Dr. Ron’s Research Review – March 7, 2012

This week’s research review has the Bioidentical hormone therapy quiz.

 

CME Questions About Bioidentical Hormone Therapy (Files, Ko et al. 2011)

For answers, please read the article below.

Dr. Ron

1. Which one of the following estrogens is the predominant circulating agent before menopause?

a.   17β-estradiol

a.   Estrone

b.   Estrone sulfate

c.    Estriol

d.   Ethinyl estradiol

2. Which one of the following hormone therapies (HTs) is approved by the US Food and Drug Administration (FDA) for treatment of menopausal symptoms?

a.   Transdermal testosterone

b.   Bioidentical and non-bioidentical medications

c.    Pregnenolone

d.   Dehydroepiandrosterone

e.   Estriol

3. Which one of the following best guides HT dosing decisions?

a.   Salivary hormone testing

b.   Blood levels

c.    Relief of clinical symptoms

d.   Bone density

e.   Patient preference


4. Which one of the following is required for compounding?

a.   The same strength and dosing for all patients

b.   Rigorous clinical testing for safety and efficacy

c.    A written prescription and a compounding pharmacy

d.   Reformulation and delivery systems available only as transdermal preparations

e.   Both salivary and serum hormone testing for personalization of therapy

5. Which one of the following best describes non–FDA- approved vs FDA-approved BHT?

a.   Safer

b.   More efficacious

c.    Better studied

d.   Assumed to have the same risks

e.   Well tolerated


Articles

Bioidentical hormone therapy

(Files, Ko et al. 2011) Download

The change in hormonal milieu associated with perimenopause and menopause can lead to a variety of symptoms that can affect a woman's quality of life. Postmenopausal hormone therapy (HT) is an effective, well-tolerated treatment for these symptoms. However, combined HT consisting of conjugated equine estrogen and medroxyprogesterone acetate has been associated with an increased number of health risks when compared with conjugated equine estrogen alone or placebo. As a result, some women are turning to alternative hormonal formulations known as compounded bioidentical HT because they perceive them to be a safer alternative. This article defines compounded bioidentical HT and explores the similarities and differences between it and US Food and Drug Administration-approved HT. We will examine the major claims made by proponents of compounded bioidentical HT and recommend strategies for management of patients who request bioidentical HT from physicians.

References

Files, J. A., M. G. Ko, et al. (2011). "Bioidentical hormone therapy." Mayo Clin Proc 86(7): 673-80, quiz 680.