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Generate a file for use with external citation management software. Epub Oct Abstract The principal findings are briefly reviewed from the Women's Health Initiative trials of the most commonly used postmenopausal hormone regimens in the United States-conjugated equine estrogens and these same estrogens plus medroxyprogesterone acetate. However, early in , a study the HABITS study was stopped early after showing that cancer survivors on HRT were more likely to develop a new or recurrent breast cancer. Doctors now feel it is too risky to treat breast cancer survivors with HRT.


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HRT is no longer recommended for treatment of osteoporosis due to its risks and available alternative options. Bisphosphonate medications are generally recommended to treat osteoporosis instead.

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Bioidentical hormones: Help or hype? - Harvard Health

Other medications that may be considered are teriparatide , denosumab, or selective estrogen receptor modulators SERMs. SERMs are a newer class of drugs, similar to estrogen, that protect against osteoporosis by increasing bone density, while also protecting against the development of breast cancer.


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Evista is a widely used SERM that has been shown to increase bone growth and density and reduce the risk of breast cancer. Unfortunately, it does not relieve symptoms of menopause such as hot flashes and may actually worsen them. It is primarily used in women who are at high risk for developing breast cancer or for those who cannot tolerate other medications used to treat osteoporosis.

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Continued The known association between HRT and breast cancer has prevented many breast specialists from recommending it for breast cancer survivors. Performing weight -bearing exercises Taking calcium and vitamin D supplements Not smoking Avoiding excessive drinking. These claims are allowed on their packaging.

And similar to other FDA approved estrogens and progestogens, these bioidenticals also carry black box warnings. Hormones from compounding pharmacies, which aren't FDA-approved, don't come with package inserts bearing the black box warning, giving the illusion of being safer than commercially marketed drugs.

Bioidentical hormones: Help or hype?

But the lack of a warning doesn't mean they're safer, only that compounding pharmacies aren't required to detail potential risks. To date, hormones from compounding pharmacies haven't been tested in clinical trials. Until then, the risks associated with them cannot be fully known.

Finally, while compounding pharmacies are regulated by state pharmacy boards, they're not required — as manufacturers of approved drugs are — to report on side effects or other adverse outcomes from their products. There actually may not be much difference between an FDA-approved bioidentical and the custom-compounded version.

Both are made from the same hormones and manufactured according to the requirements of the United States Pharmacopeia a nongovernmental authority that sets standards for prescription and over-the-counter drugs. At a compounding pharmacy, hormones are placed in a capsule, gel, cream, suppository, or other vehicle. A pharmaceutical company follows the same procedure, but it must use a standard dose in a specific vehicle because the two have been tested and approved as a unit. In this respect, an FDA-approved bioidentical may be more reliable.

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