Hormone Replacement Therapy
“I was working with a 43 year-old woman who was experiencing peri-menopausal symptoms: hot flashes, anxiety, sleep disturbances, an erratic cycle, and a general feeling of being unsettled. A compounded hormone cream from Koshland Pharm stabilized her cycle and settled her in terms of being able to get better sleep.”
– Amy Day, ND, naturopathic doctor in Berkeley
In mid-life, people’s normal hormone levels decline and can cause uncomfortable symptoms. Hormone replacement therapy is one treatment option that patients can choose in consultation with their doctor.
A compounding pharmacy can help with this kind of therapy by creating prescription hormones that are structurally identical to natural hormones, that are at the lowest possible dose, and that are in the particular dosage form that best suits an individual patient’s needs.
At Koshland Pharm, we make high-quality, customized prescription hormones. Our pharmacists work closely with both patients and their doctors to ensure optimal treatment outcomes.
- Mind Over Menopause: How to survive and thrive through mid-life and beyond
- Testosterone for Men: Media, myths, and medical facts
- A Brief Overview of Endometriosis
- Peter Koshland, PharmD Discusses Structurally Identical Hormones
If using a cream as a form of administration, it is important to take some steps to make sure the hormones are not passed to others through skin-to-skin contact. Here are a few tips when using hormone creams:
- Be mindful about the possibility of transferring your hormones to someone else. Once you know the risk, you’re more likely to be careful. The greatest risk comes from prolonged exposure right after application, such as holding a baby with your bare arms, cuddling your cat, or allowing your dog to lick the cream off your skin. Usually, just knowing the risk is enough to prevent problems.
- Keep the part of your skin where you apply your hormones covered a full 24 hours after application. This allows the hormones to absorb and reduces the risk of transference.
- If you normally apply your hormones to your forearms, try applying them to your upper outer arms or the top of your thighs, where you’re less likely to touch another person or animal.
- If it’s too warm to stay covered, or your life requires frequent exposure to children or animals (such as a day care provider or veterinary technician), you may want to consider another delivery method for your hormones, such as a patch or sublingual troches.
Symptoms of hormone imbalance
General symptoms of hormone imbalance include hot flashes, brain fog, mood swings, low energy, acne, insomnia, weight gain and headaches. If a person is experiencing such symptoms, he/she can:
- Compare symptoms to those typical of a hormone imbalance by cross referencing a symptom checklist. If a person experiences several symptoms from the list, that may indicate that she/he might benefit from hormone balancing. View our comprehensive symptom checklist of hormone imbalance.
- Learn more:
a. Click here for the U.S. National Library of Medicine’s summary about hormone therapy for women.
b. Click here for the U.S. National Library of Medicine’s summary about hormone therapy for men.
- Work with a practitioner knowledgeable in the field of hormone therapy. An experienced practitioner can help patients evaluate the numerous factors that may be contributing to their symptoms, many of which can be addressed by incorporating healthy practices into one’s daily life, such as a balanced diet and stress reduction techniques. An experienced practitioner will also be knowledgeable in the appropriate use of hormone therapy.
Visit referrals for Bay Area doctors experienced in the field of hormone therapy.
View Koshland Pharm’s healthy living checklist.
- Get tested. A person must measure hormones in order to balance hormones. Hormones can be tested with a saliva, urine, blood or blood spot test; there are pros and cons to each method. Generally, the hormones that are tested are progesterone, estradiol, testosterone, DHEA-S, cortisol, and thyroid.
Structurally identical hormones
All hormones made at Koshland Pharm are structurally identical to the hormones produced in the body. These hormones are derived from natural sources and then modified in a lab to match the chemical structure of human hormones.
This image provides an example of natural progesterone vs. medroxyprogesterone (Provera). Structurally identical progesterone looks the same in its chemical structure to the natural progesterone in the picture. Medroxyprogesterone is one example of a synthetic hormone that is not structurally identical to what the body produces.
Hormone Replacement for Men
Just like women, hormone levels decline with age, especially testosterone. Although the decline is not typically as dramatic as the drop in hormones that women can experience, the resulting low levels have been linked to multiple symptoms:
- Exercise intolerance
- Low libido
- Erectile dysfunction
- Low energy levels
Testosterone replacement may be worth exploring if these symptoms are present. Working with an experienced practitioner is important as understanding a person’s overall health status is essential in appropriately replacing testosterone. Serious health consequences can result from the misapplication of testosterone therapy or inadequate monitoring.
Quality of hormone prescriptions
Some structurally identical hormones are mass-manufactured and FDA-approved, and others are custom-made at compounding pharmacies. Compounding pharmacies are regulated by state boards of pharmacy rather than by the Federal Drug Administration (FDA).The Pharmacy Compounding Accreditation Board (PCAB) reviews and grants accreditation to only those compounding pharmacies that demonstrate they have met the highest standards for quality and safety in their profession. A PCAB accredited seal is a good way for a practitioner or patient to know that a compounding pharmacy makes high-quality medications.
Visit our Quality Assurance page to find out more about Pharmacy Compounding Accreditation Board and to see a hand-out with six key questions to evaluate quality in a compounding pharmacy.
Note: Patients using testosterone should seek medical attention immediately if symptoms of a heart attack or stroke are present, such as:
- Chest pain
- Shortness of breath or trouble breathing
- Weakness in one part or one side of the body
- Slurred speech
Hormone dosage forms include:
- Sublingual drops & troches
Commonly prescribed hormones include:
- Thyroid hormones (see our thyroid treatment page)