

Marketing and Misinformation

In a third study, researchers also found that information on bioidentical hormone therapy offered by Internet sources is not in line with current evidence.

For this study, researchers in Canada sought to evaluate the quality of information and claims made on websites offering bioidentical hormone therapy products or services. They identified various sources by searching for “bioidentical hormone therapy,” services or doctors” and “purchase or buy” on Google. Video websites, discussion forums or those published in languages other than English were excluded from analysis.

Using a convenience sample of 100 websites, the researchers assessed the quality and reliability of health information using the DISCERN instrument.

Bioidentical hormones included estrogen (64%), testosterone (53%) and dehydroepiandrosterone (DHEA; 42%).

Sixty percent of websites were from Canada, 38% from the United States and 2% from other countries. Eighty-nine percent were from health care providers advocating the use of or offering to prescribe bioidentical hormone therapy, according to the study results.

When broken down by source, data indicated that 49% of websites were created by medical clinics, 17% by naturopathic or homeopathic clinics and 19% by compounding pharmacies. Fifteen percent of websites were only selling their own over-the-counter product, such as progesterone cream, the researchers reported.

Results also showed that 62% of websites promoted bioidentical hormone therapy as custom-compounded formulations, but only 22% noted that the treatment is also commercially available.

In terms of claims and promotion, 46% of websites suggested that bioidentical hormone therapy was safer than conventional hormone therapy, with 36% also claiming that it is associated with fewer side effects.

Some websites addressed specific safety concerns, with 28% claiming that bioidentical hormone therapy is associated with less risk for breast cancer and 28% claiming that the treatment is associated with less cardiovascular risk compared with conventional hormone therapy, according to the researchers.

The most common terms and phrases used to promote bioidentical hormone therapy were “natural” (70%), “treat hormone imbalance” (56%), anti-aging (50%), “promote sexual health” (25%) and “for well-being” (18%).

Only 4%, however, displayed disclaimers from regulatory bodies like the FDA or Health Canada, the researchers reported.

The researchers also found that stock photos on the website mostly portrayed white women (70%), couples (33%) and upper or middle class (57%). They noted that most targeted women, but 62% sought to address men as well.

Additionally, 52% of websites promoted other services, including weight loss programs (43%), Botox (21%), laser (18%), skin care/wrinkles (15%) and spas (8%).

Results from analysis with the DISCERN instrument indicated that the quality and reliability of information on the website was poor. For example, only 20% offered clear sources of their information and only 2% presented balanced or unbiased information.

“The way [bioidentical hormone therapy] is promoted and the claims that are made on Internet websites are not consistent with current evidence-based recommendations from professional organizations,” the researchers wrote in an abstract.

“Understanding the mixed messaging regarding [bioidentical hormone therapy] that patients may be exposed to on the Internet can help health care professionals when educating their patients.”


  1. Mirkin S et al. Poster 79.
  2. Pinkerton J et al. Poster 89.
  3. Yuksel N et al. Abstract S-10. All presented at: North American Menopause Society (NAMS) 2014 Annual Meeting; Oct. 15-18, 2014; Washington, D.C.