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Ethical problems with bioidentical hormone therapy

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

The term 'bioidentical' hormone replacement therapy (BHRT) is widely misunderstood by the patient population and misrepresented in patient literature. Within the clinical community, BHRT is currently being prescribed by some as an 'innovative therapy' with no published evidence in peer-reviewed journals that it is better than the current standard of care; in at least one case, BHRT is being used as a study agent in unregulated and unethical research involving very high doses of estrogen and progesterone. Additionally, professional ethics problems abound within the prescribing population, since those claiming expertise and training in BHRT vary widely in competencies, may cross practice boundaries, and may have overt conflicts of interest if they are selling or promoting their own for-profit recipes of BHRT on commercial forums. Ultimately, BHRT presents clinical, research and professional ethics problems that are discussed in depth.

Original languageEnglish
Pages (from-to)45-52
Number of pages8
JournalInternational Journal of Impotence Research
Volume20
Issue number1
DOIs
StatePublished - Jan 2008

Funding

The National Center for Complementary and Alternative Medicine (http://nccam.nih.gov) is the center that would typically fund research that some BHRT promoters claim is being prevented by the pharmaceutical lobby. This agency has the authority to launch studies of BHRT through experienced investigators. This agency also reviews research grant proposals based on scientific merit. Criteria for successfully funded projects include novel research ideas, investigator expertise, ethical study design and sound methodology. Since BHRT prescribers are mostly physicians in private practice or in the CAM community, few have the training or academic support to craft an NIH-styled research proposal that would achieve a fundable score. Investigators with no publications in recognized peer-reviewed literature, and no academic affiliations, would also have difficulty being funded by the NIH or private foundations using the NIH model for reviewing grant proposals.

Funders
National Institutes of Health (NIH)

    Keywords

    • BHRT
    • CAM
    • Ethics
    • Hormone therapy
    • Menopause
    • Perimenopause

    ASJC Scopus subject areas

    • Urology

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