OTHER

5-ALA 5-Amino Levulenic Acid
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Acidophillus Lactobacillus Bifidus
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Boric Acid Pessaries
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Cycloserine Capsules
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Dibella Antioxidant Capsules
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Dose Reduction Schedules
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Estradiol Implants (Pellets) 100mg X 1
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GABA Gamma Aminobutyric Acid
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HGH Human Growth Hormone
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Hypertonic Saline Eye drops/ointment
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Indolplus(DIM) tablets DI-INDOLYLMETHANE
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Lactase Capsules
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Metronidazole
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Testosterone Implants (Pellets)
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Vitamine B12

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MENOPAUSE

Strictly speaking menopause means your final menstrual period.

More commonly it is the decade in which the ovaries stop developing eggs and there is a decline in hormone levels, most notably estrogens.

Menopause is the “change of life” brought about by biological changes that may carry with them immense physical and
emotional changes.

The root of vasomotor menopausal symptoms is the decline in estrogen levels. When this level is elevated the physical discomforts can be alleviated. Low estrogen may cause hot flushes, night sweats, vaginal atrophy and emotional displays.

Estrogen is in fact a class of hormones made up of three players – Estrone, Estradiol, and Estriol. Estradiol is the primary estrogen produced by the ovaries and is the key to the change in a woman’s body. At puberty it is instrumental in the development of breasts, genitalia and the extra layer of fat under the skin. When menstruation starts other hormones enter the picture, mainly progesterone.

From the beginning of the menstruation cycle to about day 14 estrogen flows, peaks, and then declines. At this stage (day 14) progesterone production starts to increase reaching a maximum at about day 22 after which it starts to fall dramatically (if no fertilized egg) until day 28 when menstruation occurs.

This cycle continues for the next 35-40 years.

Ovarian estrogen and progesterone begin to decline during a woman’s 30’s but do not become evident until her 40-50’s when cycles become irregular and the classic symptoms of menopause appear, i.e. night sweats, hot flushes, etc.

With this decline in estrogen the risk of heart disease, osteoporosis, and memory loss, increase.

ESTROGEN REPLACEMENT THERAPY

Estrogen replacement has profound and immediate effects on menopausal symptoms (hot flushes, vaginal dryness, night sweats, sleepless nights, depression, reduced libido, lack of enjoyment of sex, urinary incontinence, vaginal and bladder infections). However taking estrogen alone increases the risk of uterine cancer. In the body, estrogen does not exist by itself, it is balanced by progesterone. It is crucial to supplement estrogen with progesterone to re-establish the natural hormone balance, because these hormones are antagonistic in many ways and block actions of each other in certain circumstances.

NATURAL HORMONE REPLACEMENT FOR MENOPAUSE.

Considering a patient who is not taking any form of HRT, test the serum levels of estradiol, progesterone, testosterone and DHEA to obtain a baseline from which to determine a starting formula. This starting dose calculation is an educated guess as two factors are unknown i.e. the absorption rate and the level of estrogen we are aiming at. We don’t know their estrogen secretion levels in their premenopausal days, hence we don’t know where we’re aiming.

In a patient with severe estrogen deficiency problems and no history of cancer, estradiol will give the most immediate results with hot flushes disappearing within a couple of days. If the dose is too high, breast and nipple tenderness will rapidly appear and the only way to remedy this is to reduce the estradiol dose until the flushes reappear, then incrementally increase estradiol until they cease.

Using triest, which is a combination of all three estrogens (10% estrone, 10% estradiol and 80% estriol) the above problem is less likely to occur. Although a little slower, it is probably the best way to go.

Progesterone replacement is not as tricky and as long as the dose is high enough to hold the estrogen proliferation. From experience, a dose of 150-200mg of progesterone per day is usually adequate, with a Triest : Pg ratio of 1:100.

Testosterone is also very important, and not only for the libido consideration. Testosterone may also be considered a weak estrogen as it also breaks down to estrone and estradiol. Also it is a natural antidepressant – particularly noticeable in women who have had hysterectomies.

DHEA, is also a good addition for several reasons, the main being that because DHEA itself is metabolised to testosterone, estrone and estradiol, it helps to balance the formula if it is not exactly “spot-on”. The independent effects of DHEA, namely that feeling of well being, should not be overlooked.

