Bio-identical hormone replacement therapy (BHRT) restores hormones such as estrogen and progesterone and androgens like testosterone that the ovaries stop making during menopause. Hormone levels begin to change during perimenopause, the years just before menopause takes place. During this phase, some women have hot flashes, vaginal dryness, irregular periods and insomnia due to the declining hormone levels. After menopause, the drop in hormone levels can mean hot flashes, night sweats, vaginal dryness and loss of libido.

Other symptoms may include thinning hair, skin and nails; fuzzy thinking and loss of ability to concentrate; mood swings; and water retention. All of these are often signs of testosterone and estrogen insufficiency.

BHRT refers to the use of hormones with molecules that are exact copies of endogenous human hormones, as opposed to synthetic or animal-derived versions with different chemical structures that are similar, but not identical. There is some controversy about whether it is safer and more effective than traditional synthetic and animal-derived versions used in past which carried increased risks of heart attack, stroke and breast cancer. Power Surge, an established online menopause community, recommends BHRT, but the North American Menopause Society does not endorse it. BHRT has some celebrity proponents, such as Suzanne Somers and Oprah Winfrey, but there are detractors who say more research needs to be done on BHRT.

A recently published study (Jan. 2009) in Postgraduate Medicine, found that physiological data and clinical outcomes demonstrate bio-identical hormones are associated with lower risks and better effectiveness than traditional ones. 

While the risks vs. benefits of BHRT must be assessed with the guidance of your doctor, many women do much better with BHRT supplementation than with the antidepressants, anti-anxiety medications and osteoporosis treatments now typically used. Many circumstances and age groups can benefit: young women, women post-hysterectomy/oophorectomy, menstruating women with mood swings during phases of their cycles.

The Medicine Shoppe is a compounding pharmacy, meaning there is mixing of drugs by a pharmacist to fit the unique needs of a patient. Compounding is used for many reasons: to change the form of the medication from a solid to a liquid, to avoid a non-essential ingredient or obtain the exact dose needed.

Bio-identical hormone replacement therapy compounding allows tailoring therapy to each patient’s specific needs. Testosterone, DHEA, progesterone, and estriadol may all be needed–or only one or two of the hormones.

Pharmaceutically compounded BHRT medications come in many forms: topical creams, time released capsules, lozenges and suppositories are the most common forms.  Often, any medication needed can be combined into one or two products.

Patients should approach their physician regarding the subject. The proactive patient can also get testing done on their own hormone levels by using saliva testing kits available at a compounding pharmacy.

30+ Symptoms of Menopause

1. Hot flashes, flushes, night seats and/or cold flashes—clammy feeling

2. Irregular heartbeat

3. Irritability

4. Mood swings, sudden tears

5. Trouble sleeping through the night (with or without night sweats)

6. Irregular periods: shorter, lighter periods; flooding; phantom 

     periods; shorter and longer cycles

7. Loss of libido

8. Dry vagina

9. Crashing fatigue

10. Anxiety, feeling ill at ease

11. Feelings of dread, apprehension, doom

12. Difficulty concentrating, disorientation, mental confusion

13. Disturbing memory lapses

14. Incontinence, especially upon sneezing or laughing; urge incontinence

15. Aching, sore joints, muscles and tendons; increased tension in 

     the muscles

16. Breast tenderness

17. Headache change: increase or decrease

18. Gastrointestinal distress: indigestion, flatulence, gas pain, nausea

19. Sudden bouts of bloat

20. Depression

21. Exacerbation of existing conditions

22. Increase in allergies

23. Weight gain

24. Hair loss or thinning—head, pubic or whole body

25. Increase in facial hair

26. Dizziness, light-headedness, episodes of loss of balance

27. Changes in body odor

28. Tingling in the extremities

29. Gum problems, increased bleeding

30. Burning tongue, burning roof of mouth, bad taste in mouth, 

      change in breath odor

31. Osteoporosis (after several years)

32. Changes in fingernails: softer, crack or break easier

33. Tinnitus: ringing in the ears, bells, “whooshing,” buzzing, etc.

Kevin Evetts, D.Ph., graduated from the University of Tennessee College of Pharmacy in 1982.  He received his Masters in Business Administration from the University of Memphis in 1988.  Before becoming owner of The Medicine Shoppe Pharmacy in East Memphis in 2000, he worked as a manager and pharmacist at Walgreens.