Bioidentical Hormone Replacement: Guiding Principles for Practice (Tri-Est vs. Bi-Est)
Before synthetic and nonhuman hormones were in common use, there was no need for a term like bioidentical.
The term bioidentical hormone replacement has been variously interpreted.
- Use hormones identical in structure to endogenous hormones.
- Optimize hormone delivery: non-oral delivery methods may be preferable for estrogens.
- Use doses that mimic physiologically normal levels.
1) Rationale for the Use of Bioidentical Hormones
Progesterone
Progesterone versus synthetic progesterone analogs
Cardiovascular disease
Cancer
Bone density
Other
Estrogens
CEE versus estradiol
Estriol
Oral versus transdermal progesterone
3) Use Physiologic Doses
Hormone Testing
Summary
References
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