It’s important to know ALL of your options when it comes to Hormone Replacement Therapy. Custom Compounded Alternatives from T&C Compounding Pharmacy in New Jersey, may be better suited for you than Commercially known treatments. Learn why.
Hormone Replacement Therapy:
Alternatives Vs. Commercial
Vaginal Care: A Societal Taboo
The true technical term that explains some of what women may deal with in the “V” area is called Genitourinary Syndrome of Menopause (GSM). This term came from the fact that the public has a distaste for the “V” word (Vagina) and two medical societies agreed on this more publicly acceptable term.
Genitourinary syndrome of menopause (GSM) is a phrase that describes various menopausal symptoms that are related to sex.
This includes pain and dryness (lack of lubrication), related to vaginal symptom such as irritation, dryness and burning, but also urinary symptoms such as frequent urinary tract infections (UTI) and incontinence. Since GSM decreases the quality of life, women should be aware of these problems and get a therapy that is right for them.1
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Women Going Under-diagnosed
Unfortunately, among women who report symptoms of GSM, only about half seek out help or are offered treatment by their health care providers, and fewer than half are satisfied with the suggestions or information provided to them.2
Another source suggests if the healthcare provider doesn’t specifically ask them about these symptoms, it will tend to be missed and surveys show busy practitioners seldom raise the issue. According to some estimates, fewer than 10% of symptomatic women are treated with a relevant prescription product.3
Limited Access to Affordable Treatments
Over the past several years, we have seen insurance coverage for many medications change drastically. Hormone replacement prescription prices have skyrocketed over the past couple of years, with many no longer being covered by insurance plans.
An analysis by GoodRx reveals that the price of creams, vaginal rings, and tablets containing estradiol, used to treat vaginal dryness, have been increasing in recent years. While estradiol has been available for years, insurance coverage is limited, with some plans refusing to cover some products or mandating that patients pay high out-of-pocket costs.4
However, estradiol products may not attract much public outcry, in part because womens’ sex lives and their vaginas are still fairly taboo topics. According to GoodRx, the price of a tube of Estrace cream has risen from a pharmacy cash price of $183.98 in January 2013 to $372.17 in May of this year. Meanwhile, the Estring—which is inserted in the vagina for 3 months—cost $520.66 in May, compared with $284.11 in January 2013.4
Patients see ads in magazines or on TV about wonderful things these drugs can help with, but once they try to fill a prescription, they often find out the drug not covered or the copay is unaffordable. Many patients leave the pharmacy without their medications. Symptoms persist, and quality of life declines. Due to these problems, patients and practitioners often call the compounding pharmacists for help since they are known as problem solving pharmacists.
Know Your Options
Women have enough problems as menopause happens, so why do things like insurance coverage or high copays need to add more pressure to us? Why would a vaginal cream for these “V” problems cost $300-$400 per month? That is ridiculous!
View the most popular compounding formulas for Vaginal Issues
Symptoms Determine Needs
The symptoms that women struggle with during perimenopause and menopause are not all magically fixed by adding estrogen, progesterone and testosterone. The process of regulating hormone levels can take months in many cases. In addition to evaluating the female hormones, the practitioner should also check the patient’s thyroid and adrenal function. Many women experiencing hormone changes could benefit from compounded prescriptions and/or supplements.
The Compounding Pharmacy’s Role
Compounding pharmacies can be a useful resource for women going through menopause who are looking for alternatives. Pharmacists can recommend vitamin supplements for those who cannot or do not want to take hormone replacement.
Studies regarding the most popular vaginal prescription compound that is requested:
A literature review was conducted to evaluate the efficacy and safety of estriol for the treatment of vulvovaginal atrophy in postmenopausal women. Of the 22 studies that met the inclusion criteria; 13 were controlled clinical trials and nine were quasi-experimental, and 1217 women were included. These studies confirmed the efficacy of local estrogens to treat symptoms of vulvovaginal atrophy with few adverse effects reported. Following treatment, serum estriol levels rose, peaking at 1 hour. At the 6-month follow-up, there was no increase in serum estriol in treated women. The available evidence (of low and moderate quality) shows that, when administered vaginally, estriol preparations may be considered as a treatment option for women who have risk factors related to systemic estrogen therapy.5
This study evaluated the effectiveness of the application of 0.005% estriol gel to the vulvar vestibule in the management of postmenopausal dyspareunia. Postmenopausal women with dyspareunia were enrolled in the study and instructed to use a fingertip to apply estriol vaginal gel to the vulvar vestibule daily for three weeks and then twice weekly for up to 12 weeks. Assessment of symptoms (dyspareunia and cotton swab test) and signs of vestibular atrophy were performed,
and changes between baseline and weeks 3 and 12 were assessed. Adverse events were recorded. A total of 63 women were included. Of the 63, 59 (93.6%) completed the 12- week treatment period, and four dropped out for vestibular burning [which may have been a result of the base used for this particular preparation]. Dyspareunia improved or resolved by week 12 in 81.4% of patients. The patients also showed a statistically significant reduction in vestibular atrophy and cotton swab test at the end of treatment.6
Town & Country Compounding can also offer hormone saliva testing kits and help analyze results through a scheduled private consultation with the patient. The pharmacy can then get in contact with your physician and help find a treatment plan that fits your needs. Link to saliva kits that can be obtained from our pharmacy.
We can ship out to you just email or call the pharmacy.
Would you like a referral to a prescriber who specializes in bio-identical hormone replacement therapy?
We work closely with many doctors who specialize in hormones and can be empathetic to your situation. Would you like a referral where we can all work together to help you feel better? Contact Us for a list of practitioners we work with.Click here if you would like a referral to a Practitioner who is experienced and prescribes Bio-identical Hormone Replacement?
- Kim, Hyun-Kyung et al. “The Recent Review of the Genitourinary Syndrome of Menopause.” Journal of Menopausal Medicine 21.2 (2015): 65–71. PMC. Web. 8 Aug. 2018.
- Rahn, David D. et al. “Vaginal Estrogen for Genitourinary Syndrome of Menopause: A Systematic Review.” Obstetrics and gynecology 124.6 (2014): 1147–1156. PMC. Web. 8 Aug. 2018.
- Seaborg, E. (2016). The Mysteries of Genitourinary Syndrome of Menopause. [online] Endocrine News. Available at: https://endocrinenews.endocrine.org/underdiagnosed-undertreated-mysteries-genitourinary-syndrome-menopause/ [Accessed 8 Aug. 2018].
- Thomas, K. (2018). Prices Keep Rising for Drugs Treating Painful Sex in Women. [online] Nytimes.com. Available at: https://www.nytimes.com/2018/06/03/health/vagina-womens-health-drug-prices.html [Accessed 8 Aug. 2018].
- Rueda, C., Osorio, A., Avellaneda, A., Pinzón, C. and Restrepo, O. (2017). The efficacy and safety of estriol to treat vulvovaginal atrophy in postmenopausal women: a systematic literature review. Climacteric, 20(4), pp.321-330.
- Murina, F., Graziottin, A., Felice, R. and Di Francesco, S. (2016). Coital pain in the elderly: could a low dose estriol gel thrill the vulvar vestibule?. European Journal of Obstetrics & Gynecology and Reproductive Biology, 207, pp.121-124.