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Do I Need Hormone Replacement
The natural aging process is accompanied by a normal decline in our body’s production of hormones. As the result, all of the general health we took for granted in our younger years starts to diminish as evidenced by symptoms such as: erectile dysfunctions; hot flashes; forgetfulness; anxiety; sleep disruption; low libido; etc. Hormone replacement therapy (HRT) resolves these symptoms by restoring the hormonal balance we once enjoyed. HRT effectively raises diminished (symptom promoting) hormone levels back into the 'normal range', and then up to what is typically called the 'optimal range', thereby reducing and in most cases completely reversing hormonally deficient symptoms.
Natural vs Synthetic Natural hormones are 'plant derived', meaning they come from precursors found in wild yams and soybeans, which are modified in a laboratory to be identical to the hormones produced by the human body. This is possible because natural hormones possess the exact same chemical structure as hormones produced by our body, called endogenous hormones.
Synthetic hormones are 'artificial', meaning they are not found in nature. These hormones are chemically designed variations of endogenous hormones, and are not identical in structure or activity to endogenous hormones.
Exactly how low hormonal levels will be restored, i.e., the type of hormones that will be used as a supplement, varies according to the choices made by patients and their physicians. Some patients select from the various synthetic hormones available, whereas others prefer natural hormones. What's the real difference, and does it really matter which type you choose? Well technically speaking, both hormones provide the end result of elevating blood serum levels and resolving negative symptoms. However, natural hormones, due to their identical nature (chemical structure and actions) are completely accepted by the body. Conversely, synthetic hormones are not recognized by the body. In fact, they are viewed as foreign substances, and as such often result in adverse side effects which vary in both type and severity.
Why is HRT Compounded? What is compounding and how is it differentiated from conventional hormone replacement therapy? Contrary to popular belief, genuine HRT is not commercially available. This puzzles many people because they appear to purchase it commercially. However, genuine HRT is only available from a compounding pharmacy, and then only with a valid physician's prescription. This means that unless the retail source secured these hormones from a compounding pharmacy, it was likely produced in an underground laboratory (UGL).
Conventional HRT, which constitutes basic dosages and/or combinations, is limited to standardized preparations. This is a stark contrast to 'compounding', which is the centuries old art and science of preparing customized medications for patients. The primary goal of a compounding pharmacy is to achieve seamless cohesiveness between the patients' needs, the physicians' prescriptions, and the pharmacists' delivery of medication. Compounding permits the customization necessary to achieve this goal by tailoring the dosage strength, and dosage form to patients' often very specific needs. Available in a diversity preparations, HRT can be compounded into: capsules; topical and vaginal creams/gels; oral liquids; troches (lozenges); vaginal and rectal suppositories; injectable solutions; tablet triturates; rapid dissolve tablets; mini troches; and other dosage forms. If deemed necessary by the doctor and patient, testosterone can be added to address deficiency-related problems.
Benefits of Natural HRT By far the most impressive post-menopausal HRT benefit is a significantly reduced risk of mortality, heart disease/failure, myocardial infarction, and stroke. Aside for the virtual absence of therapy related side effects, which is an enormous benefit, natural HRT also provides patients with:
- Hormones that are identical in structure to those produced by the human body
- Protective benefits that were originally provided by the body at normal hormone levels
- Reduced risk of cardiovascular and autoimmune diseases
- Improved libido, and restored sexual functions
- Individualized dosages which are adjustable should the patient’s needs change
- Greater prevention of osteoporosis through the restoration of bone density
- The benefit of multi-hormone combinations in one specialized dosage and form
- Reduced frequency and severity of vaginal dryness and vasomotor symptoms
- Increased muscle mass and greater muscular strength
- Improved lipid values
- Reduced risk of breast and endometrial cancer
- Prevention dementia-related diseases
- Improved sleep quality
- Enhanced mental faculties including mood, concentration, and memory
- Preparation variety: capsules; oral liquids; lozenges; injectable solutions; topical and vaginal creams; etc
- Overall quality of life improvement and restoration
How do You Get HRT? Once the patient and the physician have determined that HRT is appropriate, our compounding pharmacists work directly with both of them to tailor a hormone regimen that “fits” the patient with the appropriate dosage strengths and preparation forms. Typically our patients have physicians who are licensed general practitioners, gynecologists, or endocrinologists, but if you do not have a physician or yours is not familiar with HRT, you can contact us for further information. Our compounding pharmacist will provide a patient consultation, which includes baseline hormone levels (if available), in some cases a saliva test, along with patient medical history, and patient goals. Based on this data, they will determine the appropriate compound, and send a consultation report to the doctor with recommendations. After the doctor approves or makes changes to the recommendation, the patient begins an initial three week course of therapy, which is reviewed by the pharmacist again before continued therapy is recommended. Any subsequent recommendations for adjustments in therapy or new consultation information is reported to the doctor for review and approval. It may take a couple of months to devise a highly effective and wholly appropriate hormone regimen.
