The Latest in HRT With Dr. Tori Hudson Part II

by Jan on April 21, 2010

Let’s go back to delivery methods.  We have these different kinds of hormones: semi-synthetic, synthetic, bioidentical, (bioidentical from a pharmaceutical company, or bioidentical from a compounding pharmacy.) That is one little clarification we should articulate again here because those are both the same and different.  Pharmaceutical companies have a few select bioidentical hormones. There is Estradiol by itself, it comes either generic or Estrace in a pill, or we have the estrogen-only patches which are actually bioidentical estradiol. Vivelle and Climara and Menostar are examples of those.  And then we have a bioidentical cream called Estrace cream.  Those are all actually made by pharmaceutical companies.  But the pharmaceutical companies only make available a small handful of doses and very select methods of delivery.  Also with the pharmaceutical company comes their patented preservative, or binder, or filler or adhesive, because, you can not actually patent the bio-identical hormone itself.  So you have to patent something special that you do to that hormone.  We are left with the limitations of the pharmaceutical company bioidentical hormones in dosing, combinations delivery methods.

Now, at our clinic, and what most people who are really accustomed to prescribing bioidentical hormones do, is they use specialty compounding pharmacies.  Because now, we can prescribe all customized and individual doses.  Maybe you don’t need just the .5, or the 1 or the 2 milligram that the pharmaceutical company makes.  We think you would do just as well with .25 or we need to tweak it a little bit and give you .35.  So, we can customize your dose and titrate the dose up or down.  We can also customize a combination.  No pharmaceutical company yet makes a combination of bioidentical estradiol with bioidentical progesterone.  They also don’t make a combination bio-identical estrogen/progesterone formula that has the testosterone in it.  So we can now individually prepare a formulation that has not only the bioidentical hormones but the select interim specific doses that we want, and in specialty combinations. And we can use other hormones that we are interested in like estriol or DHEA that have their own added benefits.  In addition, we can do this in pills, in capsules, in sublingual lozenges, in sublingual drops, in creams, in gels, in vaginal, in topical deliveries.  We have so many more variability’s and circumstances and ways that we can help women by utilizing these compounding pharmacies than by just sticking with what the pharmaceutical companies provide.  But they are, in fact, the same hormones, if we are talking about bioidentical hormones, the commercial pharmaceutical products and the compounded products have the same benefits and the same risks.  It’s just that we have a lot more flexibility, a lot more individualization, a lot more circumstances that we can help with these compounding of specialty formulations.

Dr. Tori Hudson         For excellent HRT information go to:

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