Restoring Balance - Women`s Wellness Place

Restoring
Balance
Three simple steps to hormone therapy that works
Bioidentical
hormone therapy
as individual
as you!
Our Mission
Since the first woman suffering with symptoms of hormone imbalance walked through our doors almost thirty years
ago, our mission has been one thing and one thing only — to provide women, and men, with options for healthy
living and healthy aging by supporting hormone balance — one unique individual at a time.
Table of Contents
The Women’s Health America Story
3
Is Hormone Therapy Right For You?
4
PMS Assessment
Menopause Assessment
Other Considerations
Personal Symptom Chart
WHA Self-Care Plan
Three Steps To Hormone Therapy That Works
9
Step 1. Baseline Testing
10
Step 2. Individualized Prescriptions
Bioidentical, Natural and Synthetic Hormones
What to Take, When to Take It
Patch, Pill or Cream?
11
Step 3. Follow-up Testing
15
Restore® Clinical Services Makes It Simple
16
Real Life Success Stories
17
Putting It All Together
20
Womens Health America
21
Madison Pharmacy Associates, LLC • Restore, LLC
Madison BioDiagnostics, LLC • Cyclin Pharmaceuticals, Inc.
Copyright © 2007 Women’s Health America, Inc. All rights reserved. This material is provided for educational purposes only. It is not intended
to treat, diagnose, cure, or prevent any disease and has not been evaluated by the FDA. Always seek the advice of your healthcare provider
with questions or before undertaking any diet, exercise, or other health program.
WHA
The WHA Story
Our story began more than twenty-five years ago when a young
pharmacist, Marla Ahlgrimm, was approached by a doctor who needed
help with his patient — a 35-year-old woman who suffered two weeks
each month with severe mood swings, irritability, and depression. Through
research, Marla found that in Europe they had a name for the woman’s
condition — premenstrual syndrome. She also discovered that treatment
options prescribed there weren’t available in the United States.
Marla worked with the woman’s doctor to develop a special prescription
that would modify the woman’s hormonal fluctuations. Through Marla’s
work, the woman became the first patient diagnosed with severe PMS in
the United States, and the first to use natural progesterone. “The cloud
lifted,” was the exact phrase the woman used.
Doctors learned of Marla’s success and soon brought new patients to her
to have individualized prescriptions filled. In 1982, in response to the
demand for customized prescription services, Marla co-founded Madison
Pharmacy Associates, the first compounding pharmacy in America to
specialize in women’s hormonal health.
Over the years, many of Marla’s patients began coming to her for help with
other concerns, including menopause. She and her staff continued their
research and developed even more innovative, individualized hormone
therapies, and Women’s Health America, Inc., was born. A few years later,
Restore® Clinical Services was developed, offering comprehensive hormone
therapy that included hormone testing, individualized prescription care,
and free follow-up testing to monitor outcomes.
Today, the nurses, pharmacists and staff of Women’s Health America have
used Marla’s unique approach to work with more than 10,000 healthcare
providers, offering individualized hormone therapy to more than 300,000
women — restoring balance, one woman at a time.
How to
Use This
Booklet
This booklet is designed to
provide the information you
need to make starting a program
of low-dose, bioidentical hormone
therapy easy and worry free.
We invite you to share it with
your healthcare provider. If you
have questions or concerns,
please call us for additional
information.
We can help!
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| You
Is Hormone Therapy
right For You?
You probably picked up this booklet because something’s not right
— you just haven’t felt like yourself lately. Maybe it’s PMS. Perhaps you’re
approaching menopause and your hormone levels are starting to change.
You’d like to find out more about why you feel the way you do and how to
feel like yourself again.
You’ve come to the right place. Let’s start with a couple of simple assessments
to see if hormone imbalance might be the source of your discomfort.
PMS ASSESSMENT
If you are still menstruating and your symptoms appear regularly during the
two weeks prior to your monthly period, you may be suffering with premenstrual
syndrome. Evaluate your symptoms with our PMS Assessment.
Never
Score – 0
Do you ...
