Questions

Hormone Therapy

With hormones, the warning sign is often a sales claim rather than a symptom. A promise that sounds precise deserves the same scrutiny as a risk.

What medical sources say about the hormone sales pitch

The Endocrine Society says compounded bioidentical hormone therapy, particularly estrogen and progesterone, has been promoted by some as safer and more effective than manufactured, FDA-approved hormone therapy for relief of menopause symptoms. In fact, the society says, little or no scientific evidence exists to support such claims.

Cleveland Clinic says bioidentical hormones are processed hormones designed to mimic the hormones made by the body's glands. It adds that they can help people with symptoms of low or unbalanced hormones, often in perimenopause or menopause.

For further reading, see the Endocrine Society's position statement on compounded bioidentical hormone therapy and Cleveland Clinic's guide to bioidentical hormones. The U.S. Food and Drug Administration answers questions about compounding, and MedlinePlus explains hormone therapy for menopause.

Seven questions, costliest guess first

Questions about approval, effectiveness and risk come before questions about eligibility and testing, ordered by what a wrong guess could cost you.

  1. Are compounded bioidentical hormones FDA approved? Ask this before you ask about price.
  2. Are custom-compounded hormones more effective than standard ones? This is the claim the Endocrine Society addresses above.
  3. Can testosterone therapy raise prostate or heart risk? Ask what the provider will monitor and how often.
  4. Who qualifies for testosterone replacement therapy? Find out what a provider checks before saying yes.
  5. Does testosterone therapy affect fertility? Raise this early if having children is still a plan.
  6. What does bioidentical hormone therapy mean? The term has a plain definition, and a provider should be able to give it.
  7. Do saliva hormone tests help personalize dosing? Ask what a test result will change about your dose.

Three questions for a hormone provider

A reader in West Sacramento can put three questions to any hormone provider: which products are FDA-approved, what evidence supports a custom formula, and which tests will guide the dose. If the answers lean on promotion instead of evidence, take that as the warning sign.