Author: Bob Brensel | President, Pharmacist | ScriptWorks
Bob Brensel, RPh, earned his Pharmacy Degree at University of the Pacific in Stockton, California in 1980. Former California Pharmacists Association’s Award Winner for Recognition of Outstanding Achievement in Compounding Pharmacy. Read More →
A new review published in JAMA on May 1, 2024, sheds light on hormone replacement therapy (HRT) for postmenopausal women, offering updated insights into its potential and risks.
The Women’s Health Initiative (WHI) Randomized Trials and Clinical Practice: A Review
This fresh data offers a new perspective, particularly important given the limitations of past studies.
Key Findings on Hormone Therapy for Women in WHI Study
The latest analysis from the Women’s Health Initiative (WHI) suggests that hormone therapy for women under 60 carries a low risk for adverse events, presenting a promising safety profile for managing challenging menopausal symptoms like hot flashes and night sweats. According to Dr. JoAnn Manson, Chief of Preventive Medicine at Brigham and Women’s Hospital and study’s author, these findings contradict long-held concerns about HRT.
Early Intervention is Key
Initiating hormone therapy before age 60, or within 10 years of the onset of menopause, is associated with lower rates of adverse effects, compared to starting later in life. Early intervention with HRT may provide significant relief from menopausal symptoms and improve long-term health outcomes.
MORE ABOUT THE NEW ANALYSIS
Hormones for menopause are safe, study finds. Here's what changed
Compounded Bioidentical Hormone Replacement Therapy (BHRT)
At ScriptWorks, we offer a personalized approach to hormone replacement with compounded bioidentical hormone therapy (BHRT). Bioidentical hormones are chemically identical to those naturally produced by your body and can be custom-formulated to meet your specific needs. This approach provides specific dosing and delivery methods for each patient, for an individualized therapy plan. Many women and their medical providers prefer BHRT versus commercially available HRT that is produced for the masses.
Key Differences Between Bioidentical and Synthetic Hormones
- Bioidentical Progesterone vs. Synthetic Progestin: The WHI trials highlighted risks associated with synthetic progestins like medroxyprogesterone acetate, including an increased risk of breast cancer and cardiovascular issues. In contrast, bioidentical progesterone, with its identical molecular structure to the body’s natural hormone, may offer a safer alternative for symptom relief.
- Bioidentical Estrogen vs. Conjugated Equine Estrogens: Unlike conjugated equine estrogens, which are derived from the urine of pregnant mares, bioidentical estrogen closely mirrors the estrogen produced by your body. Many women and healthcare providers consider it a more natural option for managing menopausal symptoms.
What symptoms do patients find relief with BHRT?
BHRT is frequently used to relieve symptoms such as:
- Hot flashes
- Night sweats
- Mood swings
- Weight gain
- Fatigue
- Decreased libido
- Vaginal dryness
- More
Personalized Hormone Testing and Therapy Plans
Our approach to BHRT includes a detailed hormone evaluation. A saliva or blood test is often used to assess hormone levels, which helps tailor the therapy plan. Hormone testing is crucial because symptoms of hormonal imbalances often overlap. By regularly testing and adjusting dosages, we can fine-tune therapy for optimal results.
ScriptWorks provides the most advanced saliva testing available.
Saliva Testing Kits (Female/Male Saliva Profile I)
$170
Includes a complimentary 15-minute consultation with one of our clinical pharmacists who can then send the results to your healthcare practitioner.
Interested in purchasing a Saliva Test Kit?
HRT Dosage Forms: What’s the best fit?
At ScriptWorks, we offer a variety of hormone replacement options, each customized to suit individual needs and preferences. Our pharmacists work with practitioners and make recommendations based on recent research and patient case studies.
Most Common Bioidentical Hormone Replacement Therapy (BHRT) Medications:
- Estradiol (bioidentical estrogen)
- Used for managing menopause symptoms like hot flashes, night sweats, and vaginal dryness.
- Estriol (bioidentical estrogen)
- Used primarily for managing vaginal and urinary symptoms of menopause, such as vaginal dryness, irritation, and recurrent urinary tract infections. It is a gentler form of estrogen that may also help improve skin elasticity and reduce mild menopausal discomfort.
- Bi-Est
- A compounded bioidentical hormone preparation that combines two forms of estrogen—estradiol (E2) and estriol (E3). Typically, Bi-Est is formulated with 80% estriol and 20% estradiol, aiming to mimic the body’s natural estrogen balance. It is often used to relieve menopausal symptoms like hot flashes, vaginal dryness, and mood swings.
- Progesterone (bioidentical progesterone)
- Often prescribed alongside estrogen to balance hormone levels and protect the uterus from estrogen’s effects.
- Testosterone (bioidentical testosterone)
- Commonly prescribed to improve libido, energy levels, and muscle mass.
- DHEA (Dehydroepiandrosterone)
- A precursor to both estrogen and testosterone; used to support hormone production and energy levels.
- Pregnenolone
- A precursor hormone that can improve mood, memory, and cognitive function.
These hormones can be compounded into various forms such as:
- Topical Creams and Gels: These are applied to clean skin, typically on areas like the inner arms or thighs. Rotating application sites is essential, and careful handwashing post-application helps avoid transferring the hormone to others.
- Oral Capsules & Suspensions: Immediate-release and slow-release capsules offer different absorption rates, catering to individual goals. Oral suspensions can also be used, particularly when capsules are not preferred.
- Lozenges (Troches) & Rapid Dissolve Tablets (RDTs): For faster absorption, these dosage forms bypass the digestive system, offering quicker relief from symptoms. However, taste can be a factor, though we use flavoring to enhance palatability.
- Vaginal Suppositories, Capsules, Creams & Gels: For women experiencing vaginal dryness, discomfort, or urinary issues, these options offer targeted relief. Vaginal applicators ensure proper use, and our team provides guidance on correct application techniques.
Personalized Women's Health Consultation
At ScriptWorks, we believe in empowering women with options. If you’re experiencing menopausal symptoms and are curious about hormone replacement therapy—including compounded bioidentical hormones—our team is here to help. We offer private consultations to discuss your symptoms and guide you toward the best possible medication options.
Start improving your quality of life today. Contact ScriptWorks for a personalized consultation and explore how hormone therapy can help manage your menopausal symptoms.
California medical practitioners, connect with our team to start providing your patients with more options, we’re ready to answer all of your questions. Ask a pharmacist >>
Serving California statewide. Shipping available with prescription.
Speak With A Hormone Expert
Discuss your concerns, ask any questions you may have, and receive expert guidance on potential hormone therapy options. We can provide you with hormone test kits and step-by-step guidance through your journey to hormone balance.
Call ScriptWorks today to book your free consultation at 925-934-4400, Monday – Friday, 9:00 AM – 5:00 PM.
References
Manson JE, Crandall CJ, Rossouw JE, et al. The Women’s Health Initiative Randomized Trials and Clinical Practice: A Review. JAMA. 2024;331(20):1748–1760. doi:10.1001/jama.2024.6542