Bioidentical hormone replacement therapy (BHRT) has been the historically recognized terminology to describe compounded HRT; referring to the biochemically identical hormones in the prescription. It is more commonly referenced now as compounded hormone replacement therapy (cHRT). This therapy is used for the treatment of hormone deficiencies. These low hormone levels can lead to a variety of symptoms that can effect one’s health and wellbeing.
At The Apothecary, we custom compounds bioidentical hormones for both women and men to increase levels and alleviate symptoms of hormone imbalance. The pharmacists at The Apothecary collaborate with medical practitioners to personalize bioidentical hormone prescriptions for hormone replacement therapy.
Why Patients Need a Compounding Pharmacy—
Bioidentical compounding uses molecules that are identical to the endogenous hormones found in the human body, which is not the case for other treatments. Traditional hormone replacement therapy includes animal-derived and synthetic molecules that are similar to, but not identical to, human hormones.
At The Apothecary, we can create estrogen, progesterone and testosterone in a variety of strengths and dosage forms and can simplify the process for patients by combining multiple active pharmaceutical ingredients into one dosage form as needed. Most of the time, that means increased compliance and affordability.
No two women or men are alike, and our pharmacists understand this—
As the number of women and men seeking hormone-related treatment has grown, so has the mass production of pills, patches and creams by the drug industry. Commercially manufactured products tend to be “one size fits all,” and they do not always account for the differences between individuals. That is where the Apothecary steps in—compounding permits the dose, dosage form, and route of administration to be customized and titrated to obtain the desired clinical effect in each individual patient while minimizing any potential side effects. This is why so many of our patients prefer cHRT as compared to manufactured products available only in limited dosage forms and strengths.
Compound hormone replacement treatment (cHRT) has the benefit of being adaptable to each individual’s body and hormone levels—
Compounding allows for the creation of personalized hormone prescriptions to fit your unique requirements. A pharmacist with knowledge in HRT may aid a health care professional in understanding the findings of hormone-level testing on a patient. They may then devise a treatment plan that will provide the patient with the precise quantity of hormones her body requires. A compounding pharmacist, in collaboration with the patient and her health care practitioner, may assist patients in initiating and maintaining a hormone replacement program that restores hormone balance and closely matches what the body has been doing naturally for years.
When choosing bioidentical hormones over synthetic hormones, patients report fewer side effects, increased happiness, and an improved quality of life.
Hormone replacement therapy is a team effort—
Start getting your balance back—a caring health care provider working closely with a compounding pharmacist can help improve hormonal imbalances. Ask your healthcare provider or pharmacist about compounded medications today.
Many, if not most, patients have already tried commercially available products without the desired clinical response and so they change to cHRT. These patients have a significant therapeutic need and often compliance and outcomes can improve with customized medications.
Bio-identical means that it is identical to the hormone produced by the body. The molecular structure of bio-identical hormones matches exactly the molecular structure of what is produced in the human body. Since it is the same molecular structure, it will fit perfectly into that hormone’s receptor and will elicit the same response as the natural hormone produced by the body. The synthetic hormones produced by the drug manufacturers, typically will have “similar” structures, but not exactly the same. Therefore, synthetic hormones may elicit a different effect on the body, since they don’t fit perfectly into the hormone receptor.
The most common hormones that we compound are Estrogens (Estradiol, Estriol), Progesterone and Testosterone. We may also compound DHEA, Estrone, and Pregnenolone.
We typically compound capsules, creams, and troches. The dosage form depends on the hormone. Certain hormones are not absorbed well orally or may cause effects that may not be desirable when taken orally. These are the typical dosage forms we compound with each hormone:
Progesterone — capsules, cream, troche
Estrogen — cream, troche
Testosterone – cream, troche
A troche is a lozenge that dissolves in the buccal cavity (between the cheek and gum). The advantage of a troche is that it is absorbed sublingually, and it bypasses the liver.
Biest means two estrogens. The female body produces 3 estrogens (Estrone-E1, Estradiol-E2, Estriol-E3). We will usually use two of the estrogens (Estriol and Estradiol) when compounding. Very seldom will we use Estrone because over the years it has shown to have an increased risk of cancer. Most often prescriptions will be written for Biest as “Biest(8:2)” or “Biest(5:5)”. Biest(8:2) means we will use 8 parts of Estriol and 2 parts Estradiol. Biest(5:5) means we will use 5 parts Estriol and 5 parts Estradiol.
First, you may want to see if you are experiencing common symptoms that are associated with decreased levels of the sex hormones. See our symptoms sheet: BHRT Symptom Sheet. If you have a considerable amount of 2’s and 3’s, this is an indication that you may have a deficiency in one or more hormones. You may want to consider having a test to see actual levels of hormones in your body. A test may be performed by a provider that specializes hormone therapy, or you can contact us, and we can assist you in determining your testing options.
There are four main testing options for hormones.
- Blood (serum)
This is commonly done in many provider’s clinics and may be covered by insurance. While this test may be accurate initially in determining the levels of hormones, it also has been shown to be less accurate on follow up testing because the hormones that are applied topically or via a troche do not always show up in the blood.
Saliva is one of the more popular ways to test hormones. A patient expectorates (spits) into a tube while at home, then will send the test off for results. This testing is not usually covered by insurance
- Blood Spot (capillary)
This is a finger prick test, similar to the test used for blood glucose. Because it is testing capillary blood vs. venous blood it is more reflective of hormone levels at the site of the tissue. Hence, it is believed to be more accurate than serum testing.
This test looks at the hormone metabolites. This test is commonly used after a person has started on hormones because it is reflective of how their body is metabolizing the hormones.
- What Our Customers Are Saying -
Within 2 days of starting the therapy, the hot flashes were completely gone…I was shocked and thrilled! I had forgotten what a good night’s sleep felt like until I wasn’t waking up 6 times! My other symptoms have either gone away entirely or decreased dramatically…I couldn’t be happier!
I have enjoyed the effects of The Apothecary’s compounded bioidentical hormones since 1998. Coupled with the entire staff’s expertise in health concerns and natural therapies, The Apothecary has contributed greatly to the quality of my life. Thank you!
It’s about time people start realizing that everyone is different. What works for one person may not work for another. Bioidentical is really the way to go.
I have tried different things and very few nights in the past 3 years was I able to sleep through the night. I got my hormones checked and found out my progesterone was seriously low. I was apprehensive about any hormone therapy. After talking to the health care professionals, they ensured me bioidentical hormones were very close to my natural hormones. I now sleep through the night and get about 7 hours of sleep. What a difference the bioidentical hormones have made for me.