Bio identical Hormones

How does the DR know what your "normal" levels of hormones should be if no blood test was taken before a TVH?
If you take one of the FDA approved Bioidentical Hormones such as Estace, Vivelle Dot, or Climara, will you get the same effects as a compounding pharmacy? Is not, Why?

Serene,
I think many docs base your prescription on symptoms. Testing can be helpful when you're having problems, but as we are all different there really isn't one set level where we will all feel the same. The ranges given for the tests are pretty broad also. That's why I believe that tests should be used only as a tool and not as the ultimate answer.

As for bio-identical vs compounded hormones. The answer to your question depends. Again, we are all different. Many women do fine on estrace, vivelle dot or climara. Others, don't do well on a patch or pill or may need a dose that is different than the standard and look to a compounding pharmacy. The best way to go is the way that works for you.