Compounded bioidentical hormone products, a path forward

Objective: To describe the widespread use of compounded bioidentical hormone therapies (cBHT). To define the term clinical utility and present why there is insufficient evidence to support the overall clinical utility of cBHT products. To recommend actions that pharmacists and regulators can take to promote safer cBHT use. Summary: Nationwide, millions of men and women use cBHT products. Use of these products appears to be increasing year-to-year, according to the limited data reported by the 503 A and 503 B pharmacies that formulate and dispense these products. Although use appears to be widespread, the safety, efficacy, and clinical utility of these products remains unproven. This commentary provides examples of what draws consumers to these products, comparative costs, and formulation challenges. Actions to promote the safe use of cBHT and approaches to begin the study of these products are provided. Conclusion: While significant progress was made via the Drug Supply Chain Security Act in 2013 to improve the safety of compounding practice in general, efforts to further improve the safety and transparency of cBHT dispensing and use must continue, at both the local and national level. (C) 2022 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.

Automated summary

This article describes the widespread use of compounded bioidentical hormone therapies (cBHT) and highlights the lack of sufficient evidence to support their overall clinical utility. The article suggests actions that pharmacists and regulators can take to promote safer use of cBHT. It summarizes the appeal, costs, and formulation challenges of this therapy and emphasizes the importance of ongoing efforts to improve safety and transparency.