Sometimes
Score – 5
Often
Score – 10
Find yourself crying for no reason?
Have dramatic mood swings?
Crave sweets, carbohydrates or chocolate?
Fly off the handle, feel irritable, anxious or hostile?
Have uncomfortably swollen, tender breasts?
Have weight gain, especially around the middle?
Have headaches, migraines and/or low back pain?
TOTAL
If your total score is 5 to 20, we recommend the Women’s Health America Self-Care Plan on page 8 as the place to start for managing
your symptoms. If symptoms continue, you may also consider measuring your hormone levels. (See page 10.)
If self-care is not enough, or you scored more than 20, we recommend talking with your healthcare provider about your symptoms
and measuring your hormone levels with a simple saliva hormone test. (See page 10.) If your hormone levels are outside of the normal
therapeutic range, hormone therapy may be an appropriate treatment.
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| Menopause Assessment
If you have reached menopause, either naturally or surgically, and you no longer have periods, our Menopause Assessment
will help you evaluate your symptoms.
If you are still having periods, but they have become irregular, or if you think you are starting to experience
symptoms of menopause, we recommend you take the PMS Assessment and the Menopause Assessment, combine your
score, and review our recommendations.
Never
Score – 0
Do you ...
Sometimes
Often
Score – 5 Score – 10
Have less energy, strength and endurance than you
used to have?
See more wrinkles every time you look in the mirror?
Find it easier to gain weight and harder to gain
muscle — especially in your midsection?
Have difficulty getting a good night’s sleep without
waking up repeatedly?
Have hot flashes or night sweats?
Just not care about sex the way you used to?
Find yourself starting to do something and not
being able to remember what it was?
TOTAL
If your total score is 5 to 20, we recommend the Women’s Health America Self-Care Plan on page 8 as the place to start for
managing your symptoms. If symptoms continue, you may also consider measuring your hormone levels. (See page 10.)
If self-care is not enough, or you scored more than 20, we recommend talking with your healthcare provider about your
symptoms and measuring your hormone levels with a simple saliva hormone test. (See page 10.) If your hormone levels are outside of the
normal therapeutic range, hormone therapy may be an appropriate treatment.
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| Other Considerations
The Benefits of Hormone Therapy Go Beyond Symptom Management
Whatever you scored in your symptom assessment, remember that hormone therapy is not just about keeping symptoms
at bay. Far beyond mere symptom alleviation, supplemental hormones play a key role in long-term health and wellness.
They can keep you looking and feeling younger. Hormones also assist in prevention of diseases such as osteoporosis,
cardiovascular disease, Alzheimer’s — and even certain types of cancer. If you have a family history of any of these
diseases, if you had an early menopause, or if you have had your ovaries removed in a hysterectomy, bioidentical hormone
therapy may offer distinct long-term health benefits for you.
Not All Hormone Therapy Is Created Equal
Your hormone profile is as unique as your fingerprints or your DNA. And yet, when it comes to hormone therapy,
women are often treated as if we are all exactly alike. It’s no wonder that an estimated 60 to 80 percent of women who
begin conventional hormone therapy stop taking their medication.
Standard-brand one size fits all prescriptions just don’t work for most women. For hormone therapy to be right for you,
your healthcare provider must consider your specific needs, background, and lifestyle. You are a unique individual who
deserves careful, individualized treatment at the lowest effective dose.
Individualized Hormone Therapy
You can expect a better outcome from individualized hormone therapy than from one size fits all treatment where
the same dose of the same synthetic hormones is prescribed for most patients. From conventional to customized
medication, your bioidentical hormone therapy can be individualized by utilizing hormones, dosages and delivery
systems that meet your unique needs.
Lowest Effective Dose
Unlike one size fits all dosing, the lowest effective dose of a hormone is the precise amount needed by an individual
woman to relieve moderate to severe symptoms and maintain optimal health without undesirable side-effects.
“Your hormone profile is as unique
as your fingerprints or your DNA.”