The form that we make our Natural hormone replacement in is called a troche and a typical female HRT dose is:

  • Triest 1-5mg
  • Progesterone 50-200mg
  • Testosterone 0.5-5mg
  • DHEA 5-25mg

PATIENCE

Don’t give up on hormone replacement therapy after a month. Some women on HRT will notice results immediately while others may not for several months. In these cases spend 3-4 months noting symptoms and adjusting hormone doses to devise a personalised HRT program.

Exercise has a decidedly beneficial effect on hormone balance and women who participate in regular physical activity have an easier transition through menopause with noticeably fewer hot flushes. At least three to four hours per week of moderate exercise is recommended.

Read our SIGNS AND SYMPTOMS document and take the HORMONAL TEST

VETERINARY COMPOUNDING

Veterinary Compounding making medication a treat for pets.

SOLVING DOSAGE PROBLEMS.

Because of the different shapes and weights of animals, commercially available medicines are not always appropriate. They often come in large capsules or extra large doses of 100mg or more for human use. A small kitten may only need a dose of 15mg. That’s where compounding is especially helpful. We can compound a tuna flavoured suspension with the amount that is exact for the pet’s weight and condition. Dosages for dogs can also be very tricky. An antibiotic effective for a 40kg Rotweiller would be too much for a 4kg Chihuahua.

FLAVOURED MEDICATIONS

The pet that refuses to take medication because of the taste is often a prime candidate for compounding. Cats don’t like pills, but most like tuna. Dogs don’t appreciate a traditional solution of amoxycillin being squirted into their mouths, but will gladly take it when it’s part of a tasty biscuit or treat. Take a look at the list of available flavours here.

By working closely with veterinarians, a compounding pharmacist can prepare medicines into easy-to-give flavoured dosage forms that animals devour, whether the animal is a cat, dog, ferret, bird or snake.

COMMERCIALLY UNAVAILABLE MEDICINES.

Sometimes manufacturers will discontinue a medication used in veterinary applications. A compounding chemist may obtain the pure bulk pharmaceutical and prepare a prescription for the discontinued product.

Contact us with any request large or small.

Veterinary Pet Compounding Pharmacy

IVF / Assisted Reproduction

IVF / Assisted Reproduction
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Progesterone Oily Injections
  • 50mg/ml 1ml and 2ml vials, DHEA 25mg tablets
 Oxford Journals Medicine & Health Human Reproduction Volume 32, Issue 1

Oxford Journals, Medicine & Health
Human Reproduction                     Volume 32, Issue 1

Human Reproduction features full-length, peer-reviewed papers reporting original research, concise clinical case reports, as well as opinions and debates on topical issues.

PMS

Premenstrual Syndrome (PMS) is a group of physical and emotional symptoms that occur before your menstrual period begins. It is a complex disorder affecting millions of women.

WHAT IS PMS?

Premenstrual Syndrome is the recurrence of certain symptoms before menstruation with complete absence of symptoms after menstruation.

These symptoms should not be present for more than fourteen days prior to menstruation, as this is the number of days from ovulation until menstruation, and they must be noted for a minimum of two cycles. The complete absence of symptoms after menstruation should be at least seven days. It is this absence of symptoms after menstruation that makes the diagnosis of PMS complete.

Take the PMS test

SYMPTOMS

The duration of PMS varies enormously. It may be a black depression that lasts fourteen days, to migraines that last a day or two, to an epileptic seizure that may last only a few minutes. Symptoms are always at their worst immediately prior to menstruation as this is the time when progesterone is most required.

VARIATIONS

Although the average menstrual cycle is considered to be 28 days, PMS treatment must take the length of the individual’s menstrual cycle into consideration.

It is important to note that PMS can occur in a cycle when ovulation does not take place as well as in normal ovulatory cycles. PMS may also recurr after recovery from the trauma of hysterectomy, with or without removal of both ovaries.

PMS TREATMENTS

PMS is universally recognised and is treated in many and varied ways from aspirin to antidepressants, with symptoms both physical and psychological. With the advent of molecular microbiology and the discovery of progesterone receptors, a whole new protocol for the treatment of PMS has evolved. With this advanced medical knowledge and the acceptance of these receptors, treatment should be aimed at ensuring their maximum function. To do this effectively a three pronged approach is required. By this we mean that lifestyle adaptations may be required – stress, if present must be relieved, the blood sugar level must be maintained, and finally the appropriate progesterone therapy must be applied.

PRE-TREATMENTS

Medical Background

  1. Establish a full hormonal medical background (eg. ability to tolerate the pill)
  2. Keep a menstrual chart for at least two months, as the timing of the symptoms is essential.

