Bio-identical horomones title page.pdf
The information contained in this brochure is compiled from various sources and medical experts is intended to be used only as a source of information for women making decisions about hormone replacement therapy. The benefits or health risks associated with any medical treatment progress depend on a woman's individual health profile and cannot be determined simply by reading this booklet. Every woman making decisions about her own health care and medical treatment needs to consult healthcare professional.
Saskatoon Medical Arts Pharmacy
Medical Arts Building, 133-750 Spadina Cres. E.
q ESTROGEN • PROGESTERONE • TESTOSTERONE
Dosage Conversion Protocol
1. Conversion of Premarin™ to Triest (Estrogen transdermal gel)
A. Conjugated Estrogen 0.3 mg - Triest 1.25 mg/Gm B. Conjugated Estrogen 0.625 mg - Triest 2.5 mg/Gm
Triest is 10% estrone, 10% estradiol, 80% estriol
Apply to inner arm or thigh, wrist, or under chin.
2. Conversion for Provera™ to Progesterone
A. ProveraTM 2.5 - 25 mg/Gm transdermal gel B. ProveraTM 5.0 - 50 mg/Gm transdermal gel
These are approximate equivalent conversions from Provera™. However, we compound other strengths as directed by the physician.
Apply to inner arm or thigh, wrist, or under chin.
Available Strength 0.125% Dosage 0.2 mls to 0.4 mls per day as directed.
Intravaginal application once daily.
Bio-identical hormone replacement can be compounded in a variety of forms and strengths as requested by your physician.
A Natural Hormone is defined as a hormone that is IDENTICAL
in chemical structure to
the hormone produced by the human body, regardless of the source. It is bio-Identical
What Is Natural Hormone Replacement Therapy?
Natural Hormone Replacement Therapy
(N. H. R. T.) attempts to restore the body's
1. using bio- identical hormones derived from plant sources 2. replacing estrogen in the approximate percentage equivalents normally found in the body. In transdermal use, the hormones Estrone (10-20%), Estradiol (10-20%), and Estriol (60-80%) are used together to achieve the proportions that fluctuate naturally in the body.
Natural hormones are obtained from sterol analogues found in many varieties of plants, primarily wild yam and soybean. These estrogen and progesterone- like compounds are then transformed in the laboratory to the human bio- identical natural hormones.
What Are The Compounded Natural Hormones?
Estrone Estradiol Estriol Progesterone Testosterone
Do Natural Hormones Require A Prescription?
Yes - They must be ordered by a licensed physician
Estrogen is not one hormone, but a group of similar hormones of varying degrees of activity, all made by the ovary. The three most important hormones of this estrogen group are estrone (E1), estradiol (E2), and estriol (E3).
Estrogen is the female hormone produced by the ovaries that is responsible for ovulation. Estrogen is secreted by the ovaries throughout a woman's reproductive years. Special estrogen receptors are located in the breasts, lining of the uterus, cervix, brain, bones and in the vagina. Estrogen plays an important role in a woman's life from the time she enters puberty until the end of her last menstrual period.
Strictly speaking, menopause means the end of your menstrual cycle. But more commonly it refers to the 5-10 years when the ovaries gradually stop producing eggs, and there is a progressive decline in hormone production, most notably, estrogen and progesterone.
What Does Estrogen Hormone Replacement Do?
With the onset of menopause (peri- menopause) the ovaries produce less and less estrogen. During this time many women experience hot flashes, night sweats, vaginal dryness, urinary tract infections and emotional changes such as depression and irritability. Estrogen replacement therapy can help relieve these symptoms, as well as, lower the risk of cardiovascular disease and osteoporosis.
Estrogen is not a single hormone. Technically it is more accurate to speak of "estrogens".