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| Personal symptom chart
When considering whether or not to begin hormone therapy, a Personal Symptom Chart can be a useful tool for you and your healthcare provider. Charting symptoms on a daily basis will help show the pattern and severity of your symptoms and their relationship to your
menstrual cycle or menopause. The chart is also a useful tool for recording and evaluating changes in your symptoms after beginning a
program of hormone therapy. For greatest accuracy, we recommend you set aside a specific time to complete your chart each day. Rate the
level at which you experience each symptom, using the scale of: 1 – Mild 2 – Moderate 3 – Severe
If you do not experience the symptom at all, leave the box blank. After you’ve carefully charted your symptoms for four or more weeks,
discuss your findings with your healthcare provider. Together, you’ll be able to see if there is a pattern and discuss treatment options.
And remember — if you have questions, we are always happy to help. Call us at 800.558.7046 M – F 8 am – 5:30 pm CST
Personal Symptom Chart
1-Mild
2-Moderate
DAY OF CYCLE
1
2
3-Severe
3
4
5
6
7
8
Patient Name________________________________
Date ________________________ Year __________
9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Food cravings – carbs/salty/sweet
Heachaches or migraine
Breasts tender/sore/swollen
Rapid changes in mood
Low back and/or joint pain
Warm/flushed skin
Bloating/water retention
Fatigue/tired
Anxiety
Weight gain
Irritability/anger
Muscle weakness
Depression
Nervousness
Lack of energy/endurance
Acne/oily skin
Rapid/irregular heartbeat
Forgetfulness
Hot flashes/night sweats
Vaginal dryness/pain/itching
Trouble controlling urine/leaking
Lack of sex drive/libido
Difficulty falling/staying asleep
Foggy thinking
Weight loss
Hand tremors
Decreased focus/attention
Heavy or irregular periods
Restore® is an exclusive program of Women’s Health America, Inc.
Madison Pharmacy Associates, LLC • Restore, LLC • Madison BioDiagnostics, LLC • Cyclin Pharmaceuticals, Inc. 1289 Deming Way • PO Box 259690 • Madison, WI 53725-9690 • 800.558.7046 • Fax 888.898.7412
Women’s Health America
self-care plan
Many women find a few simple self-care measures go a long way in helping to manage hormonal symptoms. That’s why — whether you
choose prescription hormone therapy or not — we recommend our self-care plan as the foundation of any symptom management program.
STEP ONE: Your Healthy Diet
Instead of “three squares,” try eating
three small meals and three snacks daily.
Frequent small meals keep your blood
sugar stable and avoid energy highs and
lows. As you plan your meals and snacks,
include a mix of these healthy foods:
• Low-fat milk, cheese, and yogurt
• Whole grain bread, cereal, and pasta
• Lean sources of protein — most
women do not eat enough!
• Legumes (lentils and beans)
• Foods with soy protein (soy nuts, soy milk, or tofu)
• Raw and leafy vegetables and fresh fruit
• Fish with Omega-3 fatty acids (tuna, mackerel, herring,
sardines, salmon, shellfish)
Foods to avoid include salty lunch meat, sausage, bacon, high-fat
cheeses such as brie, white bread, cake, cookies, jam, honey,
molasses, high-salt snacks like potato chips, caffeinated drinks,
coffee, tea, soda, and alcohol.
STEP TWO: Get Physical!
Moderate exercise is great for overall
fitness and helps reduce stress. Exercise
raises HDL (“good cholesterol”)
and reduces triglycerides (fats) in
the blood. It builds strong bones,
increases heart and lung capacity, and
reduces fluid retention. It also causes
the release of endorphins, nature’s
mood elevators, and increases oxygen
and blood flow to muscles, reducing
tension. Research shows even a
moderate amount of exercise can help. In one study as little as
1 hour and 10 minutes of aerobics, 50 minutes of running, or 1
hour and 20 minutes of swimming a week relieved symptoms.
