Supporting Your Access to Compounded Medications
As part of our continuing efforts to support your access to compounded medications, we sent three of our pharmacists to Washington, DC, to attend the International Academy of Compounding Pharmacists (IACP) Compounders on Capitol Hill meeting held on May 20. During a full day of interaction with legislators on Capitol Hill, the following topics were discussed:
- The Drug Quality and Security Act (DQSA) is designed to protect patients from potentially harmful medications. Enforcement and communications should be clarified between Federal and State Regulators. The Congressional intent of this Act is in danger.
- Fiscal Year 2015 Food and Drug Administration (FDA) budgetary appropriations should be followed as dictated. It is not appropriate to use budgets to pursue issues outside of jurisdictional guidelines.
- H.R. 4069 - Ensuring Patient Access and Effective Drug Enforcement Act - with a Manager's Amendment: Currently the DEA does not allow a pharmacist to dispense a controlled substance to the patient's doctor for administration to the patient. It is in the best interest of the patient to allow pharmacists and physicians to make the best medical dispensing decision to maintain the integrity of the medicine.
Thank you for your continued support when requested. Working together will help maintain your access to compounded medications!
Voicing the Problem
Carol Petersen, RPh, CNP- Women's International Pharmacy
We have all heard it. Your aging mother's voice has changed. It cracks, it quivers, it wobbles, and the tone is lower. The voice you hear over the phone is breathy and lacks the robustness it once had. You suddenly realize, this is the voice of an old person.
Unlike the dramatic changes a young man's voice goes through at puberty, the changes that happen to a woman's voice are gradual, often taking years to present.
A woman may use facelifts, tummy tucks and Botox to "stay young" but her voice will still betray her. She will still have an old person's voice, and it seems there is nothing she can do about it. Or is there?
Book Review: The Secret Female Hormone: How Testosterone Replacement Can Change Your Life by Kathy C. Maupin, MD, and Brett Newcomb, MA, LPC
Reviewed by Carol Petersen, RPh, CNP- Women's International Pharmacy
Dr. Kathy Maupin suffered greatly from the loss of testosterone when she had a hysterectomy and oophorectomy due to endometriosis. Replenishing with testosterone pellets has literally given her back her life. She writes passionately about what she and her patients have experienced when testosterone is restored. One of her goals is to enlighten other physicians about her practice model with the hope that more people get access to testosterone.
Dr. Maupin observed positive effects in many aspects after treating her patients for testosterone deficiency, including the following:
- Loss of libido. "Sex is science and not magic" as Dr. Maupin asserts. Restoring testosterone relieves the loss of interest in sex, the loss of wanting to be touched, and the tendency to create grocery lists in your mind rather than enjoying intimacy. You can get it all back with testosterone restored.
- Fatigue. Fatigue is at the top of the list of complaints that brings women in to see a physician. There are many causes for fatigue, including low testosterone. In addition, other complaints that contribute to fatigue (such as depression, hypothyroidism, hypoglycemia, and loss of interest in exercise) can be triggered by low testosterone, as well.
- Insomnia. Sleeplessness related to a testosterone deficiency occurs when there is a loss of deep sleep and dreaming, wakefulness in the early morning hours, and waking up feeling fatigued and not restored. Insomnia typically first occurs after the age of 35, just as testosterone levels start to drop.
June is Migraine and Headache Awareness Month-Can Estrogen Help?
Kathy Lynch, PharmD - Women's International Pharmacy
40% of women and 20% of men experience migraine headaches in their lifetime. Up to 60% of female migraine sufferers have headaches associated with menstruation. According to the International Headache Society, menstrual migraines without aura (a pre-headache visual, sensory, motor or verbal disturbance) can begin 2 days before to 3 days after bleeding starts.
Possible triggers include a decrease in estradiol, release of inflammatory substances from the uterine lining, low magnesium, decreases in certain brain chemicals like serotonin and GABA, dehydration, suspected foods and insufficient sleep. Some migraine specialists believe that a decrease in estradiol levels is the most likely trigger.
According to Dr E. Anne MacGregor, raising pre-menstrual estradiol levels can help to avert or minimize the effect of these migraines. Maintaining estrogen in a range of 45 to75 pg/ml may reduce the intensity and frequency of migraine headaches. Estradiol 1.5mg gel, applied 6 days prior to bleeding and continued through day 2 of menses, has been shown to effectively decrease the number of migraine days in some women. Extending this time period beyond day 2 and tapering the dose may help prevent "withdrawal" headaches caused by stopping estradiol abruptly. Progesterone may also help decrease these "withdrawal" headaches because progesterone helps regulate pain and pain perception through GABA receptors in the brain.
"Menstrual Migraine: Therapeutic Approaches" by E.A. MacGregor; Ther Adv Neurol Disord; 2009; 2(5): 327-336.
"Migraine in Women: The Role of Hormones" by R.A. Bellanger; US Pharm; 2012; 37(9): 29-32.
"Menstrual Migraine: New Approaches to Diagnosis and Treatment" by V.T. Martin.