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Blog: MenoPause ~ take time to think about it

  • Compounding pharmacies come under scrutiny

    by Margery Gass | Oct 02, 2013

    An investigative reporter published disturbing findings about compounded hormones in the October issue of More Magazine. Cathryn Jakobson Ramin found that the pills in 12 prescriptions filled at different compounding pharmacies and tested by Flora Research Laboratories in Grants Pass, Oregon, did not contain what they were supposed to: all had less estriol than was prescribed, most had more estrone and estradiol than was prescribed, and nine out of twelve did not contain enough progesterone.

    “Had the compounded products we tested been commercially manufactured pharmaceuticals, none would have passed the FDA’s requirements for finished drugs, which mandate that the contents be no less than 90 percent or more than 110 percent of the prescription as the physician has written it,” writes Ramin.

    Compounding pharmacies made news after last fall’s tragic meningitis outbreak caused by contamination in a Massachusetts pharmacy. It spurred the US government to draft new legislation that begins to require greater regulation of pharmacy compounding.

    That said, compounding pharmacies do provide valuable services in select circumstances. For example, if you are allergic to an ingredient in your medication, a compounding pharmacist can mix a special batch for you that does not contain that ingredient. If you buy medications from a compounding pharmacy, you can check whether your compounder is accredited by the Pharmacy Compounding Accreditation Board at www.pcab.org. Or you can ask your compounder if they do skip lot testing, meaning that they select random products monthly to test for purity and safety. Also be aware that all hormones carry risks and none is approved for anti-aging purposes because there is no adequate evidence to support the claim.

    Go comment!
  • Results of our survey on nonhormonal treatment for menopause symptoms

    by Margery Gass | May 14, 2013
    Do women really need more nonhormonal options to treat hot flashes? Last February we asked you and the answer was a resounding yes. In addition, we learned that most of you had already tried to combat your symptoms without hormones. No wonder you said you need something more!

    Here are the results of our poll, which we presented to the Food and Drug Administration Advisory Committee in April.

    • 88.6% of respondents experienced hot flashes
    • 49.4% of hot flashes were moderate, 34.2% were severe, and 16.3% were mild
    • 89.6% of respondents believed women need a nonhormonal prescription therapy for menopause symptoms
    • When asked why, 84.9% responded that it was because traditional hormone therapy (HT) was unsafe, 29.8% because they had experienced an adverse reaction to traditional HT, and 37.6% had a contraindication to HT
    • Women had previously tried lifestyle changes (71.5%), over-the-counter products (52.8%), HT (41.3%), compounded HT (12.9%), other prescription drugs (10.8%), or nothing (10.7%) to combat their symptoms
    Thanks to all who responded to the survey!






    1 Comment
  • Does grapefruit juice interact with your medication?

    by Margery Gass | Dec 20, 2012
    Do you take hormone therapy, birth control pills, or one of the other 85 medications listed here? If so, you must be careful to avoid too much grapefruit and grapefruit juice because they can cause your body to absorb higher levels of your medication.

    Grapefruit contains natural chemicals that alter how the body processes certain medications, so that you can end up with much higher levels of a drug than intended. For some drugs, higher levels can lead to inadequate breathing and dangerous increases in heart rhythm. You can learn more about how grapefruit affects your medicines from the FDA.

    If you are taking any medications by mouth, check the list to see if you should avoid grapefruit. Be safe!



    Go comment!
  • Which hormones are better?

    by Margery Gass | Sep 11, 2012
    There’s been a lot of talk about how “bioidentical” hormones and transdermal hormones (in skin patches or gels) may be safer options than the oral pill hormones used in the Women’s Health Initiative Studies. There’s been some research, too, hinting that transdermal estradiol (a bioidentical hormone in FDA-approved forms such as patches, creams or gels) and micronized progesterone (also bioidentical and government approved) might cause fewer blood clots. But we won’t know for sure until we see results from large-scale randomized trials, which may not be done anytime soon. Do different formulations of hormone therapy have different effects on blood pressure, cholesterol levels, progression of atherosclerosis, memory, or quality of life? The Kronos Early Estrogen Prevention Study (KEEPS) will answer many of these questions. Stay tuned because the results are coming soon. In fact, the first results from the trial will be presented at the NAMS Annual Meeting in Orlando in October.
    1 Comment
  • Good news about hormone therapy if you have had a hysterectomy

    by Margery Gass | Sep 05, 2012
    If you no longer have a uterus, you can use estrogen alone and perhaps use it longer than women with a uterus (who have to use estrogen plus progesterone or a similar compound). For you, the risk of breast cancer doesn’t go up for at least 7 years. In women who need to take both estrogen and progesterone, it goes up sooner—after 3 to 5 years. It is also important to note that all women who are at increased risk for stroke, heart disease, or blood clots are generally advised not to use hormone therapy.
    Go comment!

MenoPause: the blog!

Posts to our Blog are written by NAMS staff members and Dr. Margery Gass. All posts are reviewed and edited by Dr. Gass. We strive to bring you the most recent and interesting information about various aspect of menopause and midlife health. We accept no advertising for our website. We want you to have accurate, unbiased, evidence-based information. 

Margery L.S. Gass, MD, NCMP
NAMS Executive Director

An internationally recognized leader in the field of menopause, Dr. Gass became Executive Director of The North American Menopause Society in 2010. Dr. Gass has been an investigator on numerous research projects, including serving as a principal investigator for the Women’s Health Initiative, and has published and presented on a wide range of topics related to menopause, including osteoporosis, sexual dysfunction, and hormone therapy.

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