Bio-Identical Hormone Compounding

Are you experiencing symptoms such as hot flashes, night sweats, sleep disturbances, irritability, or concentration difficulties?

Are you wondering if bioidentical hormone therapy could be right for you?

Do you want to learn more? Please click on the link below to access Tache Pharmacy's BHRT Program website.

http://www.winnipegbioidenticalhormonetherapy.com/

Winnipeg Bioidentical Hormone Therapy

Bio-Identical Hormone compounding is used to supplement or replace hormones missing from the human body. Bio-identical hormones have chemical structures identical to what the body produces such as:

• progesterone
• estrogen
• testosterone

Bioidentical Hormone Replacement (BHRT) Program at Tache Pharmacy

Although hormone imbalance is common, it can be a complicated topic. Many hormones are interrelated wherein levels of one hormone can affect the functioning of another. Therefore, hormone therapy recommendations can benefit from specialized knowledge about such hormone relationships. In-depth knowledge of hormone imbalances as they relate to common symptoms such as fatigue, sleep disturbances, foggy thinking, memory lapses, anxiety, depression, mood swings, hot flashes, night sweats, weight gain, and vaginal dryness is also essential in order to make suggestions to correct hormone imbalance. Finally, knowledge of lifestyle factors (stress reduction, sleep hygiene, diet, and exercise) as well as supplements (vitamins, minerals, and herbals) can aid in optimizing an individual's overall health and well-being.

At Tache Pharmacy we offer one-on-one consultations with pharmacists who have had specialized training in bioidentical hormone replacement therapy to provide personalized recommendations to help restore hormone balance. To make our recommendations, we focus on a detailed health questionnaire completed by each patient (including treatment goals, medical history, and symptom inventory), along with saliva testing (optional but strongly suggested), to assure the most appropriate advice can be given. A personalized hormone report is prepared along with a physician report if any bioidentical hormones are being suggested. We also provide follow up to each patient, usually at one and three month intervals, to monitor progress and as required if any issues arise. Most patients notice symptom improvement and tolerate bioidentical hormone therapy very well. It is also important to mention that Tache Pharmacy is proud member of PCCA (Professional Compounding Centers of America) and can compound your custom-made bioidentical hormone preparation in our compounding department. Tache Pharmacy has helped numerous patients restore hormone balance since it established the bioidentical hormone therapy program in 2002. Every effort is made to supply you with the most up-to-date information and best advice that we can provide.

FREQUENTLY ASKED QUESTIONS (FAQ) ABOUT BIOIDENTICAL HORMONE THERAPY (BHRT)

What are Bioidentical Hormones?
Bioidentical hormones are defined as "chemical substances that are identical in molecular structure to human hormones." The term "natural" is not to be confused with the term "bioidentical". "Natural" most often refers to plant or herbal-based products. Although bioidentical hormones are produced from plants (usually wild yams and soy), these plants are pharmaceutically processed to make bioidentical hormones which are indistinguishable from the hormones produced in the body.

There are many possible dosage forms for bioidentical hormones. Most commonly, bioidentical hormones are applied topically (to the skin) in a cream or gel form. Hormones can also be applied vaginally in cream or suppository form. Oral bioidentical hormones can also be prepared in capsule form by compounding pharmacies in personalized doses. There are also some bioidentical hormone preparations which are commercially available in oral, topical (gel, patch), and vaginal (cream, tablet) forms.

What are Synthetic Hormones?
Synthetic hormones are those which are not identical to those produced by the human body. Most commonly Premarin (conjugated estrogen derived from pregnant horse urine) and Provera (synthetic progestin) come to mind when thinking of synthetic hormones used in hormone replacement therapy. Premarin and Provera (the combination product of these two medications called Prempro ) were used in the Women's Health Initiative (WHI) study in 2002 which demonstrated increased risk of heart attack, stroke, blood clots, and breast cancer with synthetic estrogen and progestin.

What is Cortisol?
Cortisol is the main hormone that is released by the body (specifically by the adrenal glands above the kidneys) in response to stress. Cortisol imbalance (i.e. high or low cortisol levels) over time can lead to symptoms such as fatigue, morning sluggishness, muscle aches and pains, foggy thinking, memory lapses, irritability, weight gain, sleep disturbances, loss of scalp hair, insulin resistance, and other. As you may notice, some of these symptoms can also be related to sex hormone imbalance. That is why an extensive knowledge in these areas is imperative in order to restore hormone balance and saliva testing can help to figure out the puzzle. Stress-reduction techniques and optimizing diet and supplementation are key to restoring adrenal health.

Why are there Safety Concerns about Using Hormone Therapy?
In 2002, the WHI study was stopped early due to observations that women treated with synthetic hormones (estrogen and progestin) had an increased risk of heart attack, stroke, blood clots, and breast cancer. Not surprisingly, after these results were released, the number of women using hormone replacement therapy decreased significantly. Some doctors are presently still reluctant to prescribe hormone therapy (of any kind) because of this study. However, in some cases, bioidentical hormone therapy may be appropriate for some women suffering from significant hormone imbalance symptoms (common symptoms listed below), which can have a considerable effect one's quality of life on a day-to-day basis.

What Evidence is there that Bioidentical Hormones are Safe?
Let's start by pointing out that not all hormones are safe for every woman. The benefits vs. risks of hormone therapy should always be discussed in detail with one's doctor to determine if hormone therapy is appropriate. Reviewing personal and family medical history is of the utmost importance when determining the safety of hormone therapy in any patient. For example, estrogen therapy is not recommended for those with a history of breast cancer.

