Please note that the term "bioidentical hormones” is misleading in the context in which it is used by celebrities or alternative health practitioners, usually to distinguish compounded hormone preparations from pharmaceutically prepared hormonal medications.
In fact, the pharmaceutically prepared hormones prescribed in Canada are molecularly identical to human forms of estrogen and progestin, and must meet rigorous federally regulated standards for dose consistency, efficacy, and safety to adhere to measures of evidence-based medicine. Custom or compounded preparations are not subject to these criteria, and their safety and efficacy cannot be verified. The use of compounded hormonal preparations should be avoided when proven safe and effective clinically tested options exist.
As a physician who practices evidence-based medicine according to the standards of the profession and guidelines from the Society of Obstetricians and Gynecologists of Canada (SOGC), and the North American Menopause Society (NAMS), Dr. Manning does not prescribe compounded formulations of hormones for menopause (or perimenopause) hormone therapy. Saliva testing and evaluation of estrogen blood levels to "customize therapy" is also not supported by evidence, and does not play a role in managing symptoms.
For more information on this subject, please take a moment to read this article from the Journal of Obstetrics and Gynecology of Canada, A Word About Bioidenticals