text_1: New hormone therapy sparks debate
text_2: The story presents bioidentical hormones as a new option for relieving bothersome symptoms of menopause such as hot flashes, cold sweats and vaginal discomfort. The story accurately reports that the active ingredients of these supposedly “natural” hormones are the same ones used in synthetic hormone replacement therapy (HRT). However, these hormones are not as well-regulated or well-tested as synthetic versions. The story provides no evidence that bioidentical hormones are more effective or safer than traditional HRT. Positive testimonials from a physician employee of a bioidentical hormone supplier, a celebrity and women who have experienced reduced menopausal symptoms with  bioidentical hormones are not a substitute for quantitative evidence. The comment that a hormone product can be tailored to a woman's chemistry is not proven. Additionally, the story does not mention the cost of bioidenticals, which are typically about $50/month, similar to the cost of conventional HRT. Any physician can provide a prescription for bioidentical hormones in a routine office visit. The story appropriately stresses that menopause is a natural part of aging and not a disease which necessitates medical intervention. The story also mentions that short-term use of HRT in any form should be evaluated on a case-by-case basis. Unless symptoms are very bothersome, many women do not need to take HRT to ease symptoms common in menopause. While the bioindentical hormones are marketed as a natural alternative to balancing hormones and easing bothersome symptoms of hormonal fluctuations during menopause, the story fails to mention the least risky “natural” interventions for managing symptoms of menopause, such as exercise and wearing loose, cool clothing to prevent discomfort from hot flashes and cold sweats. The story also does not mention non-hormonal, evidence-based pharmaceutical options for managing symptoms. However, using these medications for treatment of hot flashes would be considered an off-label prescription. (See a previous review of a story on this topic.)