I thought the Oprah show could've presented a more balanced view on the topic of bioidentical hormone replacement. I've been prescribing bioidentical hormones for over 11 years and have seen nothing but an amazing change in women who use the cream, very much like the woman Oprah interviewed from Ontario. As the "Anti-Aging Guru" for iammodern magazine, I recently replied to a reader's question about the topic in an article entitled Wyeth's Wealth or Patient's Health.

One thing that was not discussed on the Oprah show is that all compounding pharmacies may not be the same. How are they regulated? Do they employ quality control standards? Where do they obtain their raw ingredients from? I use Medaus Pharmacy in Alabama which is compliant with the standards set by US Pharmacopeia 797 (whose practice standards can be regulated by the FDA). Compounded products at Medaus are made with the highest quality ingredients obtained from FDA regulated facilities and compounded medications undergo stringent analysis by both internal and independent labs. In July 2008, Medaus Pharmacy moved into a new, state-of-the-art 14,000 square foot compounding facility that is unrivaled in the pharmacy industry.* Im sure Dr. Streicher is a very competent physician but, at least on this show, she made it sound as if these medications were being mixed up in a tent by a witch doctor shaking chicken bones.

In my opinion, the views represented by Dr. Streicher came across as quite biased towards the pharmaceutical giants and made me wonder whether she had a financial interest in one of them. I found her to be a bit excessive with her arguments implying that patients are putting themselves at risk if they obtain their compounded prescriptions the old fashioned way, which happens to be the most cost effective way. With all due respect, at one point I actually wondered whether Dr. Streicher even knew the difference between bioidentical hormones and synthetic hormones.

Her point about insurance coverage is completely false. My patients have their compounded drugs completely covered by insurance. In fact, Medaus Pharmacy personally contacts every patient after the prescription is faxed to verify their insurance information. Expense is not the issue Dr. Streicher made it out to be. Even if someone doesn't have insurance the cost of a month's supply is under $30. That's a nominal expense for the significant life changing benefits women experience. Many women in my practice are married to men 15 years younger than them. In addition to the health benefits, bioidentical hormone replacement therapy really does save marriages.

I thought the segment done by Dr. Oz was a great idea and wouldve been an opportune time to mention the differences between a mom and pop small town compounding pharmacy and a more state of the art facility.

I think it's wonderful that the topic of bioidentical hormone replacement has finally made it to a venue like the Oprah Winfrey show but that also makes the Oprah show responsible for minimizing misinformation to the public. This might include, for example, selecting a more balanced panel of experts that give complete disclosure and perhaps even recruiting a perimenopausal or menopausal member of the Oprah staff (maybe even Oprah herself) to have a "bioidentical hormone experience."

One other thing: BIHRT doesn't discriminateit benefits men as well.

*Disclosure: Dr. Dima has no financial or marketing interests in Medaus Pharmacy.