Hormone Replacement Therapy (HRT) for Postmenopausal Women
A new review published in JAMA on May 1, 2024, offers a new perspective about the benefits and considerations of hormone replacement therapy (HRT) for postmenopausal women.
Data Collection to Assess Hormone Therapy Among Women
The new analysis of the WHI study suggests that hormone therapy for women under 60 has a low risk for adverse events and a promising safety profile for managing bothersome menopausal symptoms such as hot flashes, night sweats, and more, says study author Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital.
This is quite different information than women have been given over the past 20 years, and because of the flaws in the study, many women missed out on being offered HRT for their symptoms.
Source: NPR.org
Symptom Relief
One of the standout findings on hormone replacement therapy is its ability to alleviate moderate-to-severe vasomotor symptoms such as hot flashes and night sweats. These symptoms can significantly affect daily life, and HRT offers an alternative that can greatly enhance comfort and well-being.
Potential benefits of early intervention
Starting hormone therapy before the age of 60, or within ten years of the onset of menopause, is associated with lower rates of adverse effects compared to beginning HRT later. Early intervention may provide substantial relief and improve the quality of life for many women.
Compounded Bioidentical Hormone Replacement Therapy (BHRT)
Compounded Bioidentical Hormones
Town & Country Compounding Pharmacy specializes in compounded bioidentical hormones. These hormones are chemically identical to those your body naturally produces and can be custom-formulated to meet your specific needs. Bioidentical hormone replacement therapy (BHRT) offers a personalized approach, allowing for tailored dosing and delivery methods that suit your unique physiology.
One significant advantage of bioidentical hormones is the use of bioidentical progesterone, which differs from the synthetic progestin used in the WHI trials. The WHI identified harmful effects associated with synthetic progestin, such as medroxyprogesterone acetate, including an increased risk of breast cancer and cardiovascular events. In contrast, bioidentical progesterone has a different molecular structure that is identical to the progesterone produced by the human body. This structural similarity may lead to different outcomes and is believed by some to be a more natural alternative for symptom relief.
Additionally, bioidentical estrogen differs from the conjugated equine estrogens used in the WHI trials. Bioidentical estrogen is chemically identical to the estrogen naturally produced in a woman’s body, which may provide a more harmonious response in managing menopausal symptoms. The conjugated equine estrogens, derived from the urine of pregnant mares, have a different composition and may interact differently with the body. Some believe bioidentical estrogen to be a more natural and individualized approach to hormone therapy.
Are you experiencing menopausal symptoms and interested in learning more about hormone replacement therapy, including compounded bioidentical hormones?
Our team is dedicated to providing the information and support you need to make informed decisions about your health. Let us help you improve your quality of life through symptom management.
HRT Dosage Forms
Town & Country Compounding offers personalized Bioidentical Hormone Replacement Therapy tailored to individual patients. Following a saliva test, the patient’s results are evaluated, and our expert pharmacists will then engage in consultation with the patient to establish a customized therapy plan.
How are hormones dosed?
Upon starting BHRT, physicians generally begin with low doses and gradually adjust. BHRT is not one-size-fits-all, acknowledging the uniqueness of each patient. To optimize efficacy, adjustments in timing or method of administration may be considered. However, it’s crucial for patients to adhere strictly to prescribed dosages and refrain from making adjustments without proper supervision.
Hormone testing plays a pivotal role in BHRT, as symptoms of various hormonal imbalances can overlap. Differentiating between excess and deficiency is essential, underscoring the importance of regular hormone testing to fine-tune dosages and improve optimal therapeutic outcomes.
Test Your Hormone Levels at Home; prescription not required
Saliva is best used to evaluate the balance and flow of estrogens and progesterone in women who are still having menstrual cycles. It can also be used to evaluate cortisol secretion patterns by taking multiple samples over the course of a day and evening.
*15 minute pharmacist consultation included with results (optional)
Topical Creams / Gels
- Apply on clean skin, ideally after shower
- Apply on slightly fatty skin (not too much and not too little fat). Ideal sites will vary with body types. Common locations are the inside of the upper arm or the inside of the upper thighs (if the thighs are not too heavy).
- Rotate application sites
- Apply about an area the size of a small plate for topical dose prescribed can cover as much skin as possible
- Rub in well for at least one minute
- Wash hands after application to prevent possible transfer of hormone to other people or pets
How to Use a Micropen Device – Testosterone Dispenser
Expert women’s health pharmacist, Jari Becker goes over step-by-step instructions on how to use a Micropen Device for Testosterone Cream/Gel Dispenser, commonly used for Women’s Hormone Therapy.
Oral Capsules & Suspensions
- Immediate-release capsules
- Compounded to dissolve without delaying or prolonging absorption, therefore the onset of effect is faster. However, it may require multiple doses throughout the day.
- Slow-release capsules
- Compounded to dissolve over time in order to be released slower into the bloodstream while having the advantage of being taken at less frequent intervals
- Oil-filled capsules
- Oral liquid suspensions
- May take with food or right after a meal to prevent stomach upset
Lozenges (Troches)
Lozenges can be placed between the cheek and gum or underneath the tongue. When drugs are absorbed this way instead of swallowed, they bypass going through the stomach. This often allows a more complete absorption and quicker onset for the drug to work. The downside is the taste of the drug, which can often be bitter. We use sweeteners and flavors to help make it the best it can be.
Rapid Dissolve Tablets
Rapit Dissolve Tablets or RDTs are placed on the tongue and dissolve rapidly, giving a quicker onset than a capsule that must be dissolved in the stomach before absorption.
Like with lozenges, the taste of the drug cannot always be completely masked.
Vaginal Suppositories, Capsules, Creams, & Gels
- Commonly used for women with vaginal dryness, painful sexual intercourse, urgency/frequency, and urinary tract infections
- Vaginal creams/gels:
- Insert and/or apply on the external genitalia
- Vaginal suppositories/capsules:
- Insert inside genitals
- Recommended to use at bedtime when you are moving less, to prevent leakage
- Vaginal applicators are recommended for intravaginal use
- NOTE: Applicators are provided with your Rx
- Application – The best positions to apply are to either lie on your back with your knees bent, or you can stand with your knees bent and your feet a few inches apart
- Gently insert the applicator into vagina as far as it will comfortably go and press the plunger as far as it goes. Then, remove the applicator.
- Applicators are reusable. May wash with soap and warm water.
- Make sure to wash hands right away
Hormone replacement therapy: you have options
For many postmenopausal women, HRT offers an option to manage troublesome symptoms. Starting hormone therapy early in menopause may provide relief with a lower risk of adverse effects. At Town & Country Compounding Pharmacy, we are committed to personalized care, helping you determine if hormone therapy is the right option for you.
Our healthcare professionals are here to discuss your symptoms and guide you through the potential benefits of HRT tailored to your needs.
Women’s Hormone Replacement Therapy (HRT) Rx Order Forms
Access to these Rx Forms are exclusive for prescribers.
RSVP for our next Women's Health Event
Our expert pharmacists host exclusive events for women that need answers to their health questions. Learn about options for addressing symptoms of hormone imbalance, in-person.
