Compounded hormone therapy may not pose same risks as commercial drugs

Hormone replacement therapies have great impact on women and couples

Kenny Walkup, BSPharm, often receives thank-you calls from husbands grateful for the compounded preparations he provides to their wives.

“They say, ‘You’ve given me my wife back,’” said Walkup, owner of Specialty Medicine Compounding Pharmacy in South Lyon, MI.

The compounding pharmacy creates special formulations of hormone replacement drugs for patients who cannot take those commercially available or simply prefer an alternative.

Women may take hormone replacement drugs to treat the symptoms of menopause after their natural hormone levels have begun to drop.

In its commercial form, combination hormone replacement therapy for women contains either a progesterone that is bioidentical to the hormone the body produces or a synthetic version called progestin. A 2010 study showed that combination estrogen and progestin replacement therapy put women at increased risk for breast cancer, heart attack, stroke, and blood clots.

It was at this time that Walkup began to see an uptick in women interested in more natural alternatives to commercially available therapies. Commercial progesterone comes in a 100- or 200-mg peanut oil–filled capsule. Many doctors want a different strength or a drug without peanut oil.  In those cases, a compounded preparation is needed.

“We make estrogen and progesterone that are identical chemically to what their body produces,” Walkup said.

For women who feel safer not taking the medication by mouth, the pharmacy creates topical creams or gels.

While the trend toward alternatives to synthetic hormones began as a patient preference, scientific data to support it are beginning to emerge. The 2012 KEEPS (Kronos Early Estrogen Prevention) study, presented in October to the North American Menopause Society, found that progesterone therapy, like the one Walkup compounds, improved many symptoms of menopause without the risks posed by progestin.

In addition to hormone replacement therapy, Walkup compounds many other prescription drugs, including drugs for pets.  He attributes the high quality of his products to his store’s accreditation by the Pharmacy Compounding Accreditation Board.

“Being an accredited pharmacy allows us to have standards and procedures in place to produce what I believe is the highest quality compound we can make.”