Del Meyer, MD, Pulmonary Medicine

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Compounding and Women's Health at Midlife

by Michael Goodman

Back in the "old days" all pharmacists compounded. With limited availabilities of commercial pharmaceuticals, many medications and treatments were personally made up and put together --"compounded" -- for the unique needs of each individual. Both dosage, medication (singly or in multiple combinations) and delivery system (pill, capsule, sublingual drop or troche, transdermal gel, lotion, cream, etc.) could be personally compounded by the pharmacist.

All pharmacy students still learn compounding in school, but most do not utilize this skill. There are approximately 2,500 compounding pharmacies in the US, compared to +/- 40,000-50,000 "regular" pharmacies. You may locate a compounding pharmacist in your area by contacting the International Academy of Compounding Pharmacists at (800) 927-4227 or at www.iacprx.org, or check with Professional Compounding Centers of America at (800) 331-2498 (www.pccarx.com). There are excellent compounding pharmacies in Davis, Woodland, Sacramento, Gold River and Auburn.

Upon receiving a prescription or consulting directly with a physician and/or the patient, the pharmacist takes the necessary ingredients (frequently bioidenticals derived from plant sources) and compounds (or blends) them to meet the specific needs of the individual.

Many different medications may be compounded (including medications for pain relief and novel ways of giving medications to children). For the purposes of this article, I shall only be discussing those that impact health care for midlife women. These preparations can include estriol, estradiol, estrone, progesterone, testosterone, DHEA, pregnenolone and others.

WHY COMPOUND:

A majority of women do quite well on commercially available fixed-dosage products. Why, then, compound? The reasons are multiple.


AVAILABLE PRODUCTS FOR WOMEN
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ECONOMIC FACTORS
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Just because a medication is "hand fashioned" does not necessarily mean that it costs more, although this frequently is the case. Because of economic factors and the inability of managed care organizations to make low-cost "deals" with individual pharmacists, many managed care plans (HMOs) do not pay for compounded preparations, although compounding is covered by many PPOs. As in everything else in medicine (as elsewhere), "you get what you pay for..."

Dr. Goodman’s office "Caring for Women" is in Davis, California. Dr. Goodman is the author of the recently released "The Midlife Bible: A Woman’s Survival Guide", available at bookstores or on his website, www.caringforwomyn.com.

(Please note: Articles that appear on this web site may not reflect the opinion of the editorial staff.)