title: Compounded bioidentical hormone therapy: identifying use trends and knowledge gaps among US women.
abstract: OBJECTIVE
  Two surveys (Harris and Rose surveys) were conducted to quantify the use of compounded hormone therapy (CHT; or bioidentical hormone therapy) among perimenopausal and postmenopausal women in the United States, to assess women's knowledge of CHT versus Food and Drug Administration (FDA)-approved hormone therapy, and to gather information on menopausal experience.
  
  
  METHODS
  The Harris survey was administered to 801 women aged 45 to 60 years who had experienced at least one menopausal symptom. The Rose survey was administered to 2,044 women aged 40 years or older who were ever users of hormone therapy. Women were queried about menopausal symptoms, hormone therapy use, and knowledge of CHT. Findings from the Rose survey were extrapolated using US Census Bureau data and prescription claims for FDA-approved hormone therapy to estimate the prevalence of CHT use.
  
  
  RESULTS
  According to extrapolations using Rose data, up to 2.5 million US women aged 40 years or older may use CHT annually, accounting for 28% to 68% of hormone therapy prescriptions. Harris data showed that 86% of women surveyed were unaware that CHT products are not FDA-approved. The Rose survey asked a subset of 1,771 women whether their hormone therapy had been personalized based on hormone levels; 21% (378) answered "yes" whereas 27% (476) did not know. In both surveys, most hormone therapy users stated that their physician had recommended the treatment.
  
  
  CONCLUSIONS
  We estimate that 1 million to 2.5 million US women aged 40 years or older use CHT. The data suggest that many women are unaware that compounded hormones have not been evaluated or approved by the FDA. Providers have an educational opportunity to ensure that women considering hormone therapy understand the risks and benefits of inadequately regulated CHT.
authors.affiliation: 1University of Virginia Health System, Charlottesville, VA 2University of Colorado School of Medicine, Aurora, CO.
authors.forename: JoAnn V
authors.initials: JV
authors.lastname: Pinkerton
authors.forename: Nanette
authors.initials: N
authors.lastname: Santoro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017277:Drug Approval; D004339:Drug Compounding; D015914:Estrogen Replacement Therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D011795:Surveys and Questionnaires; D014481:United States; D014486:United States Food and Drug Administration; D016387:Women's Health