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Cirigliano quotes:
“ | Pharmaceutical companies are bound to observe these restrictions in making claims concerning the efficacy or safety of their products, whereas compounding pharmacies are not even bound to disclose class warnings associated with estrogens (black box warnings). Responsible claims cannot be made about the superiority of any route or form of estrogen regarding either efficacy or safety. This is a clear problem, as unsubstantiated claims concerning BHT have been made in the past, including that BHT has few or no associated AEs, decreased risk of breast cancer | ” |
“ | Estradiol, CE, and ethinyl estradiol (EE) (bioidentical, natural, and synthetic, respectively), all appear to offer similar benefits and harms, with none faring better or worse than the others.34 The one caveat is that head-to-head comparisons of different estrogens are lacking because most studies involved comparisons with different coadministered progestogens. This recognized need should serve as impetus for further clinical trials. Nevertheless, there appears to be little sound scientific rationale or support for the most common mixture of ratios of estrogens in biest and triest or for any other customized ratios based on sera levels, as there are no sensible means of monitoring or ensuring that they are maintained (from hour to hour and day to day), and, most importantly, there is no proven physiological benefit in doing so. Although estrogen levels decrease during menopause due to loss of ovarian function, estrogen clearance rates are not significantly changed.128 The simple use of either estradiol or estrone will cause elevated levels of estriol.124 The addition of further estrogen metabolites (estrone and estriol) in an ad hoc compounded mixture containing estradiol, based on saliva or sera estrogen levels, in an effort to provide a theoretical ideal ratio seems futile because the exogenous estradiol and estrone fractions are subject to metabolism at different rates.32,129 It would make more sense to provide sufficient amounts of estradiol alone and then allow the woman’s own metabolism to provide for the other estrogens. Therefore, the claim that no pharmaceutically manufactured product mimics the body’s production of estrogens other than such compounded products as triest and biest74 not only is unproven but also is highly unlikely to be the case. (Cirigliano) | ” |
I've requested the following from TimVickers. I've struck through the ones I got, and am trying to find the rest.
or possibly intended as another paper from the same issue,
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(help)Fun article on Oprah and BHRT [30]. Not sure where to use it. WLU (t) (c) Wikipedia's rules:simple/complex
Kent Holtorf, M.D., review of the medical literature demonstrating how natural hormones are superior to their synthetic counterparts. The conclusion is clear that bio-identical hormones are a safe alternative to Premarin and medroxyprogesterone acelate (MPA), marketed as Provera. The natural bio-identical hormones are very different from their synthetic versions, often having completely opposite physical and cellular effects. It is critical that women be given the information that these natural hormones do not have the negative side effects of the synthetic hormones and in no way pertain to the conclusions reached by the Women's Health Initiative (WHI) study. Natural hormones are a safe and more conservative approach to hormone replacement therapy that does not carry the risks associated with Premarin and Provera. Premarin is made from pregnant horses' urine, hence it's name Pre (pregnant)-mar (horse)- in (urine). It consists of a combination of conjugated equine (horse) estrogens that are more potent and more carcinogenic than other natural estrogens such as estradiol and especially estriol. Postgraduate Medical Journal, a leading peer-reviewed publication for practicing clinicians, showed that non-synthetic or bioidentical HRT are associated with reduced health risks and are more efficacious than their synthetic counterparts. Conducted by a leading expert in hormone replacement, Kent Holtorf, M.D., medical director of Holtorf Medical Group Center for Hormone Imbalance, Hypothyroidism and Fatigue, in Torrance, California, the paper reviewed and evaluated results from more than 200 physiological and clinical studies. The review also showed that patients taking bioidentical HRT were less likely to experience sleep problems, anxiety, depression and cognitive effects - common side effects of synthetic HRT. — Preceding unsigned comment added by 2602:306:BD3A:5AF0:E97F:5010:A55B:505E (talk) 22:09, 29 June 2015 (UTC)
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Change "A number of claims by some proponents of bioidentical hormone replacement therapy have not been definitively established through scientific testing." to "A number of claims by some proponents of bioidentical hormone replacement therapy have not been confirmed through scientific testing." Simonemcgill (talk) 21:39, 24 November 2021 (UTC)
Done - agree that this is clearer. PianoDan (talk) 22:23, 24 November 2021 (UTC)
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Hello there. I am Deborah Moskowitz and I did not use the word "superior" in my review article on Bio-Identical Hormones. That is an extrapolation I did not make. Will you please correct. 2603:7081:7000:CAF3:78E0:D0F:173D:EA97 (talk) 16:59, 16 January 2022 (UTC)
Partly done: Skimming through the article it does seem to be the case that it only suggests that some forms of bioidentical HRT might be safer, and I've edited the article to reflect this. However, as I mentioned in my edit log, I am not a pharmacologist, so I would appreciate if another editor could look this over for me. Uberlyuber (talk) 20:35, 17 January 2022 (UTC)