As I suggested earlier, their are risks to taking any body/mind affecting agents, particularly powerful hormones (I prefer not to address Somers' particular case as haven't read her--see my first post).
One could flippantly say that 500 millions years of evolution would have made human hormones fairly well tested
We are talking about elevating - in many cases significantly - the levels of hormones above what evolution and our DNA has programmed.....
In addition to the systemic process of evolutionary development, the action of endogenous/bioidentical hormones within the body have been studied a great deal over many years (long before modern therapies) and the action of endogenous/bioidentical hormones and their metabolites are better known than the interactions of the patent drugs.
On evolution, perhaps we can just agree that any hormone therapy artificially intervenes with the evolutionarily programmed decline of hormone levels in the individual--
Whether any hormones should be taken should be left up to individual-- preferably after plenty of personal research.
Also, people are generally only "replacing" one or two hormones out of a couple dozen. That leaves the bodies balance of hormones extremely out of wack from what it was evolved to be....
I'm glad you replaced your earlier "hundreds" of hormones with "a couple of dozen"; and though you are essentially correct, the metabolites of even the "one or two" hormones frequently end up as other active hormones. But agreed, the whole is very complex, and always needs more study --and careful monitoring and self-monitoring if someone is getting hormone replacement. For those interested in a glimpse at the steroidal hormone (including sex hormones) conversions in the body (sometimes referred to as the hormone "cascade") here is a diagram: http://en.wikipedia.org/wiki/File:Steroidogenesis.svg
Testosterone is a class IV in Canada - get caught trying to buy it and there is a good chance you will go to jail. Get caught trying to sell it and you will definately go to jail. Now, like bioidenticals, I don't think testosterone should be illegal (and only testosterone is illegal).
I think you mean Schedule IV, not Class IV, but, yeah, if you sell T on the black market it is treated as the equivalent of peddling a performance enhancing anabolic steroid (which in substantial doses it is)--and you could go to jail.
However, personal possession is not illegal, and it is extremely commonly prescribed in hormone replacement regimes for both men and women in Canada--just like other HRT or BHRT hormones.
In response to the main part of your post.
Even on the face of it, the claim that bioidentical hormones carry the "same risks" or severity of risks as the more commonly prescribed non-human replacements is grossly unscientific (quackery if you will, regardless of who utters it).
Think about it.
There is ZERO justification to extrapolate that chemically different agents--(even if they act on a same receptor) behave the same in the body when it is well established they often metabolize very differently (much drug testing would be unnecessary if that absurd equivalence-thinking was instituted generally).
When you say you "can't find a single high level medical organization or journal" that favors Bioidentical HRT, I take your word that you are probably correct for the organizations (I won't blather on right now about financial dependency of organizations like ACOG on big pharma but it is usually the case).
Your journal claim is a little more puzzling because journals, as entities, seldom come out with endorsements of particular protocols.
If, however, you are referring to journal articles which suggest differences between HRT and BHRT that favour bioidentical there is considerable evidence, as a search of Medline would reveal.
As a shortcut I'd refer you to this survey of the literature paper which gives 196 references in its bibliography, many from "high level" journals:
Postgraduate Medicine: Volume 121: No.1
The Bioidentical Hormone Debate:
Are Bioidentical Hormones (Estradiol, Estriol, and Progesterone) Safer or More Efficacious than Commonly Used Synthetic Versions in Hormone Replacement Therapy?
Kent Holtorf, MD
CONCLUSION: Physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts. Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT. Further randomized controlled trials are needed to delineate these differences more clearly."
The PDF of the paper
Now, as you may point out that Holtorf has his own medical clinic which, among other things, treats with bioidenticals. Yet his conclusions in the peer-reviewed journal are backed up by plenty of peer-reviewed literature. The same cannot be said of the opposition which bizarrely claims their is "no data" or "no expected difference" to support the superiority of bioidenticals).
Among the most impressive studies for me (mentioned in the article in my first post) is the large French gov funded epidemiological study which demonstrated the superiority of progesterone over progestins in protecting against breast cancer:
"Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study.
Agnès Fournier,1 Franco Berrino,2 and Françoise Clavel-Chapelon1*
Breast Cancer Res Treat. 2008 January; 107(1): 103–111.
For a lay persons summary:
There are at least 2 common ways in which "serious" websites and some journals perpetuate the "same risks" mythology and dogma.
1) Confusion of terms: as deliberate obfuscation, inconsistent conventional usage, or ignorance. Names of very different hormones and drugs are used interchangeably. Eg methoprogesterone acetate (Provera) often refered to as "progesterone" or "progesterone therapy" add into that mix the terms "progestins" and " progestogen" both which have specific meanings but are often slung around inconsistently (not terribly scientific, that).
2)As alluded to before, studies which purport to compare bioidentical hormones with patented synthetics and use " insufficient evidence" to reach a conclusion.
In this case, drawing a conclusion of equivalence of effects on the basis of insufficient data is hardly a model of the scientific method.
Have a look at this article:
On the bases of "inadequate evidence" the article states :"Natural hormones, including estradiol, estriol, estrone, and progesterone, can be expected to have the same adverse event profile as conventional menopausal hormone regimens."
Combine this with what sounds to me loaded phrasing in the article "bioidentical is a pseudoscientific neologism" and what sounds like the same strawman "gotcha" revelation as appeared in the the OP article (eg the fake revelation that "bioidenticals are synthesized" gasp!-see my first post) as if something is being slipped past them.
J Gen Intern Med. 2007 July; 22(7): 1030–1034.