Natural Occurring Estrogens
Much
has changed in the field of women’s health the past few years when it comes to
the use of estrogen and progesterone for menopause therapy. The
 |
HRT continues to be the most effective treatment for menopausal symptoms and should always be prescribed at the lowest effective dose for the shortest period of time to relieve vasomotor symptoms and only should be used as long as risks don't outweigh benefits. (using a compounded bioidentical product makes it easy to adjust and taper the dose to achieve this goal) |
|
HRT should not be prescribed solely for disease prevention (cardiovascular disease, osteoporosis, or depression, etc.). However, |
instances exist in which disease prevention is appropriate as a secondary benefit for women who are already taking hormones for vasomotor symptoms.
| Herbal alternatives to hormones such as soy, black cohosh, and wild yam have not been shown to be effective in relieving menopausal symptoms. |
The most common formulations of isomolecular triple estrogen consists of estriol, estradiol and estrone in a 80%, 10%, 10% or a 90%, 7%, 3% ratio. The following is a brief description of these naturally occurring hormones.
Estriol
Estriol is considered to be a weak estrogen (20%-30% lesser affinity for the estrogen receptors in the body) .
Estriol's ability to prevent osteoporosis is controversial. Various studies have produced conflicting results. For that reason it is recommended to combine estriol with lesser amounts of estradiol, estrone and progesterone to maintain bone.
Estriol is not commercially available. However, it is the major component of triple estrogen compounded capsules.
Estradiol
The second most important component of isomolecular triple estrogen therapy is estradiol. Estradiol is the main estrogen secreted by the ovaries.
Estradiol is commercially available as a single agent under the trade name Estrace ® and it is one of the estrogens found in Premarin ®.
Estradiol may protect against osteoporosis and cardiovascular disease and it increases the level of HDL cholesterol (good cholesterol). The negative effect of solitary administration of estradiol is that higher levels may stimulate carcinoma of the breast and endometrium in some women.
Estrone
Estrone is the final component in triple estrogen therapy. It has wide use and acceptance in commercial preparations and it is the sole component found in Ogen ® and Ortho-Est ® and it is the major estrogen component of Premarin ®. Premarin ® has been used for many years by thousands of women to improve the quality of life in the menopausal and postmenopausal years. Premarin was first collected from the urine of pregnant mares (hence the name). It can now be synthesized.
High doses of estrone is felt to be procarcinogenic in both the breast and the endometrium.
Progesterone
Progesterone is necessary to oppose the stimulatory effects of estrogen on the uterus. It also may be needed to protect healthy bones.
Isomolecular micronized progesterone is believed to be more effective than synthetic progestins in correcting postmenopausal changes to HDL and LDL cholesterol. Also, when compared with synthetic progestins it has been associated with improved liver function, less breast tenderness, less fluid retention, improved mood and fewer complains of headache.
Micronized Progesterone is available commercially as Prometrium ® by Solvay Pharmaceuticals in 100mg or 200mg strengths. It also can be added to triple estrogen capsules or compounded into a topical cream.
To read more about our Custom Compounded Products click here.
Please Note: Webb's Family Pharmacy's two locations are in Fulton County Indiana. We do not provide mail-order service or online consultations. Our products are for local pick-up at our locations only. We believe strongly in the direct face-to-face relationship we have with our patients and their physicians and will not alter that principle. This information is provided for the direct benefit of our patents in our local market. If you live outside our market area please consult a compounding pharmacist in your area for information on the solutions they provide.
