What is your approach when counseling patients interested in bio-identical hormones for management of menopause versus traditional hormone replacement therapy?

The term bioidentical hormones commonly refers to custom-compounded hormone drugs. Before an oral capsule of micronized progesterone was commercially available, it was always prescribed custom-compounded. The problem with custom-compounded hormones is that they have not gone through the rigorous testing and quality control that is required for FDA approval. They also may not be covered by insurance because they are seen to be "experimental" drugs. Custom-compounded hormones appeal to some women ...