The Hormone Hoax Thousands Fall For

Lab tests conducted for More show that hormones custom-made to boost your well-being may do more harm than good

by Cathryn Jakobson Ramin
hormone hoax illustration
Photograph: Mark Allen Miller

The biggest danger emerges from the shortfall of progesterone that the lab identified in 11 out of 12 prescriptions, says Adriane Fugh-Berman, MD, associate professor at Georgetown University Medical Center. When estrogen is used in hormone therapy, it thickens the lining of the uterus. If a woman with an intact uterus takes the drug, the growth in the lining can become excessive, potentially resulting in uterine cancer. For that reason, a woman taking estrogen in HT or BHT must counter its effects with progesterone, which prevents the lining of the uterus from building up. When a compounding error causes the woman to take less progesterone than has been prescribed, the cancer risk is increased.

In at least nine of the samples More tested, “there is a gross overbalance of estrogen versus progesterone,” Utian notes. In other words: These capsules do not contain enough progesterone to offset the potentially cancer-causing effects of estrogen.

The pharmacies probably weren’t even consistent in their dosing. Although Flora Research did not weigh the specific hormones in each capsule, in a second set of tests, it did determine the total weight of individual capsules. Within each pharmacy’s batch, the weights changed considerably from one to the next, which implies that the doses of hormones also varied from day to day, says Sasich. Such unpredictable dosing can result in hormonal confusion; instead of smoothing things out, the varying hormone levels could make menopause an even bumpier roller--coaster ride.

More’s testing shows that compounding pharmacies have not improved their performance since 2006, when an FDA lab analysis showed subpotent amounts of hormones, including estrogen and progesterone, in compounded products, and significant variation in the medicine’s content from pill to pill.

All hormone therapies carry some health risks to women, but the results of our studyraise the possibility that compounded bioidenticals might actually pose more of a threat than FDA-approved drugs.

The myth of customization
The popularity of compounded BHT has not gone unnoticed by pharmaceutical companies, and since 2008, FDA-approved bioidenticals made by conventional manufacturers have become widely available and do about $2.6 billion a year in sales. But these medicines come in standardized formulations, and for diehard BHT believers, that’s a problem. In Somers’s just-published book, I’m Too Young for This! The Natural Hormone Solution to Enjoy Perimenopause, the writer maintains that commercially manufactured bioidenticals “have one big drawback in my estimation: they are not specifically made to individualize exactly what youmight need . . . I get my hormones compounded so that I get my hormones individualized, just for me. This allows me to achieve a perfect balance, just like Goldilocks...not too much, not too little, just right.”

Typically, doctors at hormone clinics rely on blood tests to customize BHT prescriptions. The tests cost hundreds of dollars and reveal nothing useful. In the body, hormones are secreted in pulses; therefore, levels fluctuate depending on the time of day or month. Customization assumes you have an individual hormone level that doesn’t vary much, when in fact women’s hormone profiles change tremendously from one day to another, and even one time of day to another, until several years after menopause. With these moving targets, it is impossible to truly “customize” a drug.

The dark truth, says Lauren F. Streicher, MD, an OB-GYN at Feinberg School of Medicine, Northwestern University, is that “when women hand me their special prescriptions for compounded bioidenticals, guess what? These different women have all been prescribed exactly the same thing. And then they’re asked to go back and have blood testing every few months.”

FDA-approved bioidentical-hormone products do not call for measuring a patient’s hormone levels because effective standardized dosage levels have been well established during clinical trials. If a patient’s symptoms are not improving enough, doctors can boost the prescribed dose in increments produced by the drug manufacturer.

First published in the October 2013 issue

Share Your Thoughts!


Karen 02.28.2015

It's perfectly reasonable to be skeptical of "alternatives," but I would've preferred to see just as much skepticism of the "traditional" approaches, which have, in large part, gotten plenty wrong. It's not like the FDA, the pharmaceutical industry, and their audience-doctors are exactly without flaws. It's not like it is only the alternative doctors who are in it "for the money" as this article implies. In fact, many of the theories and approaches of the bioidentical hormone movement that were heavily criticized years ago, are now being adopted by the pharmaceutical industry, who have more of the money to prove their worth through convenient testing. Now, thanks in large part to the alternative movement, hormone replacement therapy, once deemed "dangerous" is now considered "beneficial," even for BRCA patients. I also would've preferred that More quoted not just Somers' books, but more of the BHT doctors. I would've loved to hear their defense. This article was chock-full of quotes and interviews from, basically, just the opponents.

Arros 12.18.2013

Working for Wyeth are we?
You write as if you took only the worse-case scenarios, stretch the "fear factor" and sensationalize anything about compounding and put an article together to sell advertisements. Good for you for putting your bottom dollar first and not explore more into what BHRT has done for hundreds of thousands of women who get tens of thousands of different customized medications.
Also, the Estriol fiasco was debunked a long time ago when Wyeth themselves marketed Estriol in Europe as a "wonder drug". I guess I'll be looking at MORE LESS!!!!


As a woman who has tried both bioidentical and FDA approved HRT I am shocked by the misleading and quite frankly, slanderous spin of this article. I could write a novel about the years I tried to help my body get through menopause with chemical "equivalents". I could write another novel about how a Naturopathic physician who prescribed compounded BHRT (in cream form, which is better absorbed than pill form) helped me feel like a vibrant woman again, not some nut job bouncing off walls, growing facial hair and a penis from the one-size-fits-all FDA approved horse urine therapy. But I will simply say this, your story is blatantly irresponsible and will only serve to get more women interested in drugs, which will help the FDA to achieve its goal of tapping into that $2.5 billion dollar biodentical "industry". The government needs to get its hands off of my body and moreover, my constitutional right to choose what I put into it. Thank you very much, I'll pick yams over pregnant horse urine every time.

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