BMS consensus statement

Key messages

• Prescribing of cBHRT products is not recommended by national or international guidance. rBHRT options are available and cBHRT products are not evidence based for effectiveness and safety.
• There is insufficient evidence to justify multiple serum and saliva hormone tests often claimed to precisely individualise cBHRT.
• Claims for the benefits of cBHRT have been largely extrapolated from studies of conventional rBHRT.
• rBHRT studies have demonstrated some advantages over other types of HRT, particularly those with androgenic progestogens.
• Further data from larger studies on major cardiovascular and breast endpoints are required to confirm the potential benefits of rBHRT.
• The management of women with menopause related problems should be underpinned by national and international guidance and wherever possible, regulated products should be prescribed.

Summary of key terminologies

rBHRT: Regulated Bioidentical Hormone Replacement Therapy: Precise duplicates of human hormones developed in a conventional way by the pharmaceutical industry and authorised by the regulators such as the MHRA in the UK.

cBHRT: Compounded Bioidentical Hormone Replacement Therapy: Precise duplicates of human hormones which are produced by specialist pharmacies and do not follow the same MHRA regulatory pathway as conventional rBHRT.