Bio-identical hormone therapy is a poorly-defined term for using a set of hormones that are molecularly identical to natural hormones in the body. Proponents of this treatment claim that bio-identical hormones are safer and more effective than conventional hormone therapy for treating the symptoms of menopause, however there is no evidence to support these claims. Furthermore, hormones are expected to have the same risk and benefits as approved drugs for which there is an evidence base as well as extensive research and regulation. Many medical organizations, both in the US and internationally, have issued statements raising concerns about the claims made about bio-identical hormones.
This story does a good job of raising awareness about this issue, although it should have noted that many women don’t experience symptoms in the same way and that treatment with bio-identical hormones or traditional hormones should only be used by women who are bothered by their symptoms and not if they are trying to prevent heart disease.
The story could have been greatly improved by coming down harder on the proponents of bio-identical hormones. While the story includes a debate on whether there is evidence to support the use of bio-identical hormones, in doing so, it gives the impression that there really is a debate. Bio-identical hormone supporters claim that there have been dozens of clinical trials showing a benefit. However, a 2007 systematic review found "a dearth of scientific evidence to support these claims". The story should have been more critical of the evidence base to support the use of bio-identical hormones.
This is a subject sure to attract attention, given the wide range of troublesome symptoms experienced by many women during the menopausal transition. It is important for women to be aware of the potential risks of uNPRoven therapies, including bioidentical hormone preparations, that may be "prescribed" by alternative health clinics.
The story describes the cost of two bio-identical hormone products. There are many products available so costs may vary widely.
The story does not quantify the potential benefits of either bio-identical or conventional hormones. There was much talk about efficacy by the Holtorf Medical Clinic Director, all about patient perception. At the least, the story could have pointed out that patients who self-refer to such alternative care clinics (and often pay out of pocket for these services) may be more likely to report benefit from the treatment.
The story does not quantify the potential harms of bio-identical or conventional hormones. The story does rightly point out that there is no real reason to assume that bio-identical hormones are any safer than conventional hormones. There was some mention of blood clots and uterine issues, but this was not clearly delineated. Harm is one of the major concerns about any estrogen or estrogen-like compounds, and the health risks could be more serious than with other supplements.
The story includes a debate on whether there is evidence to support the use of bio-identical hormones. However, in doing so, it gives the impression that there really is a debate. Bio-identical hormone supporters claim that there have been dozens of clinical trials showing a benefit. However, a 2007 systematic review found "a dearth of scientific evidence to support these claims". The story should have been more critical of the evidence base to support the use of bio-identical hormones. This is the biggest drawback to this article, which was otherwise pretty good. The story really didn’t get at the problem of shaky to absent scientific evidence of efficacy.
The story doesn’t exaggerate the seriousness or prevalence of menopause. However, it should have noted that many women don’t experience symptoms in the same way and that treatment with bio-identical hormones or traditional hormones should only be used by women who are bothered by their symptoms and not if they are trying to prevent heart disease. The story also could have countered some of the suggested symptoms of menopause – such as "fuzzy thinking" – which are not clearly associated with menopause in epidemiologic studies. For these two reasons, we lean toward an unsatisfactory score on this criterion.
The story quotes two independent experts who provide valuable, differing opinions on the value of bio-identical hormones.
The story does compare bio-identical hormones with its most important alternative, conventional hormones.
Bio-identical hormones are clearly available in many formulations.
Bio-identical hormones have been around for some time, although they grew in popularity within the past 10 years, particularly after the publication of the results of the Women’s Health Initiative. The story didn’t make any inappropriate claims of novelty.
Because the story quotes two independent experts, the reader can assume the story does not rely solely on a press release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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