Website intended for a New Zealand health professional readership
Following the introduction to what GPs need to know about complementary hormone therapy in the previous issue, here we look at the place, if any, of "bioidentical hormones" in menopause management
Kia ora and welcome to New Zealand Doctor Rata Aotearoa
Not a subscriber? Unlock this article by subscribing here.
1. Rossouw JE, Anderson GL, Prentice RL et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA 2002;288(3):321–33.
2. Lee JR. Bioidentical hormones: Dr John R. Lee's Three Rules for BHRT. Available online
3. Langer RD. The evidence base for HRT: what can we believe? Climacteric 2017;20(2):91–96.
4. Stuenkel CA, Davis SR, Gompel A et al. Treatment of symptoms of the menopause: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2015;100(11):3975–4011.
5. Vashisht A, Wadsworth F, Carey A et al. Bleeding profiles and effects on the endometrium for women using a novel combination of transdermal oestradiol and natural progesterone cream as part of a continuous combined hormone replacement regime. Br J Obstet Gynaecol 2005;112(10):1402–6.
6. Stute P, Neulen J, Wildt L. The impact of micronized progesterone on the endometrium: a systematic review. Climacteric 2016;19(4):316–28.
7. Hunt PJ, Gurnell EM, Huppert FA et al. Improvement in mood and fatigue after dehydroepiandrosterone replacement in Addison's disease in a randomized, double blind trial. J Clin Endocrinol Metab 2000;85(12):4650–56.
8. Fedorkow DM. ACP Journal Club. Review: In peri- or postmenopausal women, DHEA does not improve symptoms and increases androgenic side effects. Ann Intern Med 2015;162(10):JC9.
9. Brown ES, Park J, Marx CE et al. A randomized, double-blind, placebo-controlled trial of pregnenolone for bipolar depression. Neuropsychopharmacology 2014;39(12):2867–73.
10. Ogilvie CM, Levenberg R, Milsom SR. Bioidentical testosterone cream: a rare cause of postmenopausal virilisation. Aust N Z J Obstet Gynaecol 2009;49(1):116–17.
11. Delfs TM, Klein S, Fottrell P et al. 24-hour profiles of salivary progesterone. Fertil Steril 1994;62(5):960–66.
12. Lobo RA. Hormone-replacement therapy: current thinking. Nat Rev Endocrinol 2017;13(4):220–31.
13. Nelson HD, Vesco KK, Haney E et al. Nonhormonal therapies for menopausal hot flashes: systematic review and meta-analysis. JAMA 2006;295(17):2057–71.
14. Loprinzi CL, Sloan J, Stearns V et al. Newer antidepressants and gabapentin for hot flashes: an individual patient pooled analysis. J Clin Oncol 2009;27(17):2831–37.
15. Santoro N, Braunstein GD, Butts CL et al. Compounded bioidentical hormones in endocrinology practice: An Endocrine Society scientific statement. J Clin Endocrinol Metab 2016;101(4):1318–43.
16. Shifren JL, Gass ML, Group NRfCCoMWW. The North American Menopause Society recommendations for clinical care of midlife women. Menopause 2014;21(10):1038–62.
Respiratory physician Lutz Beckert considers chronic obstructive pulmonary disease management, including the prevention of COPD, the importance of smoking cessation and pulmonary rehabilitation, and the lifesaving potential of addressing treatable traits. He also discusses the logic of inhaler therapy, moving from single therapy to dual and triple therapy when indicated, as well as other aspects of management
![Barbara Fountain, editor of New Zealand Doctor Rata Aotearoa, and Paul Hutchison, GP and senior medical clinician at Tāmaki Health [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/Barbara%20Fountain%2C%20editor%20of%20New%20Zealand%20Doctor%20Rata%20Aotearoa%2C%20and%20Paul%20Hutchison%2C%20GP%20and%20senior%20medical%20clinician%20at%20T%C4%81maki%20Health%20CR%20Simon%20Maude.jpg?itok=-HbQ1EYA)
![Lori Peters, NP and advanced health improvement practitioner at Mahitahi Hauora, and Jasper Nacilla, NP at The Terrace Medical Centre in Wellington [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/2.%20Lori%20Peters%2C%20NP%20and%20advanced%20HIP%20at%20Mahitahi%20Hauora%2C%20and%20Jasper%20Nacilla%2C%20NP%20at%20The%20Terrace%20Medical%20Centre%20in%20Wellington%20CR%20Simon%20Maude.jpg?itok=sUfbsSF1)
![Ministry of Social Development health and disability coordinator Liz Williams, regional health advisors Mary Mojel and Larah Takarangi, and health and disability coordinators Rebecca Staunton and Myint Than Htut [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/3.%20Ministry%20of%20Social%20Development%27s%20Liz%20Williams%2C%20Mary%20Mojel%2C%20Larah%20Takarangi%2C%20Rebecca%20Staunton%20and%20Myint%20Than%20Htut%20CR%20Simon%20Maude.jpg?itok=9ceOujzC)
![Locum GP Helen Fisher, with Te Kuiti Medical Centre NP Bridget Woodney [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/4.%20Locum%20GP%20Helen%20Fisher%2C%20with%20Te%20Kuiti%20Medical%20Centre%20NP%20Bridget%20Woodney%20CR%20Simon%20Maude.jpg?itok=TJeODetm)
![Ruby Faulkner, GPEP2, with David Small, GPEP3 from The Doctors Greenmeadows in Napier [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/5.%20Ruby%20Faulkner%2C%20GPEP2%2C%20with%20David%20Small%2C%20GPEP3%20from%20The%20Doctors%20Greenmeadows%20in%20Napier%20CR%20Simon%20Maude.jpg?itok=B0u4wsIs)
![Rochelle Langton and Libby Thomas, marketing advisors at the Medical Protection Society [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/6.%20Rochelle%20Langton%20and%20Libby%20Thomas%2C%20marketing%20advisors%20at%20the%20Medical%20Protection%20Society%20CR%20Simon%20Maude.jpg?itok=r52_Cf74)
![Specialist GP Lucy Gibberd, medical advisor at MPS, and Zara Bolam, urgent-care specialist at The Nest Health Centre in Inglewood [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/7.%20Specialist%20GP%20Lucy%20Gibberd%2C%20medical%20advisor%20at%20MPS%2C%20and%20Zara%20Bolam%2C%20urgent-care%20specialist%20at%20The%20Nest%20Health%20Centre%20in%20Inglewood%20CR%20Simon%20Maude.jpg?itok=z8eVoBU3)
![Olivia Blackmore and Trudee Sharp, NPs at Gore Health Centre, and Gaylene Hastie, NP at Queenstown Medical Centre [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/8.%20Olivia%20Blackmore%20and%20Trudee%20Sharp%2C%20NPs%20at%20Gore%20Health%20Centre%2C%20and%20Gaylene%20Hastie%2C%20NP%20at%20Queenstown%20Medical%20Centre%20CR%20Simon%20Maude.jpg?itok=Z6u9d0XH)
![Mary Toloa, specialist GP at Porirua and Union Community Health Service in Wellington, Mara Coler, clinical pharmacist at Tū Ora Compass Health, and Bhavna Mistry, specialist GP at Porirua and Union Community Health Service [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/9.%20Mary%20Toloa%2C%20Porirua%20and%20Union%20Community%20Health%20Service%20in%20Wellington%2C%20Mara%20Coler%2C%20T%C5%AB%20Ora%20Compass%20Health%2C%20and%20Bhavna%20Mistry%2C%20PUCHS%20CR%20Simon%20Maude.jpg?itok=kpChr0cc)
