Wot I understand about compounding/bioidenticals
Compounding bioidentical hrt is something that is made for a particular patient in a private pharmacy. Women go to a private practitioner they do tests and stuff and prescribe something that the compounding pharmacy makes up. You sometimes read about this in glossy magazines when celebrities talk about their menopause. It seems fashionable in the states. It is all very expensive and out of my range
Bioidentical means the hormone prescribed is like our own. Oestrodiol is usually made from Yams. It is found in compounded stuff, but it is also in a lot of tablets/pessaries/patches gel etc that come from pharmaceutical preparations such as vagifem estrodot and oestrogel and elleste/femoston. Older preparations contained Conjugated (Equine) Estrogens (CE or CEE) which does the same job but is not quite the same. There are also preparations like Estrodiol valerate used in one hrt and Ethinylestradiol which is a potent form used in contraceptives (where the purpose is to provide a negative feed back look to stop FSH and therefore ovulation)
There is also bioidentical progesterone - called micronized progesterone. Micronized means that it is in very small particles. This is to stop it being broken down in the liver before it circulates. Progesterone is very prone to this, so there are a lot of synthesised ones that are not bioidentical that were made to get past this problem. These are known as progestogens in the UK and progestins in the US to differentiate them from the natural progesterone. They attach to some receptors better than others. One is norithisterone which is very good at reducing the womb lining. Others are a bit more like the bioidentical ones, such as the one used in Femeston.
Progestogens are not as good transdermally. There is one patch with levenorgestrel in it and one with norithisterone. Micronised progestogen seems to work in the vagina where it is close to where it is needed. Non-prescription creams do not work well enough. Not sure about other cream type things .....
Someone is in trouble for advertising their compounded hrt as safer
There is no evidence that it is better the the pharmaceutical preparations. These are well tested before they are allowed to sell them and are perfectly safe when used properly.
Hope that helps. Otherwise, this thread has made my head explode