Bio-Identical Hormone Compounding
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
Do you want to learn more? Please click on the link below to access
Tache Pharmacy's BHRT Program website.
Bioidentical Hormone Therapy
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:
therapy is prescribed by physicians and is used to relieve
the symptoms of:
hormones can be prepared in a variety of delivery forms
Hormone Replacement (BHRT) Program at Tache Pharmacy
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
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)
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.
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.
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.
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.
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.
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
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.
a Prescription Required for Bioidentical Hormones?
Yes, a prescription from a licensed physician is necessary for
all bioidentical hormones including estrogen, progesterone, and
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
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.
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
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.
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.
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.
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.
Contact us at (204)233-3469
or send our pharmacists your question: