Despite medical progress, climacteric symptoms still exist. With the coming of age of the baby boomers, more and more women will be experiencing these symptoms which may be adversely affecting their lives. Mistrust of the medical community and prescription drugs has led many to search for that perfect product which will ameliorate their symptoms, with less or no risk. They are turning to compounded bioidentical hormones. However, the term is somewhat nebulous and ill defined. In this review, the term will be explained and evidence regarding efficacy and safety discussed.