Is It Hot in Here or Is It Just Me?

Hormone Replacement is no joking matter. For many women, the times of peri-menopause and/or menopause are miserable. Many women suffer silently through the symptoms of menopause such as hot flashes, night sweats, irritability, fatigue, insomnia, decreased libido and foggy headedness. They know the potential risks and adverse effects that conventional hormone replacement therapy carries. Increased risks for conditions such as blood clots and cancer were well publicized after the results of the Women’s Health Initiative (WHI) were released. Is there a treatment option for these women who hesitate to try conventional hormone therapy? Yes! Your local compounding pharmacy, Tiger Town Pharmacy, has the answer. Many compounding pharmacies specialize in hormone replacement therapy. This therapy option allows the pharmacist to prepare medications using chemicals whose structures are identical to the chemical structure of the human hormones. This allows a more natural therapy.

To start, we should discuss basic physiology. Once physically mature, a woman’s body engages in a hormonal cycle that lasts for, on average, 28 days, and then repeats. The single purpose for this cycle is procreation. The hormone cycle prepares a woman’s body for a possible pregnancy. The normal menstrual cycle is driven mainly by 2 hormones: estrogen and progesterone. To clarify further, the woman’s body produces 3 different estrogens: estradiol, estriol, and estrone. Each of these contributes to the total effect of estrogen. Estrogen is dominant during the first half of a woman’s cycle, with day one being the first day of a woman’s menstrual period. During this half of the cycle estrogen works in the ovary to stimulate the development of the follicle and release of an egg into the fallopian tubes. Simultaneously, estrogen works in the uterus to increases the uterine lining for possible implantation of a fertilized egg. Estrogen peaks at ovulation when the egg is released from the ovary into the fallopian tubes. Once the egg is released, estrogen levels begin to drop and progesterone becomes the dominant hormone for the second half of the menstrual cycle. Progesterone is dominant during the second half of the cycle. Progesterone opposes the continued growth message sent by estrogen and sends the message of development to the same cells in the ovary and uterus. This completes the growth process and further prepares the body for pregnancy. If there is no implantation of a fertilized egg into the uterine lining, levels of both progesterone and estrogen drop which stimulated the beginning of the menstrual period. As you can see, Progesterone balances Estrogen. As a result, the balance of the levels of these 2 hormones is critical for optimal health and well-being. Many other factors influence the regularity of the menstrual cycle, some of which are testosterone levels (yes, women have “normal” levels of testosterone), thyroid function and stress. These must also be considered when evaluating hormone replacement therapy.

As a woman ages, hormone levels drop and a women enters a phase known as peri-menopause. During this time, symptoms such as increased PMS symptoms with shortened cycles and heavy menses (bleeding) may be present. As time progresses, the menstrual periods become irregular, skipping some months. Menopause is diagnosed once 12 consecutive periods have been missed.

The following summarizes the effects of the main hormones of the menstrual cycle:

Functions of Estrogen:

Prepare follicle to release egg from ovary into fallopian tubes
Prepare uterine lining for implantation
Prepare breasts for possible lactation
Supports bladder
Affects mood & cognition
Prevents bone loss

Functions of Progesterone:

Promotes development and maturation of cells
Natural Diuretic
Natural Anti-depressant
Increases Libido
Cancer Protective
Increases Bone formation

Functions of Testosterone:

Maintain Muscle tone & Strength
Increased Energy
Increased Mental Alertness
Normal Libido
Increased feeling of well-being

So, what are the symptoms of a hormone imbalance?

Estrogen Deficiency

Hot Flashes/Night Sweats
Sleep disturbances
Vaginal Dryness
Painful Intercourse
Low Libido
Foggy thinking
Depression
Bone Loss

Progesterone deficiency (Estrogen dominance)

Swollen, tender breasts
Headaches Irritability
Irregular Menses
Cramping
Mood Swings
Depression
Fuzzy Thinking
Joint Pain
Anxiety
Weight Gain
Low Libido

Testosterone deficiency

Fatigue
Decreased libido
Decreased mental alertness
Decreased sense of well-being

Do any of these symptoms sound familiar? At Tiger Town Pharmacy we offer help for Peri-menopausal and menopausal women. Our comprehensive program involves collaboration between the patient and doctor. The program begins with collection of objective data in the form of salivary hormone levels. From the results of the salivary testing and patient evaluation/interview, an individual prescription is formulated, specific for each patient. Each patient’s therapy is unique and individualized to their needs. What a concept! No one-size-fits-all!

The goals of Hormone Therapy are simple: Symptom relief using a prescription medication that closely mimics the natural menstrual cycle. The medication is dosed to provide symptom relief while avoiding adverse effects. Since many adverse effects occur as a result of high estrogen levels, frequent monitoring can be utilized to adjust doses and thereby avoiding many adverse effects. Further individualization of each prescription comes in the choice of dosage form. Medications can be compounded in many different dosage forms to meet each patient’s needs/desires. These dosage forms include: topical creams, lozenges, capsules, vaginal creams or suppositories to meet any patient’s needs/desires.

So, what about the guys? No need to worry. Hormone therapy can also used to treat the male equivalent of menopause called Andropause. The diagnosis and treatment is very similar to the women’s program. We begin with salivary testing of several hormones, including testosterone. A patient evaluation follows with again, collaboration between the patient, pharmacist and physician. If testosterone is found to be deficient, it can be replaced with again, a variety of dosage forms.

With each hormone therapy prescription dispensed, the professionals at Tiger Town pharmacy perform an initial patient consultation discussing the patient’s salivary tests results and proper use of their medication. A follow-up consultation is also done with each patient to determine the effectiveness of the current formula as indicated by symptom relief. The goal is re-establishment of the patient’s ultimate feeling of well-being with little or no hormonal related side-effects. We will continue to work with the patient and their doctor until that goal is achieved. Contact the staff at Tiger Town Pharmacy to begin your walk on the road to the destination of ultimate health.