A brisk 20 to 30 minute walk three times a week is a favorite
exercise routine among many women who contact Women’s
Health America. And, because walking is a weight-bearing
form of exercise, it has the added benefit of building strong
bones. Other forms of weight-bearing exercise include dancing,
tennis, certain yoga poses, running, and weight training. The
quantity and type of exercise are less important than exercising
regularly. We recommend about 20 minutes of exercise three or
four times a week.
STEP THREE: The Right Nutritional Supplements for You
Our ProCycle™ vitamin/mineral supplements were developed to
support a woman’s healthy hormone balance.
ProCycle™ PMS was specially developed for women with PMS.
This therapeutic nutritional supplement contains a balanced
combination of B vitamins, magnesium, and calcium. ProCycle
PMS contains a beneficial 2-to-1 ratio of magnesium to calcium,
shown to help regulate muscle relaxation and blood sugar, and
to promote sound sleep. Magnesium may also help reduce the
risk of heart attack, stroke, and hypertension, and help prevent
migraines in pregnant women.
ProCycle™ Gold is designed exclusively
for women during perimenopause,
menopause and beyond. It contains a
precise ratio of vitamin E, B vitamins,
magnesium, calcium, zinc, and boron.
The calcium citrate in ProCycle Gold is
easily absorbed. ProCycle Gold is ideal
for women using hormone therapy, as well as those who can’t
take estrogen or prefer to manage their menopausal symptoms
by combining diet and exercise.
For more information about either ProCycle™ vitamin or to
order, call 800.588.7046 or visit www.womenshealth.com.
STEP FOUR: Stress Management
The hectic pace of women’s lives can make it difficult to find
time to relax. That makes it even more important to set a regular
time to slow down. For most women, relaxation isn’t just one
thing — it’s a balance of social, physical, creative, and spiritual
activities. But remember, if you experience ongoing physical
symptoms or illness, don’t assume they’re “just stress.” Talk to
your healthcare provider.
STEP FIVE: Educate Yourself
Self-care also includes taking time to learn
about your body and options for healthy
living. We recommend that every woman
read The HRT Solution by Marla
Ahlgrimm, R.Ph. and John Kells. Self Help
for Premenstrual Syndrome by Michelle
Harrison M.D. and Marla Ahlgrimm,
R.Ph., is another helpful reference for
those with PMS. For these books and the latest
women’s health information, simply visit our online bookstore at
www.womenshealth.com.
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| Steps
Three Steps to Hormone
Therapy That Works
You’ve identified your symptoms and discussed them with your
doctor. Your self-care plan is in place as the foundation of your symptom
management. You’ve done some research and decided you would like to
try hormone therapy — but before you take any pills, apply patches, or
rub in creams, you need the answers to some questions. What should you
take? How much should you take? When should you take it?
Answering these questions involves three simple steps:
1. Baseline testing
Measuring your hormone levels before starting hormone therapy
is essential for determining your unique hormone profile. We also
recommend a baseline measurement of your rate of bone loss for use in
developing a self-care or prescription plan for preventing osteoporosis.
2. Individualized hormone prescriptions
When individualizing your prescription, there are many options to choose
from. Should you choose bioidentical or synthetic hormones? Which
dosage form is best for you? Our staff of nurses and pharmacists is here to
help you and your healthcare provider understand your options and make
those critical decisions.
3. Follow-up testing
Periodic saliva hormone and NTx urine rate of bone loss testing are the
most accurate and convenient ways to monitor how well your hormone
therapy prescription(s) are working. These tests show if your medications
have brought your hormone levels and rate of bone loss within the
optimal range. If you are experiencing symptoms of overdosing or
underdosing, follow-up testing takes the guesswork out of finding where
adjustments need to be made.
Three
Simple Steps
1. Baseline Testing
2. Individualized prescriptions
3. Follow-up testing
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| Step 1:
Step 1: Baseline Testing
Would you take blood pressure medication without first
knowing what your blood pressure is? Then why begin
hormone therapy without first measuring your hormone levels.
Before taking any hormone medication, it just makes sense to
know what your hormone levels are and if they are within the
recommended therapeutic range.
