Are custom-compounded hormones more effective than standard ones?

"Custom" sounds like it should work better than a standard dose. Before you pay extra for it, check what the published guidance says.

What the advertising says and what the evidence says

Cleveland Clinic names the pitch and answers it in two sentences: "Compounded bioidentical hormones are advertised as being a safer, more effective, natural and individualized alternative to conventional hormone therapy. However, these claims remain unsupported."

The claim you are asking about is "more effective". Cleveland Clinic lists it among the ones that remain unsupported.

Why the products should behave alike

The Endocrine Society gives the reasoning. It says "If dosage and purity were equal", it expects a compounded product and an FDA-approved one to behave alike. In its words, they "would be expected to carry essentially the same risks and benefits."

The cause and effect follows. If a custom product is better or worse, the difference should come from dose and purity, not from the word "custom".

Questions to put to the provider

Take these to a consult in West Sacramento:

• What evidence shows your custom formula works better than a standard one?
• How do you confirm the dose and purity of each preparation?
• What would I use if I chose an FDA-approved product instead?

Where the quotes come from

For background on menopause, MedlinePlus has a page on hormone therapy for menopause. On the regulator side, see the FDA's questions about compounding. The quotes above come from the Endocrine Society's statement on compounded bioidentical hormone therapy and from Cleveland Clinic's page on bioidentical hormones, their uses, safety and side effects.

The bottom line

Personalized is a description of how a product is made. Whether it works better is a separate claim, and you are entitled to ask for the proof.