What are the Natural Hormones? The body contains numerous hormones, all with very specific structures and actions. However, the four groups of hormones that are of major concern in HRT include:
Estrogens of which there are three basic types namely: estrone (E1); estradiol (E2); and estriol (E3). The plant source of these chemicals is the Chinese yams and soybeans, and the three types are sometimes blended together. The combination of E2 and E3 is referred to as Bi-Est, and a preparation of all three is collectively known as Tri-Est. These estrogens are often prescribed for women who are or have experienced menopause, ovarian failure, or hysterectomies with removal of the ovaries. Some of the primary benefits to estrogen hormone replacement include the resolution of such symptoms as hot flashes, sleeplessness, mood swings, depression, osteoporosis, night sweats, as well as vaginal symptoms of menopause such as dryness, itching, and burning or discomfort during intercourse.
Progesterone is a predominantly female hormone, that’s naturally derived from the Mexican yams and soybeans. Although the ovaries are primarily responsible for the production of endogenous progesterone (both before and after menopause), it is also produced in part by the brain and peripheral nerves. Progesterone prepares and maintains the uterus for pregnancy by stimulating the uterine lining to thicken with rich, densely vascular tissue which supports an embryo. Progesterone: affects the brain by producing a calm, anti-anxiety effect which helps promote rejuvenating sleep; helps resolve vasomotor symptoms like hot flashes and night sweats; is also prescribed for the treatment of infertility; luteal phase defect; PMS; and used in combination with estrogens to combat various menopausal symptoms.
Testosterone is a hormone produced by both men and women. In men, testosterone is primarily produced within the testicles and secondarily within the hypothalamus and pituitary gland. In women, testosterone is primarily produced in the ovaries, adrenal glands. This multi-faceted hormone in traditionally prescribed to promote: muscle growth; increased energy; elevated mood; strengthened bones; menopausal symptom relief;; enhanced sex drive; and to help prevent heart disease; osteoporosis; stroke; and vascular disorders such as diabetic blindness.
DHEA (dehydroepiandrosterone) is derived from chemicals found in wild yams and soybeans. Endogenously, DHEA is primarily produced within by the adrenal glands than any other hormone, and secondarily produced by the ovaries, testes, and brain. The body uses DHEA as a buffer hormone, or as a storehouse from which the body can produce other hormones such as estrogens or testosterone when needed. For this reason, it is often referred to as a “parent hormone”. The body first converts DHEA to a hormone called androstenedione, which is then further converted into the major male and female hormones. Undoubtedly, the least understood of the group, research has indicated that this hormone may have important therapeutic benefits within the areas of: erectile dysfunction in men and women; menopause; cardiovascular disease; autoimmune diseases; cancer; weight loss; performance enhancement; chronic fatigue; Alzheimer’s disease; fibromyalgia; and that it may even possess anti-aging properties. According to the U.S. National Library of Medicine, DHEA is being investigated and may eventually be approved by the U.S. Food and Drug Administration as a prescription drug for treating systemic lupus erythematosus (SLE) and improving bone mineral density in women with lupus.
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