Troches- Bioidentical Hormones

I often hear women mention that their doctor/gynecologist say that troches have no foundation in research, are untested and untried. I went to a lecture last night by a gynecologist who did just that. Here is further evidence (not that further evidence is necessary) following a proper study. I wish Gyne’s would get off their high horses and accept that there is a number of ways of treating menopausal women, and Bioidentical HRT using troches is one  of them. After all, it is a women’s choice as which way they would rather go.
Int J Pharm Compd. 2014 Jan-Feb;18(1):70-7.

The effectiveness of sublingual and topical compounded bioidentical hormone replacement therapy in postmenopausal women: an observational cohort study.


Prior studies demonstrated improved menopausal symptom relief following treatment with compounded bioidentical hormone replacement therapy; however, clinical effectiveness studies evaluating different routes of bioidentical hormone replacement therapy administration are lacking. The objective of this study was to determine the effectiveness of sublingual and topical compounded bioidentical hormone replacement therapy for the treatment of vasomotor, mood, and other quality-of-life symptoms in post-menopausal women. This was a prospective, observational cohort study of women > or = 18 years of age who received a compounded sublingual or topical bioidentical hormone replacement therapy preparation between January 1, 2003 and October 1, 2010 in a community pharmacy. Data collection included patient demographics, comorbidities, hormone regimens, and therapeutic outcomes. Patients rated their vasomotor, mood, and quality-of-life symptoms as absent, mild, moderate, or severe at baseline, at one to three months follow-up, and three to six months follow-up. Baseline characteristics were compared using the chi-square test for categorical variables and the Wilcoxon rank sum test for continuous variables. Symptom intensity between baseline and follow-up periods were compared using the Wilcoxon signed-rank test. A total of 200 patients met study criteria; 160 received topical bioidentical hormone replacement therapy, and 40 received sublingual bioidentical hormone replacement therapy. Most sublingually-treated patients (70%) received an estrogen combination and 100% received progesterone. Nearly half (43%) of the topically treated patients received an estrogen combination (43%) and 99% received progesterone. The percentage of sublingually treated patients reporting “moderate” or “severe” symptoms was significantly reduced at one to three months follow-up for the following target symptoms: hot flashes (31%, P = 0.04), night sweats (38%, P < 0.01), irritability (36%, P = 0.01), anxiety (42%, P < 0.01), emotional lability (38%, P < 0.01), sleep disturbances (35%, P < 0.01), memory loss (35%, P = 0.04), fatigue (33%, P = 0.04), and libido (26%, P = 0.03). Similar reductions were seen at three to six months follow-up compared to baseline. Patients who received topical therapy did not experience significant symptom reductions at one to three months follow-up; however, significant symptom reduction was seen at three to six months for the following: emotional lability (31%, P < 0.01), irritability (29%, P = 0.02), and night sweats (20%, P = 0.04).

Compounded sublingual bioidentical hormone replacement therapy is effective in reducing vasomotor, mood, and quality-of-life symptoms experienced in post-menopausal women. Topical therapy does not appear to improve symptoms as extensively or rapidly as sublingual therapy.

Furthermore, this is a very recent study(below) again repeating the fact that bioidentical HRT via the skin (creams or troches) is the best and safest way to take hormones. Print this out and take it to your doctor/gyne next time you visit them.

Int J Gen Med. 2014 Sep 1;7:433-40. doi: 10.2147/IJGM.S46310. eCollection 2014.

Prevention and treatment of venous thromboembolism during HRT: current perspectives.


Many large trials in the past 15 years have proven an increased risk of vascular complications in women using oral, mostly non-bioidentical, hormone therapy. The risk of vascular complications depends on the route of administration (oral versus transdermal), age, duration of administration, and type of hormones (bioidentical versus non-bioidentical). Acquired and/or hereditary thrombophilias (eg, factor V Leiden, prothrombin mutation G20210A, and others) lead to a further increase of risk for venous thromboembolism, stroke, or myocardial infarction. Therefore, bioidentical hormone therapy via the transdermal route seems to be the safest opportunity for hormone replacement therapy, although large trials for bioidentical hormone therapy are needed.

About Dr Colin Holloway

Gp interested in natural hormone treatment for men and women of all ages

Posted on March 9, 2015, in Uncategorized. Bookmark the permalink. 2 Comments.

  1. Thanks for the lovely comments. I enjoy what I do and hope to keep doing it for many more years.

  2. Hi Dr. Holloway – You should give all of your patients a survey to fill in with regards to Bio Identicals and that would illustrate how great they work. There is no denying how effective they are. They have definitely given me a much better quality of life. All of your patients are very lucky to have you helping us out. I know that l would have done it a lot tougher if l hadn’t had you to explain everything to me. You have also been very supportive – so thankyou for everything.

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