Compounding Pharmacies Help Personalize Male Bioidentical Hormone Therapy

It’s no secret that as we age, our bodies produce fewer hormones. While women experience drops in estrogen hormones, leading to menopause, men also experience drops in testosterone, which can lead to andropause or “manopause”. Both of these conditions are associated with low libido, increased fat mass and other quality of life issues that come with low levels of testosterone in older men.

Craig Batogowski, PharmD and co-owner of Mark Drugs Pharmacy, in Deerfield and Roselle, explains that men generally produce their peak testosterone levels between the ages 25 and 35. “But as you get older, the enzyme machinery you had might start to wear out and not produce as much testosterone that you could at one time,” he says. “By the time men are in their 40s, the body’s testosterone production begins to gradually slow down significantly.”

Solutions can include bioidentical hormones, which are identical copies of hormones that the body makes. They are available off the shelf by prescription from a medical provider.

Men can have their medical provider test for testosterone levels. If they are low or at the low end of “normal,” bioidentical testosterone can be administered to help mitigate symptoms and possibly lose body fat, and increase muscle mass and libido. Batogowski points out some misconceptions about bioidentical hormones, such as their association with bodybuilders, or that one will become bulky or very large after using them.

“Hormones used for bodybuilding contain super-high levels of testosterone, more than you would have produced naturally during your peak years,” Batogowski says. “Bodybuilders also may use synthetic testosterone analogs. Those are things that don’t occur in nature and are considerably stronger than natural testosterone.”

He adds that because synthetic testosterone analogs are stronger, there is increased potential for side effects and the body might stop making its own testosterone all together. “There is a balance you need to achieve. That’s why consistent monitoring is crucial to make sure a patient is achieving healthy, desired levels.”

Compounding Pharmacies Help Customize Medications for Best Results

Because compounding pharmacies have more of a direct practitioner-to-pharmacist relationship, pharmacists such as Batogowski can guide clients toward a medical professional such as a nurse practitioner, osteopath or medical doctor that has experience with a client’s particular situation.

Once a patient has an idea of what he needs, the pharmacist can help recommend solutions that might include prescription bioidentical testosterone; however, the products available off the shelf are often only available in one strength. This can be troublesome when a patient might need a stronger or weaker dose. “We can compound a cream or gel to a specific dose that meets the clients’ needs, ” says Batogowski.

A compounding pharmacist can also adjust bioidentical hormone prescriptions for people with allergies. They can remove an irritant or substitute with another ingredient to create a hypoallergenic form.

Building a Patient Wellness Team

Batogowski says the practitioner-pharmacist-patient relationship is crucial to building a wellness team that will best serve each patient’s needs. Whether a patient wants a holistic or a nutrition/food-based approach toward improving their quality of life, or if they want a prescription, a pharmacist that works closely with a prescriber can help dial in the right medicine for the best outcomes.

“There are times that I’m also educating not just a patient, but also prescribers about bioidentical hormones,” he notes. “Some practitioners are familiar with what was taught in school, but have less experience with customized hormones. That’s where I come in to work with them on appropriate starting doses and monitoring.”Batogowski emphasizes that while using bioidentical hormones, regular monitoring is key for both success and for the safety of the patient. “By using a compounding pharmacy, you are getting medication customized for you. I find it can be more effective for patients to at least be offered customized medication solutions right out of the gate.”