ACOG Advice on Compounded Hormone Therapy

ACOG has published a clinical statement on compounded bioidentical menopausal hormone therapy. This page sets the marketing description beside what ACOG says, so you can see which claims come from a cited review and which are only wording. The Endocrine Society keeps a menopause library for background.

The marketing description

ACOG says many compounding pharmacies use the phrase "bioidentical hormone" as a marketing term. It says the phrase implies the preparations are natural and, thus, safer and more effective than FDA-approved menopausal medications.

That is the pitch. It is a description of how the words are used, not a finding about the products.

The guidance, line by line

ACOG says compounded bioidentical menopausal hormone therapy should not be prescribed routinely when FDA-approved formulations exist. It tells clinicians to counsel patients that FDA-approved menopausal hormone therapies are recommended for managing menopausal symptoms over compounded ones.

On the marketing claims, ACOG says evidence to support marketing claims of safety and effectiveness is lacking. That is the clearest gap between the pitch and the review.

ACOG also says that if a patient requests a compounded preparation, clinicians should educate them on the lack of FDA approval of these preparations and on their potential risks and benefits, including the risks specific to compounding.

For the agency side of that sentence, the FDA publishes questions and answers on compounding.

What the statement leaves open

The lines quoted here give no dose, price or timeline. They set a default and describe a conversation, and they stop there.

What to ask about a compounded offer

Ask whether an FDA-approved formulation exists for your symptoms, and if the clinic still recommends a compounded one, ask what its risks specific to compounding are. A general-reader overview of hormone therapy for menopause from MedlinePlus helps you frame those questions before the visit.