In adult human women, three different natural hormones predominate: Estrone, Estradiol,
and Estriol. Triestrogen
is a hormone replacement that contains 10-20% estrone, 10-20% estradiol,
60-80% estriol. Under normal circumstances, hormone levels vary according to the stage
of the menstrual cycle, but the amount of each hormone usually fluctuates within the
proportions of the triest formulation.
Does Triestrogen Therapy Require A Prescription?
Yes they do. You will need to consult your doctor regarding estrogen replacement therapy (ERT).
Frequently Asked Questions About Progesterone
Progesterone is one of two main hormones produced by the ovaries. More specifically, it is produced by the corpus luteum just after ovulation.
Progesterone is responsible for preparing and maintaining the lining of the uterus in
preparation for the fertilized egg. Progesterone secreted from the ovary is necessary for
the survival of the ovum and the resulting embryo until the placenta takes over this
production. The decline in progesterone each month triggers the menstrual cycle.
Progesterone and Estrogen are closely interrelated and their actions in the body are in a
delicate balance. PMS symptoms can be relieved by progesterone therapy from day 14 to
day 28 of a woman's cycle. After menopause, progesterone stimulates osteoblasts to
help build bone
and increase bone density.
What Is The Difference Between "Natural" Progesterone And Other Progestins?
Progesterone is the natural hormone produced by the ovaries. Progestin refers to the group of synthetic hormones (like medroxyprogesterone) that have actions similar, but not identical to that of progesterone.
What Exactly Is Natural Micronized Progesterone?
Natural micronized progesterone is obtained from wild yams or soybeans as a precursor substance called diosgenin. This precursor is then converted in the laboratory to progesterone. It is exactly the same as the progesterone produced by the ovaries. It is bio- identical. The term "micronized" refers to the small particle size of the progesterone itself. Progesterone is better absorbed when it is micronized and compounded in P L.O. transdermal base and oral capsules.
Any woman taking estrogen replacement therapy who still has a uterus should take a
progestin or progesterone. It will oppose the stimulatory effect of estrogen on the
endometrial lining and protects against uterine and cervical cancer.
Women with an
intact uterus, who do not take progesterone or a progestin with their estrogen replacement
therapy, should see a physician every 6 months for a checkup. There is a growing feeling
among some physicians that all women taking estrogen hormone therapy should be
Does Progesterone Require A Prescription?
Yes- Progesterone requires a prescription and you need to consult your physician.
Wild yam creams are available in health food stores under various trade names,
but they do not contain enough progesterone to be medically effective
progesterone gels and capsules must contain standardized levels of natural micronized
Progesterone gel 25 mg / Gm
- package size of 50 gm
Progesterone gel 50 mg / Gm
- package size of 50 gm These strengths are a guideline for starting treatment. A variety of doses are
compounded according to a woman's individual needs.
(A small pink spoon is supplied with each prescription. One level spoon
supplies a 1 gm dose.)
Apply 1 gm once daily. Some women respond better to 1/2 gm
applied twice daily. Apply to the thigh, inside of upper arm, lower abdomen, back of hand or wrist. Rotate sites for best results.
Store the cream at room temperature. DO NOT REFRIGERATE
Progesterone Oral Capsules
- 50 mg and 100 mg
These strengths area guideline for starting treatment. A variety of doses are compounded according to a woman's individual needs.
Clinical Applications- PMS, Menopause, Osteoporosis, history of breast cancer
Use the 50 mg strength for mild to moderate symptoms. Start 7 to 10 days prior to
the onset of menses. Start patients at 1 gm once or twice a day and increase as required
for control of symptoms. If patient is not responding sufficiently then use the 100 mg
For women without a uterus and on an ERT, use either the 25 mg or 50 mg
strength to balance their estrogen and control symptoms. Apply 1 gm once or twice a day
on a continuous or cyclical schedule. For women with a uterus, and on ERT, who do not
have a menstrual cycle, use 50 mg once or twice a day on a daily basis. Monitor these
women more closely for endometrial hyperplasia.
