Is Bio-Identical Hormone Replacement Therapy Safer than Traditional Hormone Replacement Therapy? A Critical Appraisal of Cardiovascular Risks in Menopausal Women.

Authors: Curcio JJ, Wollner DA, Schmidt JW, Kim LS.

Publication Year: 2006

Citation: Treat Endocrinol. 2006;5(6):367-374.

This review examines currently used bioidentical hormones used as alternatives to conventional hormone replacement therapy.  The authors acknowledge that the clinical evidence shows natural progesterone to be superior to synthetic progestins, because of its more beneficial effects on lipids, the nervous system, and overall quality of life.  Oral estriol has been associated with similar adverse effects to oral synthetic estrogens with respect to cardiovascular risks, but there is evidence that transdermal application of estrogens offers a safer alternative that “should be explored”.  The authors recommend longer term clinical trials of topical estriol to confirm its cardiovascular safety.