Diet

  1. It is essential to maintain blood sugar levels.
  2. Consider the patient’s normal diet (weekdays and weekends)
  3. Check the BMI and gauge fluid retention.

Sleep Patterns

Consider the quality and duration of sleep.

The Three Hourly Starch Diet

If there is a drop in blood sugar, progesterone receptors cannot bind to or transport progesterone. Thus even if your serum progesterone levels are normal, progesterone deficit symptoms will be evident.

As blood sugar levels fall, adrenaline is released which causes sugar to be transported from within the cells to the bloodstream. As this sugar goes into the blood it is replaced by water. This in turn causes fluid retention and bloating and subsequent weight gain.

To make the situation even worse, consider the effects of this adrenaline in the blood. Adrenaline is the hormone that causes the “fight, flight or fright” response- the emotions that are exacerbated by PMS.

It has also been established that progesterone levels drop after a large meal, thus women with PMS should eat smaller meals more frequently. This is why the three hourly starch diet has been established. If it is not followed, buckets of progesterone will not help.

Starchy foods are the ones containing wheat, potatoes, oats, rice, rye and corn. The starch diet does not mean that you stop eating healthy, varied and nutritious food. It simply means that you modify it by adding starchy snacks every three hours, eat within an hour of going to bed and within an hour after rising. By doing this your main meals will be reduced as your hunger will be less and many people on this diet actually lose weight.

It will take seven days to feel the benefits of this diet and another seven if you break it by going for long periods without eating. Often it has been found that by simply following this diet PMS symptoms disappear.

Treatment of PMS using Progesterone

OSTEOPAROSIS

Osteoporosis is a major problem throughout the world today.

The increase bone mass or density, many steps involving hormones, vitamin and mineral supplementation, load bearing exercise and lifestyle modifications must be undertaken to make a significant impact.

PHYSIOLOGY OF BONE

Bone is a living structure made up of very specialised cells that constantly model and remodel the state of the bones. It is a honeycomb of cells that in the extreme osteoporotic state looks like a torn fishing net. Thus, from a dense mass the breakdown of these cells leaves a most unstable structure that will fracture very easily.

The two types of cells are, osteoclasts that control the modeling/remodeling of the bone by absorbing calcium. Osteoclasts travel through bone tissue and when they come across old bone they dissolve and resorb it, leaving tiny spaces or pores in its place. The second type are the osteoblasts that follow on, lay down new bone, filling the defects caused by the osteoclasts. This goes on through youth to middle age. When the number of osteoblasts outnumber the number of osteoclasts, osteoporosis begins. Thus the whole idea is to increase the number of osteoblasts at the expense of the osteoclasts.

WHY AND WHEN

Treatment for osteoporosis should be started sooner rather than later. To expand on this consider the following facts:

 

AGE RANGEFRACTURE ANYWHEREFRACTURE OF HIP
50-5914.8%3.9%
50-6921.6%8.0%
70-7938.5%24.5%
80+70.0%47.5%

 

Risk of osteoporosis also varies according to genetic and controllable factors. If you have a body weight less than 60kg, had menopause before 45, do less than 4 hours exercise each week, smoke, drink more than two alcoholic drinks per day, and have a low calcium diet, then you are at a high risk to suffer from osteoporosis.

With lifestyle modifications in place, the addition of hormones will have a major impact on the result. The hormones that are required are estrogen, progesterone and testosterone and even DHEA to a lesser extent. Osteoclast activity is decreased by all these hormones.

In osteoporosis, bones lose calcium as well as other minerals and become weaker and increasingly prone to fractures, even after mild impact. The most susceptible bones are those in the hip, shoulder, wrist and spine.

Women’s bones reach their peak in their mid-thirties when a slow decline begins until menopause, when it accelerates at a rate of 1-1.5% per year. As osteoporosis accelerates so rapidly after menopause (or surgical removal of the ovaries), it is apparent that both estrogen and progesterone must play a part in this complex procedure. Bone density rises because estrogen and progesterone act directly on bone tissue to enhance mineral deposition. As their levels drop, bone loss occurs and bone density decreases. If estrogen and progesterone are replaced, bone loss can be reversed. The earlier this replacement therapy is started the better the results.

It should be noted that estrogen acts mainly to stop further bone loss and, as at this point in time, estrogen in itself does not promote bone regrowth. Other studies with regards to the role of testosterone, indicate that it plays a part in the reversal of osteoporosis.

