RESUMEN

Testosterone is integral to men's sexual and overall health, but there is a gradual decline in the ageing male. The topical administration of testosterone is a valuable option as a supplement (replacement) therapy to alleviate hypogonadal symptoms. The clinical efficacy of a compounded testosterone 5% topical gel was assessed retrospectively in a male patient in his seventies by evaluating the laboratory testing of the serum total testosterone and the results of a validated androgen deficiency questionnaire. After treatment, the patient's hypogonadal symptoms improved and the serum total testosterone level achieved was considered clinically optimal. The skin permeation of the testosterone topical gel (biological testing) was evaluated in vitro using the Franz finite dose model and human cadaver skin, and it is shown that testosterone can penetrate into and through ex vivo human skin. Testosterone therapy is often prescribed for extended periods, and consequently, it is crucial to determine the beyond-use date of the compounded formulations. The analytical testing involved a valid, stability-indicating assay method for compounded testosterone 0.5% and 20% topical gels. This multidisciplinary study shows evidence supporting topically applied testosterone's clinical efficacy and the compounded formulations' extended stability. Personalized, topical testosterone therapy is a promising alternative in current therapeutics for hypogonadal patients.

RESUMEN

Why compound bioidentical hormones? Are there no similar commercial products? What is unique about the options compounding pharmacists offer compared with what is out in the marketplace? These are questions that physicians and other practitioners are asking, and it is very important that we have intelligent, well-thought answers when we respond. Times have changed, and the challenges we face today in marketing our compounded therapies are not the same as those of twenty years ago. Premarin is no longer at the top of the heap, and there are topical, commercial products that contain bioidentical estradiol, and capsules that contain the same progesterone that we use. Our compounding advantage comes from our abilities to prepare unique patient-specific products, and, very importantly, from our growing understanding of hormone receptors; we now know there are two main estrogen receptors, 1) estrogen receptor alpha and 2) estrogen receptor beta, and the growing knowledge base associated with the discovery of estrogen receptor beta is quite significant.

Asunto(s)

RESUMEN

Male hypogonadism is a common condition widely associated with the aging process. Understanding of this condition is continuing to grow as new information is available. Pharmacists are in a very unique position to work with patients and physicians in achieving better diagnosis and treatment plans for the hundreds of thousands of men in the U.S. who are hypogonadal. This article discusses various methods that can be employed to restore testosterone in men and the varying expectations associated with each treatment method.

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RESUMEN

Male hypogonadism is a condition that is receiving increasing medical scrutiny, resulting in research producing results favorable to the consideration of maintaining physiological levels of testosterone. As healthcare professionals interested in the health and welfare of a significant portion of the population, surely compounding pharmacists are interested in what can be done for men with this condition to help these patients improve their quality of life and long-term health. This article discusses the various ways that men's testosterone levels can be raised and provides insight into the importance of androgen-estrogen balance.

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Between warnings from the U.S. Food and Drug Administration and many articles being published with the consensus that testosterone-replacement therapy had an increased cardiovascular risks in men, thereby questioning the relative safety of the therapy, the needs of hypogonadal (low testosterone) men, who also present with symptoms related to this condition, are much less likely to receive a treatment that can significantly improve their quality of life. This article discusses a major research project that determined that testosterone replacement therapy was no worse than a placebo in men with cardiovascular disease or at high risk for cardiovascular disease.

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RESUMEN

Why compound bioidentical hormones? Are there no similar commercial products? What is unique about the options compounding pharmacists offer compared with what is out in the marketplace? These are questions that physicians and other practitioners are asking, and it is very important that we have intelligent, well-thought answers when we respond. Times have changed, and the challenges we face today in marketing our compounded therapies are not the same as those of twenty years ago. Premarin is no longer at the top of the heap, and there are topical, commercial products that contain bioidentical estradiol, and capsules that contain the same progesterone that we use. Our compounding advantage comes from our abilities to prepare unique patient-specific products, and, very importantly, from our growing understanding of hormone receptors; we now know there are two main estrogen receptors, 1) estrogen receptor alpha and 2) estrogen receptor beta, and the growing knowledge base associated with the discovery of estrogen receptor beta is quite significant.

