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'Bio-identicals were pushed out of the picture by the more profitable versions produced by the drug companies,' says Schwartz. Last February, a major review of more than 200 studies on bioidenticals in the Postgraduate Medical Journal concluded that they were more effective and had greater health benefits than regular HRT.'Many physicians state there is no evidence they are safer,' says the author Dr Ken Holtorf, 'but the medical literature clearly shows they are highly effective and have some distinctly different, often opposite, physiological effects to regular HRT.' One doctor, whose clinical experience chimes with this study is Dr Marion Gluck, a private GP in London who has been prescribing bioidentical hormones for 20 years. 'Many women like her aren't comfortable with the sort of oestrogen used in HRT,' she says.Not only is this new HRT said to be more effective in treating menopausal symptoms, but it's also said to be safer.It contains the same hormones found in regular hormone therapy, but they come in a subtly different form known as 'bio-identical' - which means they have been chemically manufactured to be the same as the ones your body was making until it reached the menopause.What many women don't realise is that the replacements you get are not exactly the same as the versions your body was making before.For instance, because the oestrogen in widely-used brand Premarin comes from the urine of pregnant mares it contains forms of oestrogen normally found only in horses.Disheartening for any woman, but for Ivana it was serious; she runs a Pilates and body conditioning studio for athletes and for people needing rehabilitation after injury - and looking well and fit is essential to her livelihood. After what had happened to me when I went on the Pill - nausea, headaches and a vanishing sex drive - there was no way I was going to start taking extra oestrogen in this form.' That was ten years ago and now Ivana is a remarkably sleek and fit 55-year-old.'The most likely explanation seemed to be that I was moving into the menopause,' she says. And it's all thanks, she says, to a new form of HRT.

At the moment, few patients or medics here have heard about them (although they are also used widely in France). Conventional HRT works by replacing women's two main sex hormones - oestrogen and progesterone.Conventional HRT, on the other hand, uses hormones that are slightly different from the ones found in the body and are designed to achieve the same as the body's hormones.It sounds like a subtle difference, but, in fact, this is supposedly what makes bio-identicals safer and more effective.Following the study, called the Women's Health Initiative, the use of conventional HRT in America and Britain dropped by around 50 per cent.

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Many experts later said the study was irrelevant to most women.'It involved women over 60 who had been oestrogen- deficient for ten years so they were more at risk to both cancer and heart disease than a woman taking HRT at the beginning of the menopause in her early 50s,' explains Dr Sarah Jarvis, a spokesperson for the Royal College of GPs.



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