Baseline hormone testing for women should include:
• Estradiol
• DHEA
• Progesterone
• Cortisol
• Testosterone
We recommend saliva hormone testing over
serum (blood) hormone testing for its precision
and convenience.
Saliva hormone testing is precise
When we measure hormone levels, we want to know how much
of the hormone is “free” or available to work for us. Your saliva
contains only the “free” form of your hormones, so it is an
excellent way to measure this. Blood tests, on the other hand,
measure both the free and the inactive, or “bound” form of
hormones. This measurement is less useful work for you.
Saliva hormone testing is convenient
The convenience of saliva testing is another plus. Our test
kit allows you to collect saliva samples in the privacy of your
home and use the mailer provided to send them back to our
lab for evaluation. This is easier, more convenient and more
cost-effective than making an appointment with a local lab for
serum testing.
Saliva or
Serum Testing?
Blood (serum) tests do not always
distinguish between free and bound
forms of hormones, so the results of a blood test are less precise than saliva testing.
Results from your saliva test
are sent to your healthcare
provider along with our
suggestions for your
individualized hormone
therapy prescription.
Bone Remodeling
Strong, healthy bone is continually maintained through
the two phases of bone remodeling: resorption (removal) and
formation. Bone-resorbing cells called osteoclasts remove old
bone by releasing acids and enzymes to remove minerals and
collagen. Cross-linked N-telopeptides (NTx) are released into the
bloodstream during osteoclastic activity.
Once the osteoclasts have done their job, protein-secreting
cells called osteoblasts are recruited to the newly resorbed
areas on the bone where they deposit new collagen to form
new bone.
Approximately 20% of bone tissue is replaced annually
by this process. When resorption and formation are
in balance, there is no net change in bone mass.
NTx urine testing measures rate of bone loss
Osteoporosis is one of the greatest health concerns for women. Though many believe osteoporosis is a normal part of the
aging process, this is not true. Lifestyle and diet are putting
younger generations at a higher risk than the generations that
went before them. That is why we also recommend an NTx
urine test to measure rate of bone loss.
The NTx urine bone loss test is a simple and affordable test
where a urine sample can be collected at home and mailed to
our lab for analysis. Results can be used to:
• Help assess who will receive the greatest long-term bone
health benefit from hormone therapy.
• Determine the probability of bone mass decreasing in a
postmenopausal woman if she does not initiate hormone
therapy.
• Monitor response once hormone therapy is begun.
In as little as three months, NTx measurements can show
the effect of your bone loss prevention self-care plan and/or
prescription therapy. This is a distinct advantage over the one
to two years required to see a change in bone densitometry
(DEXA) measurements. You can understand why NTx bone
marker technology plays such an essential role in preventing
and managing the bone loss that leads to osteoporosis. DEXA
testing simply is not enough.
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| 10
Step 2:
Step 2: Individualized Prescriptions
The consulting pharmacists at Madison Pharmacy
Associates work with many women and their healthcare
providers to individualize hormone therapy regimens, and are
available to advise you and your healthcare provider. Before
getting started, it is important to understand why we use only
natural, bioidentical hormones in our prescription formulations.
Bioidentical, Natural and
Synthetic Hormones
Bioidentical and synthetic hormones are very different
— the difference is in the molecular structure. A bioidentical
hormone has a molecular structure that is identical to the
hormones naturally produced by the body. That’s why
bioidentical hormones are also referred to as “natural.”
A “synthetic” hormone has a molecular structure similar to but
not exactly the same as the hormones produced by your body.
This difference can mean synthetic hormones interact differently
in your body, producing substantially different effects.
For example, let’s look at the difference between the synthetic
progestins and bioidentical progesterone. The synthetic
progestins, such as commonly prescribed Provera®, are similar to
the progesterone your body produces, but the subtle molecular
differences can significantly influence the hormone’s action.
Synthetic progestins can cause side-effects of irritability, nausea,
depression, and water retention in some women. Bioidentical
progesterone is identical to the hormones made in the body, and
many women find it easier to tolerate.