Side Effects -
Possible delay or lengthening of menstrual cycle; drowsiness; dizziness; or
lightheadedness may occur. Adjust the dose or change the time of day it is applied.
Women are requested to keep a daily diary and report any spotting or bleeding problems
to their physician.
Progesterone can be used with or without estrogen. Alone it can be used to stop hot flashes. Natural progesterone may be added to Triest cream to improve bone dens ity. Studies have shown that not only does it stop resorption of calcium from the bone, but that it builds up bone mass. This is of major consideration for women of any age suffering from arthritis or osteoporosis.
Frequently Asked Questions About Testosterone
Testosterone is a hormone produced by both men and women. It is not just a male sex hormone. In men testosterone is primarily produced in the testes and to a lesser extent in the adrenal glands. In women testosterone is produced in the ovaries, adrenals and to a lesser extent in the skin, brain and liver.
Testosterone behaves differently in the bodies of men and women, but it plays a very
important role in the overall health and well-being of both sexes. In men
builds muscle, enhances sex drive, elevates the mood, prevents osteoporosis and
increases energy. In women
testosterone enhances the sex drive, helps relieve
menopausal symptoms, restores energy, strengthens bone, elevates the mood and
increases the sensitivity to sexual pleasure in the nipples and genitals.
What Are The Benefits And Risks of Taking Testosterone?
Testosterone can improve the energy and strength in both men and women. It has a
"tonic" affect on the body. Reports indicate that adequate levels of testosterone can help
prevent heart disease, stroke and vascular disorders such as diabetic blindness.
Testosterone supplements in men and women can increase the risk of liver toxicity,
especially if taken orally. This is because the oral drug goes directly to the liver. It is
better to take testosterone transdermally - by patch, gel or injection for men and by
gel or vaginal ointment for women.
In women side affects
such as oily skin, acne,
irritability of behavioral changes and increased facial hair
are dose related. When
dosed correctly these problems rarely occur.
What Is The Difference Between Testosterone And Methyltestosterone?
Testosterone is the active form of the hormone. It is this form that binds to receptors in the body and causes the desired affects. However, testosterone may increase the levels of estrogen in some men and women which is not always desirable. The "methyl" form of testosterone is less likely to be converted to estrogen and is better absorbed orally, however, your physician will need to monitor your liver function more closely.
Does Testosterone Require A Prescription?
Yes, it must be ordered by a licensed physician or practitioner.
Is There A Commercial Source Of Testosterone For Women?
Compounded forms of Natural Testosterone can be ordered by your doctor.
Diagnosis: Loss of Libido, Vaginal Atrophy
Patient Instructions: Apply 0.2 mls to 0.4 mls total per day, to be applied directly to the genital tissue. Use daily after bathing. If topical testosterone is used long enough for spontaneous genital stimulation to occur, it is a signal to cut back the dosage and/or frequency of application. (The Hormone of Desire - Susan Rako M.SD.)
Patient Instructions: This is a superior product for vaginal dryness. It is also helpful for many vaginal symptoms and recurrent urinary tract symptoms. Insert one applicator full in the vagina daily. Frequency of dosing may be reduced according to the benefits achieved. Estriol exerts a very powerful local action, but is weak systemically.
Osteoporosis is defined as a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone frailty and susceptibility to fracture.
