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Oprah and Bioidentical Hormones: FAQ

Oprah Is Talking About Bioidentical Hormones for Menopause; Experts Weigh In

Can You Take Bioidentical Hormones Indefinitely?

Hormone therapy has been linked to increased risk of breast cancer, so most health experts recommend that women take the lowest dose for the shortest time, if they need it.

That research wasn't done on bioidentical hormones. But that doesn't necessarily mean that it's safe to take them for a longer time, Schiff says.

"If you have the exact same estrogen as one's own body makes, it doesn't mean it's any safer," says Schiff.

Schwartz counters that bioidentical hormones are chemically different from the hormone therapy drugs that were linked to health risks, saying "there is no reason to compare recommendations because they're not the same product."

Schwartz says she's been prescribing bioidentical hormones for 14 years and takes them herself, having switched from other hormone therapy years ago. "I feel great and the women I work with feel great," she says. "I have no complaints."

Schiff doesn't dismiss bioidentical hormones. "If I have a patient who says she wants a bioidentical ... then I personally would prescribe a hormone like estradiol, which is what her ovaries made, and I would give it to her in a skin patch by one of the drug companies that I know; it has oversight by the FDA and it has the exact dose that I want her to have," says Schiff, who has no ties to any drug companies. If a patient is already on a bioidentical hormone, "I try to find out exactly what she's taking and try to make sure that it's a safe dose and that she could be followed carefully," Schiff says.

Schwartz says she gives her patients a choice between standardized bioidentical hormones or compounded products made by a lab she has vetted. She stresses the importance of doctors being trained about bioidentical hormones by other physicians who are knowledgeable about bioidenticals. "The physician has to work with the patient and the compounder," Schwartz says.

Are Saliva and Blood Tests FDA Approved?

Yes, those tests are FDA approved for diagnostic purposes -- but not to tailor hormone treatment.

"The tests are not approved for use to measure hormone levels to adjust hormone therapy," says Uhl, who points out that hormone levels can fluctuate throughout the day.

Schwartz says she doesn't believe saliva testing is appropriate and only uses blood tests with her patients.

What About Oprah's Experience?

"I'm happy that Oprah feels better," Schiff says. "Every experience is an important experience ... but everybody's individual and they have to work that out with their doctor."

Some women, Schiff notes, feel better when they start hormone therapy, but he's not sure if bioidentical hormone therapy would give them an additional boost.

Compounded or not, bioidentical hormones are only part of the picture, Schwartz says.

"A lot of people just want to follow the celebrity," she says. "Sometimes people come in and what they really need is to address their diet, their exercise, their lifestyle."

"I think bioidentical hormones are great," Schwartz says. "But if you don't address them in the context of the whole person -- with her diet, her exercise, her lifestyle, with her relationships, with her stresses -- and you don't work with everything, you're not really going to be able to come up with the results that women would like to see."


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