Bio-Identical Hormone Replacement Therapy

Bio-identical Hormone Replacement Therapy

Horst Pharmacy can meet the needs of peri-menopausal and menopausal women and men (andropause) by compounding plant derived, bio-identical hormones.  This type of hormone replacement therapy is appealing to because they help to mend a hormonal imbalance with hormones that are identical to those produced in the human body.

Bio-identical hormone replacement therapy has many benefits:

  • Same identical hormones as exist in the human body
  • Hormones are derived from a natural source
  • Therapy is individualized
  • Avoidance of side effects
  • Proven benefits

Bio-identical hormones can be placed in a variety of dosage forms including: capsules, topical creams, suppositories and sublingual troches or lozenges. Our pharmacists work with the patient and his/her physician to choose the dosage route and strength that is most beneficial and pleasing to him/her.

Female Patients

All women are not the same.  Therefore, each patient needs an appropriate dosage strength and form of medication to fit the individual.  Our compounding pharmacists can tailor a hormone regimen, which mimics what the female’s body has been doing for the past 50 years.

Compounding Options with MucoLox™

  • A one-of-a-kind polymer network that provides improved moisturization, mucoadherence and superior film-forming action
  • Bonds to the mucosa and won’t easily wash away, creating a powerful but lightweight coating effect
  • Ideal for use in formulas for: Oral, Rectal, Vaginal, and Esophageal/gut preparations
  • Pleasant, neutral taste
  • Can be diluted with water to adjust viscosity and coating effects

Male Patients

For male patients who are experiencing andropause, we can develop an effective supplemental treatment of the basic hormone testosterone.

Compounding Options with Atrevis™ Hydrogel

  • Advanced topical base designed to deliver testosterone through the skin in male patients
  • Uses a novel delivery system to drive testosterone through the skin
  • Superior testosterone delivery: Independent testing showed that Atrevis Hydrogel delivered more testosterone than a competitor base, allowing for lower volume dosing
  • Alcohol-free: Atrevis is formulated without alcohol, reducing the risk of evaporation and maintaining chemical stability while not drying the skin
  • Quick absorption: It absorbs quickly when rubbed into the skin, leaving a smooth texture without a greasy residue

An Emerging HRT Dosage Form for Women

With the sky-rocketing costs of commercial vaginal estrogens, patients and prescribers are looking for affordable and
customizable options. A compounding pharmacist working with a practitioner can create customized medications with a variety of active pharmaceutical ingredients in different dosage forms that are uniquely suited to individual patients.  Options include:

Treating vaginal dryness and atrophy with estriol, estradiol or testosterone is not a novel idea, but the dosage form may warrant a closer look. Many times patients will complain about a vaginal cream, as it can feel messy
or unclean. Previously, the other options available were vaginal suppositories, troches or capsules. All of these
dosage forms have their own pros and cons. However, a recent study showed higher treatment compliance and
adherence of postmenopausal women with estrogen tablets over estrogen creams or gels.

Example Formulas

  • Estradiol 5 mcg Rapid Dissolve Vaginal Tablet (PCCA RDT-Plus) (SF)
  • Estriol 0.5 mg/Testosterone 0.5 mg Rapid Dissolve Vaginal Tablet (PCCA RDT-Plus) (SF)
  • Estriol 0.5 mg Rapid Dissolve Vaginal Tablet (PCCA RDT-Plus) (SF)

Female sexual dysfunction (FSD) is a complex, multifactorial disorder. Sexual function results from several
systems working together. Hormones, psychological status and adequate blood flow to the genitals all must
be functioning in order for a woman to have a satisfying sexual experience.  After evaluating the hormonal status, many times improving blood flow to the clitoris can be the final piece of the puzzle.

In clinical practice, the use of various combinations of vasodilators either applied or inserted vaginally have
demonstrated a therapeutic effect in women with FSD.

The improvement in blood flow will not directly increase desire, but will make the tissue more sensitive and
improve potential to climax.

Example Formulas

  • Arginine 12 mg/Papaverine HCl 0.2 mg Rapid Dissolve Vaginal Tablet (PCCA RDT-Plus)
  • Sildenafil 2 mg/Arginine 12 mg Rapid Dissolve Vaginal Tablet (PCCA RDT-Plus)

Many prescribers order compounded testosterone creams or gels for women for a variety of androgen-deficiency
symptoms, as there is not a commercial product currently available that is indicated for women. Either due to poor absorption or adherence, many women do not achieve the full benefit from topical testosterone. Therefore, a look at a unique delivery system is needed.

Sublingual absorption of testosterone using PCCA Rapid Dissolve Tablet Powder or PCCA RDT-Plus reduces the
amount swallowed due to the rapid dissolution. You can advise patients to not eat or drink for 30 minutes to allow maximal absorption via the mucous membranes sublingually or buccally.

Example Formulas

  • Testosterone 0.5 mg Rapid Dissolve Tablet (PCCA RDT-Plus)
  • Testosterone 5 mg Rapid Dissolve Tablet (PCCA RDT-Plus)

As a part of Horst Pharmacy’s compounding service, our pharmacists regularly conduct patient consultations with any individual undergoing bio-identical hormone replacement therapy.  If you are interested in this treatment, and would like to learn more, please call us at 1.573.243.8174 / Toll Free 1.800.640.5940, or fill out the Consult the Pharmacist request form.

Our pharmacists will also be happy to educate physicians about bio-identical hormone replacement therapy.  We have 20 years of experience compounding hormones and extensive training in this field.  Please fill out this form to request a meeting with our chief pharmacist, Steve Horst, RPh.