I haven't forgotten you!

I know it's been a while since I have posted.  I haven't forgotten you, a couple of things are going on:

• I have some sort of problem in my hip (I think it's a pulled tendon) that is making it very difficult to sit for more than a few minutes at a time.  Limits my computer use!  Even worse, it's screwing up my exercise routines (I am able to exercise some, but it's a lot slower, modified routines, and it's tough to keep up my core strength, which is so important for my back).

• The news right now is so dominated by election coverage, the meningitis outbreak from that one pharmacy in MA, and now, Hurricane Sandy that health related articles, particularly about menopause, are getting pushed to the back burner.  This happens sometimes when there are a bunch of big news stories all at once.  I'm sure once the election is over, the news will settle down a little and more articles that are appropriate for this blog will be featured. 

I'm from NY State, so of course, my thoughts are certainly with all of those in NY, and the other coastal states, suffering from that terrible storm that came ashore on Monday.  Here in NC, I live in an area that was actually largely unaffected, a few showers and wind and cold, but no property damage, loss of power, or anything like that.  NC was in the odd situation of having a hurricane warning at the east end of the state, and a winter storm warning at the west end of the state.  It's snowing about 2 1/2 hours from here in the NC Mountains, schools are closed and some have lost power.  Cold and gray here today; I went to the gym this morning, just got back from lunch with a friend, and now I am in for the day.  Plan to snuggle in for a little horizontal time to rest my back, and I think I will snuggle in with a good book.  Tomorrow I plan to put a big pot of chicken noodle soup in the crock pot ---- makes the house smell so good!

I promise to post any good articles about bioidentical hormones (or related menopausal issues) as soon as they come up, but for now, have a happy, safe Halloween.  Someone asked me what I was going to be for Halloween, and I said "home". 

Today is------

World Menopause Day (no, really, such a thing exists!)  I hope you all are celebrating it as I am, by not having hot flashes, having a good night's sleep, improved bone health, improved cardiac health, better cognitive function, and the list goes on!

Hormone update!

Good afternoon from sunny but cool North Carolina!

Thought it was time to update you a bit on my own "hormone journey"........

Back early this summer, I was experiencing problems with really disrupted sleep. I felt like I wasn't sleeping for more than 60-90 minutes at a time, and many mornings I was awake for the day by 5 am.  Not good.  Dr. Carr tested my estrogen level and found it had dropped even further, and he suggested that I begin taking once weekly estrogen (estradiol specifically) shots.  He gave me the option of using the creams instead, just like I do for progesterone and testosterone, but because my sleep was so disrupted he said doing shots would get my level up faster. 

I started the injections in early July.  The downside first. I gained 6 pounds in 2 weeks.  Took me 4 weeks, but I lost those 6 pounds.  Way upside----I can't tell you how much better my sleep is!!!!  I now sleep hours at a time and definitely feel more rested.  An additional benefit----I think my cognition seems to be better too, I just feel like my brain is working a little better---more focused, not as forgetful.  The estrogen costs about $50 for a five week supply (that includes my syringes), and the needle in the syringe is so small that I barely feel it.  I inject into my upper arm every Sunday morning.  This is far more cost effective than using the creams, and I only deal with it once a week rather than every day. 

I talked to Dr. Carr last week and we discussed how I was doing on the estrogen shots, and I asked him if testosterone by injection was available for women.  Turns out it is!  I'm really liking this because right now I am taking testosterone twice a day as a cream, and I sometimes forget that second dose in the early afternoon (plus I have to put it on my upper arm which is a pain in the winter when I wear long sleeves).  Starting next week, I will be taking a teeny, tiny dose of testosterone by injection weekly.  Besides being easier, this is going to be WAY more cost effective----the bottle of testosterone costs about $100 but will last for a year (remember, tiny dose), and my testosterone cream was nearly $100 for a 60 day supply! 

Now, this is not for everyone, particularly if you are not comfortable giving yourself injections.  I just wanted to let you know what is working for me, and if it's something you might be interested in pursuing, talk it over with your healthcare professional. 

Have a great week, everyone! I love the month of October, always so much to do, and the weather here in NC is gorgeous!  I made my annual trek to the NC State Fair earlier in the week, and as always, had a great time.  I posted some pictures on my Needle Notes blog if you would like to take a look.  A day out with my friends is good for my mind and spirit!

Compounding Pharmacies

You have no doubt heard a lot about compounding pharmacies in the news the last couple weeks.  My heart and thoughts go out to those affected by the contaminated spinal injections from the New England Compounding Center in MA ------ what happened was a terrible tragedy.  As someone who has had back injections in years past, it scared me and I understand how concerning it is to those of us who depend on compounding pharmacies for our bioidentical hormones. 

Important to remember that this was one pharmacy, not all compounding pharmacies as the media would like you to believe.  From my reading, the NECC went way beyond the scope of compounding into manufacturing, and the contaminated drug was something that was already readily commercially available and has been for years.  New England Compounding Center violated the scope of their pharmaceutical license, and they should and have been shut down.  For most of us who take our hormones transdermally (creams), intramuscularly (injections) or by pellet therapy, the body has natural defense barriers for contamination.  Those barriers to not exist for medications injected directly into the spinal coloumn. 

