Featured Topics

Improving Androgen Deficiency in Women with a Compounding Pharmacy

Improving Androgen Deficiency in Women with a Compounding Pharmacy

Androgen deficiency in women is a controversial but nonetheless significant topic in the fields of medicine and research at both large pharmaceutical drug manufacturers and at the local community compounding pharmacy. Androgen production is crucial in maintaining normal cognition, bone growth, muscle function, mood, and sexual health. After a woman turns 50 years of age, there is a gradual decrease of androgen hormones; by 70 years of age, it is said that most women maintain only about 10% of their peak androgen level. This decline warrants healthcare professionals, such as physicians and compounding pharmacists, to dive into the discussion of the important roles that androgen play in the healthcare of the aging woman. Furthermore, this post will aim to discuss androgens in the form of bioidentical compounded testosterone and explain the potential of natural hormone replacement therapy (HRT) as the solution to androgen deficiency.

Androgen Production in Women

Androgens are sex hormones that are commonly synonymous to men; however, women also produce these same androgen hormones as well. The three main androgens produced in women are testosterone, androstenedione, and DHEA. The release of these androgens plays a significant role in the normal cascade that starts puberty and the development of womanhood. These androgens originate from the ovary and adrenal glands, with levels rising during the midcycle surge of ovulation, which is around day 14 of the menstrual cycle.

Testosterone is 10 times more potent than androstenedione and 20 times more potent than DHEA. Even so, testosterone levels in women are only about 10% what men naturally possess. Moreover, there are only 1 to 2% of total testosterone that are “free testosterone” or available for biological activity. This means that as a women ages, the decline of androgens can be even more detrimental for regulation of a woman’s system due to the limited amount of active androgens already available.

Androgen deficiency may affect women at any age, but most commonly occur during the transition to menopause, or before menopause — also called "perimenopause," typically two to eight years before menopause. With clinical studies and anecdotal observations, specialists have narrowed down the symptoms of low androgen in women to the following:

  • Lethargy
  • Decline of libido
  • Loss of motivation
  • Decreased mood
  • Lowered sense of well-being
  • Diminished muscle mass
  • Reduced muscle strength

Despite such a prevalent, reversible problem, most women are not properly evaluated and do not get the right treatment. It can be difficult to determine the exact level of a woman’s androgen supply since they vary depending on when it was tested. They change not just in relation to a woman’s menstrual cycle but based on the time of the day as well. In addition, the amount of testosterone circulating in a woman’s blood does not accurately reflect the amount active inside her body cells.

To determine accurate testosterone levels, it is essential to have them tested in the morning when androgen levels peak, and 8-20 days after the beginning of a menstrual period. The normal and optimal reference ranges for androgen levels in women are as follows:

  Optimal Reference Range Standard Reference Range  
DHEAs (mcg/dl) 280 80-480 Recommended
DHEAs (ng/ml) 2800 800-4800 Recommended
DHEAs (mmol/L) 9.7 2.8-16.6 Recommended
DHEAs (nmol/L) 9716 2800-16600 Recommended
Androstenedione (ng/mL) 2.2-2.5 1.0-3.5 Optional
Androstenedione (nmol/L) 7.7-8.7 3.5-12.2 Optional
Total testosterone (ng/dl) 35 10-50 Recommended
Total testosterone (pg/ml) 350 100-500 Recommended
Total testosterone (nmol/L) 1.2 0.3-1.7 Recommended
Free testosterone (pg/ml) 8/td> 2-15 Recommended
Free testosterone (nmol/L) 0.028 0.007-0.052 Recommended
Free testosterone (pmol/L) 28 7-52 Recommended
SHBG (mg/L) 6.1 3.8-7.4 Recommended
SHBG (pmol/L) 65 41-79 Recommended

If a woman’s androgen blood levels are not in the optimum range, it is critical that to get a full medical check-up. For those who have been tested to have low androgen levels, it is advisable to use compound medications that off natural, bioidentical HRT instead of commercially available options.

The Problems with Commercially Available Androgen Solutions

Most testosterone therapies are designed for men. This means that their potency and dosages are too high for women. Furthermore, they are not specially formulated to address the varying levels of androgen production throughout women’s lifecycle. Using commercially available solutions can put a women’s health at risk due to a possible overdosage of androgen therapy.

Compounded bioidentical HRT for androgen deficiency is a great alternative to the one-size-fits-all solutions available in the market today.

  • Bioidentical hormones share the same chemical structure of the human hormones, allowing the body to synthesize and use them efficiently
  • Compounded HRT is specially developed for the patient’s unique needs and background
  • Compounded HRT is updated regularly to suit the patient’s hormone levels and ensure its efficacy

At Harbor Compounding Pharmacy, we compound testosterone and DHEA formulations as low as 0.01mg to as high as 50mg for women. They can be compounded into various forms such as

  • creams
  • topical solutions
  • sublingual suspensions
  • sublingual troches
  • slow release capsules
  • Immediate release capsules

We offer a plethora of base creams that exhibit hypoallergenic profiles for vaginal applications without compromising absorption. We can also provide testosterone in static or rhythmic dosing, like in the Wiley Protocol. In addition, patients can also have all their hormones formulated into one product, e.g. estriol/estradiol/progesterone/testosterone combination cream. These are the major advantages in comparison to the traditional medications commercially available.

Visit Harbor Compounding Pharmacy today. Call us at 949-642-0106 and we will work with your doctor to determine the right combinations and dosage for you.

References

  1. Cutter, Christopher B., MD (2004). Androgen Deficiency in Women: Understanding the Science, Controversy and Art of Treating Our Patients- Part 1. International Journal of Pharmaceutical Compounding, 8(1): 16-21.
  2. Cutter, Christopher B., MD (2004). Androgen Deficiency in Women: Understanding the Science, Controversy and Art of Treating Our Patients- Part 2. International Journal of Pharmaceutical Compounding, 8(2): 96-99.

Leave a Reply