"The Real Thing," a play by Tom Stoppard, first appeared on Broadway in 1984. It's a sometimes-desperate search for laughs and true love.

Along the way, a newly coupled couple, played by Jeremy Irons and Glenn Close, revealed that despite all claims to the contrary, they might not have found the real thing.

According to a recent editorial in JAMA Internal Medicine ("Compounded Bioidentical Hormone Therapy: Does the Regulatory Double Standard Harm Women?"), the search for the real thing also seems to have failed women using some forms of hormone therapy to handle menopause-related symptoms.

Around 26 to 33 million prescriptions for compounded bioidentical hormones are filled every year in the U.S. Women believe they're getting safer, more natural hormones.

But, says author Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital in Boston, those compounded hormones contain estradiol and progesterone: the same ones you can get from a prescription filled at a regular pharmacy.

And compounded drugs are not Food and Drug Administration-approved, so they lack the quality control of FDA-approved products.

They also have the same risks (not fewer) as FDA-approved hormone therapy products.

Do you have to abandon bioidentical hormones? No.

There are FDA-approved bioidentical hormones. We are advocates of starting hormone therapy before or soon after menopause (for 10 or more years), using an FDA-approved bioidentical estrogen and micronized progesterone, always taken with a low-dose aspirin morning and night with half a glass of warm water before and after.

Menopause symptoms are a real thing. They deserve real therapy that's safe and dependable.