Also, the mainstream media is hyped up about how the FDA needs to crack down on compounding pharmacies.  The FDA stands for FOOD and DRUG ADMINISTRATION.  Their job is not to oversee pharmacies period, compounding or your local big box pharmacy.  That is the purpose of the state pharmaceutical boards, and they are collectively represented by the National Association of Boards of Pharmacies (NABP).  Click here for their mission statement and purpose. 

I am frequently asked how to find a compounding pharmacy in a particular area.  The Professional Compounding Centers of America lists their mission as:

PCCA’s mission is to strengthen the role, position and skills of member compounding pharmacists so they can meet the unique health care needs of patients through our exceptional service, highest-quality products, shared innovations and education.

I use their "find a compounder" tool frequently to help people find an independent compounding pharmacy in their area.  Every compounding pharmacy I have used for my hormones is a member of PCCA.

The Professional Compounding Accreditation Board (PCAB) is a group started in 2006 (thereabouts) to try to bring some order to the standards for independent compounding pharmacies.  Not all compounding pharmacies are PCAB accredited, and in fact, I understand from talking to several compounding pharmacists that the process is quite rigorous.  Only a handful of compounding pharmacies in each state are at this point accredited by PCAB, but my guess is that this number will increase over the next few years as compounding pharmacies a) become more popular with the increase in use of bioidenticals, and b) compounding pharmacies come under greater scrutiny by the public.  PCAB has a link to assist you in finding an accredited pharmacy in your area.  They also have a great page of information for consumers that is well worth taking the time to read. 

The International Academy of Compounding Pharmacists (IACP) lists their mission as: 

 to protect, promote and advance the art and science of pharmacy compounding. (IACP website)
They also have a  site for consumers  P2C2 (Patients and Professionals for Customized Care).  You can join their mailing list by clicking here, and/or their Facebook page here.

I hope this information helps; I know it's a lot to absorb and it can get very confusing.  However, it's worth the effort to research the issue, after all, this is your health we are talking about and compounded medications and hormones are every bit as powerful as any other medication we put in our bodies. It's important to be safe. 

HRC’s New Owner Defends Clinic

HRC’s New Owner Defends Clinic: HRC Medical will be in court next week trying to stop the state Attorney General from shutting the entire company down, after investigators found it had been run in a "persistently fraudulent manner."

This is an update to a post from last week about HRC Medical.  If you are a patient at one of their facilities, you just need to be aware of this, and possibly start researching other options if the company encounters other issues and you have to seek hormone treatment elsewhere. At the very least, find out what your options are as far as getting a copy of your medical records in case you need to change practitioners. 

Attorney General Seeks Closure Of HRC Medical (TN)

If you are a patient at HRC Medical at any of the TN locations (I believe they are located in Nashville, Memphis and Knoxville), you need to check this article out from NewsChannel5.com.  The station did an investigative report on HRC Medical earlier this year, and the TN Attorney General's offfice has taken action based at least in part due to the findings of the investigative piece. 

Also, there are issues with HRC Medical in the state of NC.  This letter to Dan Hale, the now retired head of the company, from the Attorney General of the state of NC, is interesting reading.  I've gotten a number of complaints about the NC centers located in Cary and Charlotte. 

On another topic, I am certainly aware of the issues with the fungal meningitis in the news recently and that the steriods injected came from a compounding pharmacy.  Please bear in mind this was one pharmacy, and from what I have read and researched, this is not the norm for compounding pharmacies.  I am compiling a list of ways to check out the safety record of a compounding pharmacy you may be considering, and I will have a post about it up shortly, hopefully by the weekend.  Also, you are hearing a lot in the news about how "lax" the FDA is on compounding pharmacies. That's very misleading, that's like saying the FDA is far too lax in handing out driver's licenses -------- compounding pharmacies are not under the jurisdiction of the FDA.  Pharmacies, compounding and otherwise, are regulated by state pharmacy boards.  Much more on that, too!

Source: healthland.time.com via Andrew on Pinterest

You Are Not Your Body: Janine Shepherd at TEDxKC

This woman is my hero!

Wow. As someone who was bullied as a kid and even reecently as an adult about her weight, this woman is my hero.

Like Fine Wine, Sex Gets Better With Age

I'm going to play devil's advocate here a bit ----- check out this article from The Huffington Post.

A couple of points here:

The article talks about having spontaneous sex (and keeping the blinds closed).  If you are (bioidentically) hormonally balanced, chances are your libido is healthy and this is great if it happens.  If you are depleted of hormones, a whole different story.  You are tired because you're hormonally imbalanced, and your sleep is likely disrupted by your lack of estrogen.  If you're tired, you don't want sex, you want to sleep, or at least rest.

If you are hormonally balanced but your husband isn't, HE may be the one not wanting sex.  Low testosterone causes fatigue, loss of libido, erectile problems.  For a satisfying partner relationship, it needs to be satisfying for both partners!

Point number five in the article is very important----if you are not in a long term, monogamous relationship, absolutely protect yourself from sexually transmitted dieases.  Just because you can no longer get pregnant doesn't mean you don't need a condom with a male partner. 

Point number six struck me as odd ---- you'll have more time and energy to devote to your relationship.  Not necessarily, see above about fatigue, loss of libido, etc if you are not hormonally balanced, and many of my friends who are about my age are not only dealing with children who are teens or in their 20s, but also dealing with aging parents.  Some tell me they have never felt more overwhelmed in their lives!

Wishing you all great sexual health!