Bioidentical Hormones for Menopausal Therapy

Cynthia K Sites


Women's Health. 2008;4(2):163-171. 

In This Article

Relevance of Salivary Hormone Measurements For Menopause Symptoms

Advocates of compounded hormones in the USA often recommend salivary hormone measurements of estradiol and progesterone for adjustment of hormone doses. Why saliva rather than blood tests? Proponents argue that saliva is similar to a blood ultrafiltrate, so saliva levels more accurately represent free hormone over total or bound hormone as measured in serum.[44,45] Unfortunately, this argument poses several problems. First, salivary hormones vary extensively depending on the collection technique, time of day and between and within individuals.[46,47] The correlation of salivary hormones with serum levels is poor.[5,17] Second, in an excellent review, Boothby argues that blood serum concentrations are more appropriate for monitoring drugs that undergo low hepatic extraction such as steroid hormones.[17] Lastly, adjustment of doses of menopausal hormones should be made based on symptoms (i.e., continuing bothersome hot flashes), not on serum or saliva levels.[48] It is therefore this author"s opinion that salivary hormones are not useful in the management of women with menopausal symptoms receiving hormone therapy.


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