Progesterone
There is no set combination or dosage of hormones that
works for every woman. Hormone therapy typically includes
estrogen, progesterone, and/or testosterone. However, it is also
important to measure your levels of DHEA and cortisol as these
hormones may influence levels of the other three.
Which hormones you need and the amount you need depend
upon your individual hormone levels and symptoms.
• Premenstrual Syndrome: Symptoms of PMS such
as mood swings, cravings for sweets and chocolate, anxiety,
irritability, and crying for no reason may be associated with
low levels of progesterone and relatively elevated levels of
estrogen.
• Perimenopause: Declining levels of estrogen and
progesterone, and, in some cases testosterone, may be
associated with perimenopause symptoms such as hot
flashes and sleep disturbances.
• Menopause and beyond: Lower levels of estrogen,
progesterone, and testosterone which are typical after
menopause, may be associated with hot flashes, sleep
disturbance, bone loss, and loss of libido.
Let’s look more closely at these hormones and what they do in
our bodies.
Estrogens: They’re not all alike
“Estrogen” is often used as a general term, but it is actually a
category of hormones. Of the many types of estrogen our bodies
make, three are produced in major amounts.
CH3
C
What To Take: Estrogen,
Progesterone, Testosterone
O
You can see that
CH
O
the synthetic hormone
C
O
O
C
CH
medroxyprogesterone
acetate, commonly known
as Provera® (bottom), has
a different molecular
CH
structure than natural
Medroxyprogesterone
progesterone (top).
3
3
3
Many women call Women’s Health America and the
consulting pharmacists at Madison Pharmacy Associates to
ask if there is a “natural estrogen” they can take. They are
often surprised to learn that commercially manufactured and
frequently prescribed forms of estrogen are bioidentical (or
natural) estrogens.
acetate (Provera)
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| 11
Estrogens:
While we tend
They’re not all alike
to think of estrogen’s
“Estrogen” is often used as a
relationship to our
general term, but it is actually
reproductive function first, this
a category of hormones. Of
hormone actually nourishes and
protects our bodies in hundreds
the many types of estrogen
of ways, from our hearts, to our
our bodies make, three are
bones, to our skin and hair.
produced in major amounts.
In the uterus, estrogen causes
the lining (endometrium) to
Many women call Women’s
thicken and build up each
Health America and the
month until it is sloughed
consulting pharmacists at
as a menstrual
Madison Pharmacy Associates
period.
to ask if there is a “natural
estrogen” they can take. They are
often surprised to learn that commercially manufactured and
frequently prescribed forms of estrogen are bioidentical (or
natural) estrogens. Choosing among estradiol, estrone and estriol
is a decision best made based on the specific symptoms that need
to be managed. Specially compounded estrogens like Biest or Triest
combine two or three of the natural estrogens: estradiol, estrone,
and estriol.
Estradiol
Estradiol is the most potent form of estrogen, and the one
produced in the largest amounts by a woman’s ovaries before
menopause. Estradiol levels decline after menopause. The
brand names Estrace®, Estraderm®, Vivelle®, Alora®, FemPatch™,
Estring®, and Climara® contain bioidentical estradiol.
Estrone
Estrone is the predominant estrogen in a woman’s body after
menopause. When ovarian function declines, the fat cells in a
woman’s body take over the role of synthesizing estrone.
Estrogen
Bioidentical estrogens, derived from soy,
include estrone, estradiol, and estriol.