Dr John Lee states “Postmenopausal osteoporosis is a disease of excess bone loss caused by progesterone deficiency and secondly a poor diet, and lack of exercise. Progesterone restores bone mass. Natural Progesterone is an essential factor in the prevention and proper treatment of osteoporosis.”

Over a ten-year period Dr. John Lee found that, in a group of women, of average age 65, who had already experienced considerable bone loss, natural progesterone replacement resulted in remarkable bone density increases. Some increases were 20-25%, while the mean increase was 15.4%. This was over a three-year period where the average loss would be expected to be 4-5%, if they had not been on progesterone.

Long term clinical trials using synthetic estrogen and progesterone showed a result of a 3-5% increase.

However it must be emphasized that taking progesterone is not the complete answer, as diet, weight bearing exercise and lifestyle play a major role in the big picture.

Do the self test for Osteoporosis and Read more about Natural Progesterone

DERMATOLOGY AND SKIN CARE

5-ALA 5-Amino Levulenic Acid
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Bleach and Fade Gel
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Clobetasol Cream
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Collagen Cream
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Estradiol Cream
  • Prescription Only
Estriol Cream
  • Prescription Only

ESTROGEN CREAMS

The coincidence of climacteric symptoms and the beginning of skin aging is directly associated with estrogen deficiency. As we age into menopause the estrogen levels begin to fall with the subsequent aging and lining of the skin. By application of refined estrogens (either estriol perimenopausally or estradiol menopausally) this process may be reversed by use of this therapy.

Available on prescription only

ESTROGENS AND THEIR USE AS FACIAL CREAMS

A dermatological cream has three primary functions :

  • To protect the skin from the environment and permit skin rejuvenation
  • To provide for skin an emollient or hydration effect
  • To provide a means of conveying medication to the skin for a specific effect either systemically or, as in this case, locally.

The cream is elegant, nonallergic, nonsensetising, low-irritant and stable.

SKIN AGEING

The coincidence of climacteric symptoms and the beginning of skin ageing suggests that estrogen deficiency may be a common and important factor in both the peri- and menopausal woman. Often hormones have been considered important in endogenous ageing of skin. Thus by using topical application of estrogens this ageing may be reversed eg by either estradiol 0.01% cream for the menopausal and postmenopausal woman, or estriol 0.3% cream for the premenopausal woman- available only on prescription. From research we have found that elasticity and firmness was markedly improved after a period of six months, and wrinkle depth and pore size had decreased by 61-100%. Furthermore, skin moisture, type III collagen and the number of collagen fibres all improved dramatically. With all these external benefits no systemic absorption was found, and thus no estrogenic side effects occurred. From studies done it has been found that at the and of a six month clinical trial, marked improvement of skin ageing symptoms was noted;

  • Clinical improvement of specific skin parameters was evaluated and was seen in 9-19 weeks with estradiol and 7-17 weeks with estriol.
  • Improvement in skin elasticity and firmness was noted after 13 weeks with estradiol and 11 weeks with estriol.
  • Improvement in skin moisture was noted after 9 weeks with estradiol and 8 weeks with estriol.
  • Improvement in wrinkle depth was noted after 16 weeks with estradiol and 17 weeks with estriol.
  • Reduction of pore size was noted after 19 weeks with estradiol and 16 weeks with estriol.

All the above improvements appeared in 61–100% of cases.

In more detail wrinkle depth reduction was significant with estradiol and highly significant with estriol. Side effects were more pronounced with the estradiol group than the estriol group.

Both estradiol and estriol exhibited significant effect on increasing collagen fibre and striking increases in collagen III. This is why skin was firmed and wrinkles reduced. Type I collagen is predominantly in adult skin while type III is although distributed about the body is predominant in fetuses.

The positive effect of the estrogens on hydration was noted in all patients. This may be due to the increase in skin thickness with subsequently elevated amounts of natural moisturising factor.

CONCLUDING

By considering the results of topical estrogen treatment in skin ageing in women, a better insight can be gained as to the hormonal aspects of endogenous ageing of the skin. Various structures involved in skin ageing are under hormonal control. If decreased estrogen levels contribute to decreased functions of the skin, local estrogen treatment of the skin would in turn represent a local hormone substitution therapy of the skin. So far, estrogen compounds and, in particular estriol represent a new and promising therapeutic approach towards skin ageing in peri and menopausal women.