Verbatim response from Perplexity
Doctors generally say BHRT is not proven safer than standard hormone therapy, especially when it refers to compounded bioidentical hormones; major medical groups and the Mayo Clinic say the “bioidentical” label does not make it safer, and there is no good evidence that it works better for menopause symptoms.[12][13][3]
What doctors do say is more nuanced:
- FDA-approved bioidentical hormones can be safe for appropriate patients because they have been tested and meet FDA standards.[6]
- Compounded BHRT raises more concern because potency and quality can vary, which can lead to under- or overdosing and other safety problems.[11][13]
- Like other forms of hormone therapy, BHRT can still raise risks such as blood clots, stroke, gallbladder disease, and in some patients breast cancer or endometrial cancer.[6][16][11]
- The Endocrine Society says there is little or no scientific evidence supporting claims that compounded bioidentical hormone therapy is safer or more effective, and no comprehensive trial has proven its safety or efficacy.[13]
- Some reviews note that bioidentical progesterone and estrogen may have a more favorable profile than some synthetic hormones, but those findings do not prove compounded BHRT is safer overall.[14][1]
The practical medical view is that hormone therapy is often reasonable for symptomatic women, especially if started before age 60 or within 10 years of menopause, but the choice of hormone, dose, route, and monitoring should be individualized.[13][2]
If you want, I can also break this down into:
- BHRT vs FDA-approved hormone therapy
- who should avoid BHRT
- what questions to ask a doctor before starting it