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RESUMEN

There are a lot of options that pharmacists, including compounding pharmacists, can offer urologists to assist their patients. Compounding pharmacists are in a great position to offer unique, effective preparations for many of the conditions urologists treat on a daily basis. It would be well worth the time to learn a little about the conditions these specialists treat and become familiar with what you can offer.

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RESUMEN

Estrogen therapy is a well-known and commonly used symptomatic treatment of hot flashes, night sweats and vaginal dryness associated with menopause. The most active estrogen, estradiol, is also understood to have a protective effect against osteoporosis. Like many hormones, though, estradiol has many roles in the body, both in males and females, and studies of these roles continue to emerge. A major function of estradiol involves obesity, insulin resistance, and cardiovascular disease; studies have shown the beneficial effects of estradiol in these areas, and this is somewhat at variance with traditional belief. In recent years, many researchers have studied its protective, beneficial effect, and have arrived at convincing evidence. In females, and, to some extent in males, estradiol is very important in protecting against obesity and lessening the likelihood of insulin resistance and cardiovascular disease. For both menopausal women and hypogonadal men, estradiol levels should be monitored and considered for long-term healthcare benefits.

Asunto(s)

RESUMEN

Male hypogonadism is a common condition widely associated with the aging process. Understanding of this condition is continuing to grow as new information is available. Pharmacists are in a very unique position to work with patients and physicians in achieving better diagnosis and treatment plans for the hundreds of thousands of men in the U.S. who are hypogonadal. This article discusses various methods that can be employed to restore testosterone in men and the varying expectations associated with each treatment methods.

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RESUMEN

This article discusses the importance of compounding pharmacies offering consultation services to patients, specifically in the areas of exercise, weight management, and nutritional support. With approximately two-thirds of the adult U.S. population falling into the overweight category and almost one-third falling into the obese category, most of which are also underactive, clearly weight management is an area of great concern. Included in this article are some brief literature reviews; important information for those looking for statistics on the benefits of exercise and nutritional support. Vitamin D and Omega 3 fatty acid research information is provided, highlighting the broad-based benefits of these important supplements. Having a private, inviting space for your patients to discuss their concerns and prescription needs, encourages patients to use consulting services and having fact-based information can help educate your patients about the topics discussed in this article, as well as other healthcare needs.

RESUMEN

Pharmacists who are involved with patients and physicians have a tremendous opportunity to serve in the realm of prostate cancer, and there are numerous compounding opportunities. For example, compounded testosterone gels can help keep testosterone levels in the mid to upper range with proper dosing and patient counseling. Also, estradiol levels can be held in check or lowered by compounding aromatase-inhibitors such as anastrazole or letrazole into the lower doses that men require, rather than their more potent versions for female patients. Nutraceuticals such as omega-3 fatty acids, vitamin D, zinc, and selenium all play an important role in prostate health, as these agents have 5a-reductase inhibiting and anti-inflammatory properties. More than anything else, we see that the pathophysiology of prostate cancer, although quite complex, is being explored at an amazing rate. The author believes that hormonal balance is critical, and that it is largely hormonal imbalance that is involved in prostate disease. In that regard, the author concludes that the levels of testosterone, estradiol, and drotestosterone, experienced at a more youthful age are vital if we are to improve prostate health.

RESUMEN

We have learned a great deal about testosterone over a long period of time and are familiar with its role in sexual function, libido, muscle strength/tone, erythropoiesis, and bone mineral density. What we are less familiar with are the consequences of low testosterone-hypogonadism-as it relates to the Metabolic Syndrome, and the strong association with diabetes and cardiovascular disease. It is clear that many medical researchers have taken a strong interest and are finding significant data in hypogonadism as it affects certain comorbid conditions.

RESUMEN

Male hypogonadism is a condition that is receiving increasing medical scrutiny, resulting in research producing results favorable to the consideration of maintaining physiological levels of testosterone. As healthcare professionals interested in the health and welfare of a significant portion of the population, surely compounding pharmacists are interested in what can be done for men with this condition to help these patients improve their quality of life and long-term health. This article discussed the various ways that men's testosterone levels can be raised and provides insight into the importance of androgen-estrogen balance.