Estrogen protects against:
• Osteoporosis
• Alzheimer’s disease Estrogen enhances:
• Colon cancer
• Mental sharpness/memory
• Urinary incontinence • Brain moleculars like
serotonin and endorphins
• Tooth loss/decay
• Sleep
• Mood
• Digestion
• Sex drive
• Skin tone
Estriol
Estriol is known as the “weak” or “forgotten” estrogen. Produced
in large amounts by the placenta during pregnancy, estriol
is also converted in small amounts by the liver. The fact that
estriol is “weak” has pluses and minuses. Estriol has been used
vaginally to manage vaginal dryness, urinary infections, and
stress incontinence. Estriol does not provide as much heart and
bone protection as other more potent estrogens like estradiol
and estrone. However, low doses of estriol typically have little
or no effect for most women on breast or uterine tissue, so
estriol avoids the risk of breast or uterine cell abnormalities
associated with estradiol and estrone. Estriol can be taken
alone, without progesterone, because it has little to no effect
on the uterine lining. A woman who suffers from vaginal
dryness and/or incontinence with no family history of heart
disease or osteoporosis and with cholesterol and bone density
levels within normal ranges, may be a good candidate for
estriol. Estriol is not commercially available in the U.S. and
must be compounded by a pharmacist.
Progesterone
The balance of progesterone and estrogen in a woman’s
body is very important. At different times in her life, an
imbalance in these hormones can result in symptoms of PMS,
perimenopause, or menopause. Symptoms of progesterone
imbalance include mood swings, anxiety, cravings for sweets,
depression, weight gain, bloating, and breast tenderness.
When taken alone as a
medication, estrogen can
cause the cells in the
uterine lining to become
crowded or malformed.
Progesterone, on the
other hand, controls
that effect, protecting
you from endometrial
abnormalities. You can
choose between synthetic
forms of progesterone
(progestins) and
bioidentical progesterone
(progesterone USP),
which must be
compounded by a
pharmacist. At Madison
Pharmacy Assocites, we
only use bioidentical
progesterone in our
formulations.
Progesterone
The balance of progesterone
and estrogen in a woman’s body
is very important. Progesterone
USP (Natural Progesterone
Cream, Prometrium®, Crinone®) is
a bioidentical progesterone derived
from wild yam or soy.
Progesterone:
• Decreases risk of endometrial cancer
• Stabilizes blood sugar, thyroid
function, and mineral balance
• Is necessary for fertility and
maintaining a pregnancy
• Increases energy and sex drive
• May help protect against breast cancer, fibrocystic breasts,
and osteoporosis
• Regulates fluid balance
• Has a calming effect
• Enhances mood
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| 12
Arriving at the right bioidentical estradiol/progesterone
combination for you can take some time and adjustment. For
many women, 0.5 mg of estradiol and 100 mg of progesterone
USP is a good starting dosage. The dosage of progesterone,
however, may vary depending on the route of administration,
and whether you are on a continuous or cyclical regimen. If
the initial dose gives you uncomfortable side-effects or doesn’t
alleviate your symptoms, your doctor can adjust the dose or
try a different route of administration such as a patch, cream
or tablet, depending on your individual situation.
TESTOSTERONE
Testosterone
While traditionally
An androgen, produced in men
thought of as the “male”
and in substantially smaller amounts
hormone, testosterone
in women, this hormone declines in
plays a dramatic role
both men and women as they age.
Testosterone:
in many aspects of a
• Builds and promotes muscle tone
woman’s physiology and
• Increases energy
quality of life, including
• Decreases fatigue
libido, sexual satisfaction,
• Increases sex drive
bone density, sense of well• Enhances well-being
being,
vasomotor symptoms,
• Strengthens bone
and body composition.
Testosterone is particularly important because it activates the
sexual circuits in the brain.
At menopause when our ovaries no longer release eggs, they
also stop producing the potent forms of estrogen (estradiol
and estrone) and progesterone, and they slightly decrease
production of testosterone, which changes the ratio of
testosterone to estrogen and progesterone.
Today it is not unusual to include testosterone in a woman’s
hormone therapy regimen. Transdermal patches, sublingual
tablets, topical gels, and oral capsules can be prescribed and
individually compounded for each patient using bioidentical
testosterone.
DHEA
Another critical hormone manufactured in the adrenal glands
is dehydroepiandrosterone, commonly known as DHEA.
DHEA has received a great deal of media attention and is
often referred to as the fountain of youth hormone.
Levels of DHEA peak at about 20-25 years of age then begin
to decline. DHEA protects against the effects of stress. The
decline of DHEA levels that comes with age correlates with
a general decline in immunity, memory, libido, energy, and
lowered resistance to age-related diseases.
