Natural Hormones and Alternative Therapies

July 20th, 2010 Posted in Alternative

One of the many reactions to the published results of the canceled Women’s Health Initiative (WHI) trials has been a turn toward alternative therapies, natural hormones, and bioidentical hormones. Whatever you call them, the aim is the same: to sell products. The marketing implication is that these approaches escape alleged side effects associated with trade formulations,and in some way are better suited to a woman’s physiology. Measurement of multiple hormones in saliva often is part of the package, allegedly to tailor hormone administration based on the assay results.

The marketing of bioidentical hormones preys on emotions, including the response to the WHI. But clinical decision-making, in contrast, must be based on a foundation of knowledge: accumulated information and understanding acquired through experience, education, and appraisal of the literature. Applying this knowledge to a patient does require individualization, but it is dependent on the clinician’s familiarity with and understanding of that particular woman. The entire process is the art and science of medicine. It is the fundamental reason that clinicians enjoy being clinicians and why clinicians are so valued by patients.

There is only one medicine. Anything that claims to treat or prevent health problems must withstand the rigor of scientific studies of efficacy and safety. That information becomes part of our foundation of knowledge. Anything with the potential to affect health must be subjected to this requirement. Treatments that pass this test will become part of our medical practice; those that fail will fall by the wayside. The simplicity and correctness of this argument is so overwhelming that it must be required for any future therapies, whatever they are called.

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