A 10 year observational safety study done in France showed no increase in the risk of stroke, heart attack, or breast cancer in women who used bioidentical estrogen (estradiol) combined with progesterone (De Lignieres, B., et al. (2002). Combined Hormone Replacement Therapy and risk of Breast Cancer in French Cohort Study of 3175 women. Climacteric, 5:332-340). There was another study published which supports the safety and efficacy of bioidentical hormones concluding that, "Physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal derived counterparts" (Holtorf, K. (2009). The Bioidentical Hormone Debate: Are Bioidentical Hormones (Estradiol, Estriol, and Progesterone) Safer or More Efficacious than Commonly Used Synthetic Versions in Hormone Replacement Therapy? Postgraduate Medicine, 121(1):1-12). To view click on the link at the bottom of this page.

How can I tell the Difference between Bioidentical and Synthetic Hormones?
There are three types of bioidentical estrogens: estradiol (E2), estriol (E3), and estrone (E1). An example of a nonbioidentical estrogen medication is Premarin, which are tablets derived from conjugated equine urine. Progesterone is bioidentical (this is not to be confused with progestins, which are synthetic). Testosterone, DHEA, and pregenolone are also bioidentical hormones.

Is a Prescription Required for Bioidentical Hormones?
Yes, a prescription from a licensed physician is necessary for all bioidentical hormones including estrogen, progesterone, and testosterone.

What are the Possible Benefits of Bioidentical Hormones?
If you and your doctor decide that it is right for you, hormone therapy can improve many symptoms commonly associated with menopause and general hormone imbalance. Of course not all women experience the same symptoms when it comes to hormone imbalance (and not to the same extent for that matter). However, there are some symptoms that are commonly associated with hormone imbalance. Menopausal and perimenopausal symptoms can include hot flashes, night sweats, foggy thinking, memory lapses, fatigue, sleep disturbances, irritability, mood swings, depression, anxiety, decreased libido, weight gain, and vaginal dryness. Bioidentical hormones can also be helpful for premenopausal women with irregular menstrual cycles, premenstrual syndrome, polycystic ovarian syndrome, uterine fibroids, and other hormonal conditions. Other than improving quality of life, bioidentical hormone therapy may also have health protective benefits such as preventing bone loss, maintaining muscle mass, and preserving brain function.
Note: It is important to note that many of these symptoms can also be related to other conditions (such as thyroid and other endocrine disorders just to name a few), so it is essential to work closely with your physician to rule out other causes.

What are the Possible Side Effects of Bioidentical Hormone Therapy?
As with any medication, the benefits vs. risks should always be carefully considered with your doctor. To minimize the possibility of side effects related to bioidentical hormone therapy, it is ideal to use saliva testing to determine your hormone levels prior to starting treatment to ensure that appropriate (personalized) doses are used. As mentioned under "What Evidence is there that Bioidentical Hormones are Safe?", there are studies that show that bioidentical hormones may be safer and associated with significantly fewer side effects than synthetic hormones. Of course, possible side effects are also dependent on which type(s) of hormones are used and awareness of them along with regular monitoring will assist in achieving the goal of optimal hormone balance.

What is the Cost of the Personalized BHRT Consultation?
The initial one-on-one consultation lasts approximately one hour at a cost of $120 (there are no taxes). This time is spent reviewing the patient questionnaire (including treatment goals, medical history, and symptoms inventory). The fee also includes a personalized hormone report including possible bioidentical hormone therapy recommendation along with lifestyle and supplement suggestions, if applicable. If bioidentical hormone therapy is recommended, this cost also includes a report to your physician to request a prescription. Unfortunately, this service is not currently covered by Manitoba Health or most third party (private) insurance plans.

What is the Cost of Saliva Testing?
There are different types of saliva test kits available. Costs vary, but the most common saliva tests used begin at $220 + tax. The type of saliva test which would be most beneficial to a specific individual is usually determined during the one hour personalized BHRT consultation. The most common saliva test used test for estrogen (estradiol), progesterone, testosterone, DHEA-S, and cortisol. Saliva testing is not covered by Manitoba Health or most third party (private) insurance plans.

How Long Does it Take Until I Will Notice Results?
Since every person is unique, the benefits of bioidentical hormone therapy may be noticed at different points during the initiation period. This will usually also depend upon important patient lifestyle factors including stress level, diet, sleep patterns, exercise habits, concomitant health conditions, which types/dose of hormones are being used, etc. In general, however, some people begin to notice results within a few weeks after starting bioidentical hormone therapy, while most notice benefits between about three and six months.

What is the Average Duration for Using Bioidentical Hormones?
This answer will depend upon the individual using hormone therapy. In general, it is ideal to use hormones at the lowest possible dose for you and for the shortest possible duration. One key factor determining length of treatment will be symptom management. If you stop using your hormone therapy and symptoms are still present, therapy may need to be continued. Ultimately, the goal is to balance hormones and once this is achieved, it may be possible for some people to gradually decrease their dose of hormones and eventually discontinue therapy altogether. Again, this is person-specific.

What if I have more Questions about the BHRT Program at Tache Pharmacy?
Please contact us by email at tacheBHRT@mts.net or call us at (204) 233-3469.

Questions? Contact us at (204)233-3469
or send our pharmacists your question: