Hormone Replacement Therapy
By Joseph Serio R.Ph. Registered Pharmacist
What is natural hormone replacement therapy
and why is it one of the leading grass roots movements for women
in the 90's? To best describe it, I should state what is the general
rule for hormone replacement and then differentiate from it. A
typical course for women post menopausal is the estrogen and progesterone
combination of Premarin and Provera.
The first is touted as coming from natural
sources. Natural, certainly to the horse that it came from, but
not to the women's body that it is going into. To clarify, Premarin
is a drug that is derived from pregnant mares; hence the name
PreMAREin.Although sharing some of the same estrogen hormones,
a horse possesses additional hormones not found in a women. Because
of this difference women can experience side effects that may
result in discontinuance of therapy.The second drug Provera is
a synthetic progestrin that does not have the same metabolic pathway
as natural progesterone and can cause side effects such as fluid
retention, irritability and depression.
In natural hormone replacement therapy,
the estrogens found in a women's body are replaced in the identical
ratio that they are found in the body. The progesterone replaced
is bio-identical to the physiologically source. Additionally testosterone
is in some cases indicated in a women's regime. Typically thought
of as a male hormone, testosterone is also produced by the female
ovaries and is essential for sexual desire, as well as the strength
of the muscle and bone.
The burning question once again as I addressed
in my last column is, if there are therapies available that are
more beneficial and cause less side effects, why aren't they used?
I don't want to repeatedly dwell on the answer, but the reason
is vital for the American population to understand. If a substances
cannot be patented, it is not a major source of interest to the
Pharmaceutical industry, who basically does most of the continuing
education for the doctors, nurses, and pharmacists. So how do
you get these substances if the pharmaceutical manufacturers don't
make them? That's where we come to the "Back to the Future"
part of the equation. There are a group of pharmacists (about
1500-2000) in the country who custom mix these natural substances
in their own on-site laboratories. This is not a new phenomena.
It is the art of compounding that has governed pharmacists practice
before the pharmaceutical industry ever existed.
Most pharmacies however stopped custom preparation
of medications in their stores as commercial manufacturers made
more and more of the finished products. In fact as late as the
1950's twenty percent of the prescriptions were custom prescriptions
written by the doctor, specifically for each individual patient.
In hormone replacement therapy the ability of pharmacists to custom
mix the medications specific to each individuals women's needs
helps in insuring that each women is getting exactly what she
needs. The means of administration are varied as capsules, troches,
vaginal suppositories and topical creams can be formulated.
The point here is each women is unique and
in many cases needs a regime that is tailored to the individual
as opposed to a one size fits all approach that is common with
commercial medication. If you are in an area where you are not
sure who is a compounding pharmacist, simply call the International
Academy of Compounding Pharmacists at 1(800) 927-4227 to get a
referral. They can also direct you to a physician who practices
and writes for Natural Hormone Replacement Therapy. If any of
what I write interests you and you want further information ,
please stop in at Westminster Pharmacy and references will gladly
be supplied. We have an extensive library of books and articles
and are always looking to give our patients the information they
need to be proactive towards their own health.
In our next column , we will explore the
explosion in nutritional supplementation and other holistic options
in the quest for optimal health.