Hormone Replacement Therapy

 Hormone Replacement Therapy is  most often used to address the physiological changes a woman encounters as she approaches and progresses through menopause. It may also be  used to treat menstrual cramps, infertility, irregular periods, endometriosis, fibrocystic breasts and in men, the symptoms of andropause.

Customized Hormone Replacement Therapy for Women

• Micronized Progesterone
• Estrogens
• Other Common Hormone Replacement Therapy Considerations(Testosterone, DHEA, Cortisol)

Micronized Progesterone
Production of progesterone drops dramatically at menopause. This decrease in progesterone levels often contributes to the estrogen dominant, progesterone deficient symptoms observed in menopause. Symptoms of progesterone deficiency parallel those of excess estrogen:

The most common symptoms of Progesterone deficiency are:

The most common positive effects of Progesterone are:

• Has a calming effect
• Enhances mood
• Regulates fluid balance
• Increases energy and libido
• Necessary for fertility and maintaining pregnancy
• Relieves menopausal symptoms
• Balances blood sugar, thyroid function and mineral balance
• Decreases risk of endometrial cancer and may help protect against breast cancer

Normalizing the balance between progesterone and estrogens is essential to treating menopause and perimenopause.

  Studies have shown that there are progesterone receptors in osteoblasts which are involved in new bone formation. Dr. John Lee discovered that bone mineral density can be increased with progesterone therapy and thereby produce an increase in physical activity, relief of bone pain, and fracture prevention in women.

Micronized Progesterone (Natural Progesterone) is compounded in several dosage forms at ScriptWorks.  We commonly compound this progesterone into topical creams or gels, which are electronically mixed and then milled to further insure a pharmaceutically therapeutic product. Equipment and expertise to mix topical dosage forms like this are rarely found in pharmacies. Our modified-released capsules are compounded using an industry standard formulation. We then take our mixed powders, sift them and remix them to make sure that our capsules have the utmost pharmaceutical bioavailability. Other dosage forms such as sublingual troches, suppositories and combinations with estrogens or androgens are also available.

 Estrogens
Estrogen is not one hormone, but a group of similar hormones with varying degrees of activity. The three most important hormones of this class are Estrone (E1), Estradiol (E2) and Estriol (E3). Estradiol is the primary estrogen produce by the ovary. Estrone is formed from a conversion of Estradiol. Estriol is produced in very large amounts during pregnancy and is the least potent of the three hormones. These hormones are commonly found in the body in a 10% estrone, 10% estradiol, and an 80% estriol ratio. The popular compounded formula Tri-Est, mimics this ratio. Many physicians prefer Bi-Est, which omits the estrone and can be compounded in various ratios. ScriptWorks can compound many different combinations of estrogens. It is important to know that everyone is different and that one basic dose is not going to work for everyone.

The most common positive effects of Estrogen are:

• Protects against osteoperosis, heart disease, Alzheimer's disease, colon cancer, incontinence, and tooth loss and decay
• Increases the level of serotonin and endorphins, as well as other neurotransmitters
• Enhances sleep, emotional well-being, reduces depression
• Enhances mental acuity, focus, and sensory function
• Aids in digestion, libido, and skin tone
• Relieves menopausal symptoms (i.e. hot flashes, night sweats, irregular periods, vaginal dryness)
• Increases tolerance to pain
• Necessary for fertility

ScriptWorks commonly compounds many different forms and doses of estrogen. We use only micronized, pure chemicals. We can tailor our dosage forms to each patient's needs and/or lifestyle. ScriptWorks can effectively communicate with both the patient and physician to help determine the need for hormone replacement therapy.

Other Common Therapy Considerations
In some cases, it is necessary to consider the additions of the androgen testosterone to a woman's hormone replacement regimen. Typically thought of as a male hormone, testosterone is also produced by the female ovaries and is essential to normal sexual development. Testosterone plays an important role in maintaining sexual desire as well as the strength and integrity of skin, muscle, and bone.

Testosterone can have the following positive effects on a woman:

• Powerful effect on libido
• Helps build strong muscles, bones and ligaments
• Reduces stress from exercise
• Prevents tissue breakdown
• Prevents osteoperosis and loss of muscle development
• Helps restore a youthful level of energy

DHEA (Dehydroepiandrosterone) is another type of sex hormone that is important to be considered when analyzing the entire hormonal picture. It is the most abundantly produced sex hormone in both men and women. It is very important in the chemical cascade. Low levels are associated with chronic health problems such as chronic fatigue, hypothyroid, insulin resistance, as well as hypertension. DHEA levels decline with age some of these symptoms of low DHEA  levels can be low energy, poor memory and less than optimal brain function. Cortisol production by the adrenal glands increases in response to stress. High cortisol levels are often responsible for numerous symptoms including weight gain, feeling "tired but wired", memory problems, depression, and bone loss. Low cortisol levels are associated with fatigue, low blood sugar, allergies, aching muscles, cold body temperature, and poor exercise tolerance. ScriptWorks can counsel you on the emotional, mental and physical aspects of menopause. By working with your physician to help you balance your hormones, we can assist you in attaining an accepting attitude of the aging process and therefore show you how to make menopause a positive experience.