• Affects approximately 25 million Americans, predominantly women • 1.3 million osteoporotic fractures annually • As many as 40% of 50 year old women will experience an osteoporotic fracture during their remaining lifetimes • Hip fractures lead to incapacitation in more than 50% of patients, and up to 20% will die within 1 year from complications • Lifetime risk of death due to hip fracture is comparable to breast cancer
• Women more at risk than men • Age - risk increases as we get older (over 65) • Small frame size • Early menopause (normal or surgical) • Women who do not take estrogens or progesterone • Diets that do not include enough calcium & vitamin D • Excess caffeine intake - due to increased urinary excretion of calcium • Excess alcohol intake - increases risk of falls and hepatic disease • Decreased physical activity • Smoking • Heredity and Race - Caucasians and Asians at greater risk • Medications - Corticosteroids used for arthritis or asthma increase your risk, excess thyroid hormone, anticonvulsants and excess aluminum antacids increase risk
Clinical observations such as Kyphosis (rounding of the shoulders), height loss, wedge deformity on X-ray or a fracture - all of these are after the fact. Early detection is through bone mineral density testing. The most reliable method is Dual Energy X-Ray Absorptiometry. (DXA)
Your medical doctor will decide the most appropriate treatment for you if you are diagnosed with osteoporosis or osteopenia. Osteopenia is a condition that precedes osteoporosis and is a condition of low bone mass, but not yet as severe. Your treatment can include:
• Lifestyle changes such as change in diet, exercise, smoking cessation and reduced alcohol consumption
• Medications such as estrogen or progesterone • Nutritional Supplements such as Calcium, Vitamin D and other essentia elements
The Success Of Your Menopause Therapy Depends
q Irritability q Lethargy/Fatigue q Depression q Headaches q Hot Flashes q Night Sweats q Forgetfulness q Mental Fatigue q Weight Gain q Insomnia q Joint Pain/Backache q Palpitations q Crying Spells q Loss of Bladder Control q Burning or Pain Upon Urination q Vaginal Dryness q Decreased Sexual Desire q Decreased Sexual Activity q Loss or Thinning of Hair
If you wish to know more about N.H.R.T., read, consult your physician, or your Compounding Pharmacist.
Saskatoon Medical Arts Pharmacy offers.
• Free Prescription Counseling on all Medications
• Specialized Counseling by appointment only
• Educational Books and Video Lending Library
We believe that you must be fully involved in your treatment outcome. Before the consultation you will be asked to complete a personal medical profile. Your information package will contain a symptom diary to take home so that you can monitor your progress. Your body's signals are most important indicators of an optimal hormonal balance. Together, you, your doctor and your compounding pharmacist will establish the dosage level that is right for you.
Natural Hormone Replacement
Shows how natural hormone replacement offers a safe and effective alternative for the
treatment of Menopause and PMS. (Jonathan Wright, M.D.)
Women's Bodies, Women's Wisdom
New vision of women's health and wellness. Empowers women to take control of their
physical and emotional health. (Christiane Northrup, M.D.)
What Your Doctor May Not
Tell You About Premenopause
Offers simple safe solutions to women who may be suffering from symptoms of
premenopause. (John R. Lee, M.D. & Jesse Hanley, M.D.)
What Your Doctor May Not
Tell You About Menopause
Important information on PMS and Menopause and other women's health issues.
(John R. Lee, M.D.)
Take Charge of Your Body
Empowers women to take charge of their health. Use your doctor as a resource rather Ti
than the final authority. (Carolyn DeMarco, M.D.)
The Hormone of Desire: The Truth about Testosterone
The truth about sexuality, menopause and testosterone. The first book to reveal the benefits of
testosterone to women. (Susan Rako, M.D.)
How to Prevent Breast Cancer
A lifestyle guide for prevention of breast cancer and its recurrence with an investigation of the
critical risk factors. (Ross Pelton, R.Ph., Ph.D., C.C.N.; Taffy Clarke Pelton, M.A.; Vinton C.
Preventing and Reversing Osteoporosis
Overview of osteoporosis. What you eat affects your bones. Natural remedies. (Alan Gaby,
Hormone Heresy: What Women Must Know About Their Hormones
Reiterates the benefits of N.H.R.T. and the mind-body connection in women's health. (Sherrill
I'm Not In the Mood
What everyone should know about improving her libido. (Judith Reichman, M.D.) The above referenced books are considered a must read for all women that want to take
charge of their own health. Achieving optimal health begins with education.
Estrogen Replacement Therapy: Preventing and Reversing Osteoporosis
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