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 Hormone Replacement Therapy

Information for Physicians

Like all medical therapies, Hormone Replacement Therapy (HRT) may not be appropriate for all patients. Both the benefits and potential risks of the therapy should be discussed with your physician before beginning treatment.

 
Information for Physicians

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Information for Physicians
 
Given the current literature and sensitivity to the issues relating to HRT, the practice of routinely prescribing hormones without the appropriate testing for levels is highly questionable. To be accurate, testing should include levels of free (bioavailable) hormones that are more significant indicators of true deficiency or imbalances. Testing choices include serum (blood) or saliva tests.

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Information for Physicians
 
Use hormone baseline test results to prescribe hormone replacement therapy to bring your patient’s hormones to their optimum targeted levels. Then, monitor hormone levels with periodic follow-up visits and re-testing to assess the effectiveness of the therapy and adjust as necessary.
 

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Information for Physicians

Estrogen Replacement Therapy (ERT) restores declining hormone levels associated with menopause (women with a personal history or a family history of breast cancer may not be candidates for estrogen replacement). The principal estrogens in a woman are estrone (E1), estradiol (E2), and estriol (E3). Estradiol is the most potent of these estrogens and is produced by the ovary. Estrone and estriol are both metabolites of estradiol and are less potent, with estriol being the weakest. The most common form of ERT is a compounded formulation of Bi-Est (80% estriol / 20% estradiol) and Tri-Est (80% estriol/10% estradiol/10%estrone). The percentages of estrogen in each compound can be adjusted based upon test results to achieve an optimal patient outcome.
 

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Information for Physicians

Progesterone (P4) is a hormone produced in women by the adrenal glands, the ovaries and in the placenta during pregnancy. In men, smaller amounts of progesterone are produced in the testes and adrenal glands. Progesterone interacts with and mediates estrogen. Progesterone is known as a precursor hormone for estrogen, luteinizing hormone, and testosterone, among others. To a certain extent, progesterone controls the production of these other hormones and can help balance any deficiencies or excesses of them in your body. In addition to helping relieve the symptoms of menopause and PMS, progesterone is known to enhance energy and sexual libido, and to heighten feelings of well-being. Progesterone should not be confused with progestin. Progestin is a chemical synthetic and is unable to synthesize other hormones or help our bodies produce the other hormones it needs to function at full potential. Progesterone can be administered orally (powder or micronized in oil base), vaginally or rectally (with suppositories), through injections or topically with transdermal creams or gels. 
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Information for Physicians
 
Testosterone, although a primary male hormone, also plays a role in women’s health. A decline in testosterone levels in men may be indicated by symptoms including loss of libido, erectile dysfunction, deterioration in ability to concentrate, poor muscle tone and strength, lack of endurance and mood swings. A decline in testosterone levels in women may accompany a decreased libido, irritability, weight gain, loss of lean muscle and osteoporosis. Testosterone contributes to energy levels, overall sense of well-being,  increases lean body mass and helps in building strong bones. 

For people not producing high enough levels of testosterone, Testosterone Replacement Therapy (TRT) may be appropriate. This therapy should be considered when hormone deficiency has been clinically proven through laboratory testing of blood serum or saliva.

Testosterone can be administered orally, topically (creams or gels) a pellet implant (pellet placed underneath the skin) or injectable form. Testosterone taken orally should not be considered a primary method of delivery. Topical application of testosterone is usually the preferred method for TRT. AnazaoHealth offers testosterone creams, gels, pellets and injectables in a variety of strengths. Although there are advantages to different dosage forms, the physician should consult with the patient for the most appropriate dosage compliant form. 

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Information for Physicians

Topi-CLICK Dispensing Applicator

AnazaoHealth provides Topi-CLICK, a new metering dispenser for prescription topicals.

Benefits of the Topi-CLICK include:

  • Consistent dispensing volume
  • Easy to use for all types of patients
  • Easier to use than oral dosing syringes
  • Domed applicator pad for application - so hands stay clean
  • Available with pink or blue caps
  • Improves compliance and reduces patient complaints
  • Audible, visual and tactile click registration for user recognition
  • Dispense volumes of 5 ml to 35 ml of topical creams or gels
  • Patient "Refill" reminder line

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Information for Physicians

Hormone replacement therapy in pellets are placed beneath the skin, typically in the buttocks or abdomen, to provide a reservoir of testosterone or estradiol for your patient. Implanting the grain-of-rice-sized pellets takes about five minutes and should be repeated every four to six months. Pellet implantation offers stronger patient compliance due to not having a daily regimen of hormone dosing.
 

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Information for Physicians

Hormones for Men & Women

 

  • Androstenedione - A steroid hormone used to increase testosterone levels
  • Armour Thyroid/Synthroid – Thyroid hormones that are very important in metabolism and effect the central nervous system, heart tissue and the peripheral blood vessels – Armour thyroid is a natural hormone that contains both T3 and T4; Synthroid is the synthetic version consisting of T4 only.
  • DHEA – An adrenal cortex steroid hormone that raises levels of sex hormones and has been linked to increased lean body mass, improved immune and cognitive functions and skin tone.
  • Estrogens – The primary female hormones consisting of Estradiol / Estrone/ Estriol – Biest or Triest
  • Human Growth Hormone (HGH) – Replacement in deficient individuals may result in improved immune systems, higher energy levels, healthier cardiovascular systems, improved mental function, loss of body fat and increased lean body mass.
  • Melatonin – Helps regulate a good sleep/wake cycle and is recognized as a powerful free radical scavenger.
  • Human Chorionic Gonadotropin (HCG) – Used to stimulate the testicles to produce testosterone.
  • Pregnenolone – a steroid hormone produced by the adrenal glands and synthesized directly from cholesterol. It is a precursor hormone, from which all other steroid hormones are made.
  • Progesterone – An ovarian hormone that helps maintain menstrual cycles, PMS and mediates other hormones.
  • Testosterone – The primary male hormone.  
  • Thyroid - the thyroid gland secretes two hormones, T3 and T4 which helps to regulate metabolism.  The thyroid-stimulating hormone (TSH) is produced by the pituitary gland which prompts the thyroid to produce T3 and T4.

References: 
Julian Whitaker, MD. Dr. Whitaker’s Guide to Natural Hormone Replacement. Phillips Publishing, Maryland. 1997 
R. Livesey, MD & J Raffaele, MD. A Woman’s Guide to Bioidential Hormone Replacement and Anti-Aging Therapies/ PhysioAge Medical Group
Facts About Menopausal Hormone Therapy. U.S. Department of Health and Human Services, National Institutes of Health.

Topi-CLICK® is a registered trademark of Custom Rx TDA, LLC.

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