The WHI Clinical Trials—A Brief Explanation

In 1991–1992 the Women's Health Initiative (WHI) clinical trials were designed to assess the balance of risks and benefits of the most commonly used hormone therapy in the United States, estrogen and progestin. Several strategies including diet, vitamin/mineral supplementation, and varied hormone therapies were given to a group of healthy, post-menopausal women. In July, 2002 the Estrogen-Progestin Trial was stopped, and in March, 2004 the Estrogen-alone study was stopped. In both cases, preliminary data indicated that the synthetic hormones provided greater risks than benefit. Because of the adverse results, the data and safety board decided to stop the trials short of the intended completion date in 2005. Physicians and patients alarmed by these results decided to discontinue synthetic hormone therapy in light of the results from these trials. They were left with a challenge to find alternative therapies. We at ScriptWorks are addressing that challenge to provide alternatives to the old standard, synthetic hormone therapy.

Further explanation of the WHI Clinical Trial:
•  The hormone treatments used in the WHI study were Premarin® (conjugated estrogens made from a combination of hormones found in horse urine) and Prempro® (Premarin® plus medroxyprogesterone, a synthetic analog used instead of progesterone).
•  The products used in the WHI study are not biologically identical to the human hormones they are intended to replace or supplement. As such, these products are known to have unintended side-effects, including the risks identified in the WHI study, which have been studied elsewhere and well-documented for some time.
•  Each person's body chemistry, including their hormone levels and the ratios among hormones, is unique, fluctuates over time, and is influenced by diet, exercise, stress, and other factors. Maintaining proper hormone balance requires identifying and correcting each individual's specific hormone deficiencies and excesses. Monitoring hormone levels, adjusting the treatment as the levels change is essential.

What is the future of  Hormone  Replacement Therapy?
•  As we've known for quite some time, hormone balance is essential to overall health and well-being. Numerous studies (other than the WHI study) and the successes of thousands of patients validate the benefits of appropriately balanced hormone therapy. We cannot dismiss this knowledge based on the results of one study.
•  Maintaining optimum hormone balance requires counselling, testing, treating, and monitoring a deficiency or excess. This means working closely with a practitioner to diagnose clinical signs, monitor on-going lab results, and adjust the treatment accordingly.

For additional information regarding hormone replacement therapy or copies of other studies done on the subject, you can email your request to one of our pharmacists at ScriptWorks.

Customized Hormone Therapy for Men— Male Menopause Exists!

Talk about Old Wive's Tales! The idea that menopause is exclusive to women sounds more like an old husband's tale.

As they watch the women in their life go through the hot flashes, night sweats, and mood swings of menopause, men usually give a sigh of relief that they don't have to go through it themselves. Men, however, are not necessarily immune to such a phenomenon. The effect may be more gradual, unlike the roller coaster ride many women endure, but male menopause is very real and it has a name, Andropause.

Functions of Male Hormones
Androgens decrease energy and increase fatigue; they help in maintaining erectile function and normal sex drive and they are instrumental in increasing the strength of all structural tissues-the skin, bone, muscles, and heart. Men make more testosterone than do women, accounting for their greater muscle and bone mass. A proper balance of the androgen hormones also helps prevent depression and mental fatigue. These are the hormones that help provide virility, stamina and strength that we associate with the male of the species. To make a long story short, they put the "M" in macho.

Symptoms of Andropause
Testosterone and DHEA levels have a major effect on both the physical and mental makeup of men. Their decrease with age and the possibility of an increase in the female hormone estrogen can eventually lead to urinary and prostate problems. Symptoms such as subtle loss of sexual desire, loss of strength, mild bouts of depression, many trips to the bathroom, and feeling rundown, edgy, or anxious may be apparent. One thing for sure, he is not feeling like his old self.

Restoring Balance-Hormone Testing and Treatment
The best way to detect a deficiency in androgens is to get your levels tested. Tests can be ordered by your physician or by calling us at ScriptWorks. These tests can range from blood tests to saliva tests taken at home to get accurate hormone levels. Compounded Hormone therapy as well as commonly used nutritionals may also be helpful.

Contact us toll free at 866-234-4488 to help you get started.