Unfortunately, DHEA’s
DHEA
fountain of youth
Called the “fountain of youth”
reputation has led to
hormone, DHEA helps protect
a dramatic increase
against ailments associated with
in its over-theaging such as cancer, diabetes
counter usage. We
and heart disease.
say unfortunately,
DHEA:
• Enhances brain function and memory
because there are some
significant potential side- • Supports the immune system
• Helps prevent blood clots
effects from taking too
much of this hormone.
Remember, hormones are powerful substances the body
produces to carry out critical functions, and the level of
one hormone can affect the level of another. When other
hormones are balanced, DHEA levels typically increase without
supplementation. On the other hand, too much DHEA can
“cascade” or turn into other hormones in the body, creating
imbalance and the side-effects associated with it.
DHEA is also a mild blood thinner and stimulant, which can
lead to over-stimulation of the thyroid. People who take aspirin,
blood thinners, stimulants, or a thyroid prescription may need
to have dosages altered if they are also taking DHEA. Though
DHEA is available without a prescription, measuring your hormone levels before supplementing this hormone is as important
as with any other hormone.
Cortisol
The most important and potent hormone produced in the adrenal
glands is cortisol, known as the stress hormone. Cortisol helps in
responding to and coping with stress, injury, and infection. It also
affects the activity of other hormones such as insulin, thyroid, and
DHEA. Cortisol is involved in balancing blood sugar, protein
synthesis, proper immune function, and REM sleep — the
deep sleep where the body is relaxed, but the brain is active and
dreaming. It also affects rate of bone breakdown.
Chronic stress may decrease your cortisol level while acute
stress may elevate it. As with other hormones, too little or too
much cortisol can be damaging. The
symptoms of too little cortisol
CORTISOL
include fatigue, sugar craving,
Often referred to as the
“stress” hormone.
allergies, molecular sensitivity,
Cortisol helps:
stress, cold body temperature,
• Cope with stress and injury
and heart palpitations. Too
• Control weight gain
much cortisol can result in
• Balance blood sugar
sleep disturbances, depression,
• Maintain immune function
• Aid protein synthesis
bone loss, weight gain in the
• Improve REM sleep
midsection, thin skin, and loss
of muscle mass.
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| 13
Patch, Pill, or Cream?
AL
IN
S OR
I
G
•
AL
IN
MP
S OR
I
G
•
ORI
PA
NAL
GI
ORI
PA
Symptom Management. Identifying the symptoms
you want to manage will help determine the appropriate
dosage form. For example, the level of heart and bone
protection differs with
various hormone dosage
forms. Your individual
profile and family history
may also come into play.
Convenience. Some
women choose the form
of hormone therapy that
is easiest for them to
remember to take.
Cost. For some women,
cost factors into their
decision.
MP
•
NAL
GI
NAL
GI
ORI
PA
S OR
I
MP
There are several factors you and your healthcare provider will
want to consider when choosing the dosage form that is best
for you. These include:
M
AL
IN
Several of our dosage forms have been developed by and are
available exclusively from Madison Pharmacy Associates.
M
G
Available Exclusively from
Madison Pharmacy Associates
M
There are many forms of bioidentical hormone therapy
to choose from, ranging from conventional forms like the
estradiol patch, to customized forms like the Even-Release
Oral Tablet — available exclusively from Madison Pharmacy
Associates.
MP
• Estrogen in cream form is very effective in treating urinary and vaginal problems.
• Vaginal estrogen creams may not protect
against heart disease or bone loss.
ORI
PA
NAL
GI
ORI
PA
S OR
I
MP
AL
IN
S OR
I
G
M
• The adhesive on the estrogen skin patch sometimes
causes skin irritation and the patch is more expensive
than oral estrogen.
NAL
GI
M
AL
IN
Rapid Act Sublingual Tablet
Our innovative sublingual (under tongue) delivery
system is convenient, pleasantly orange-flavored, and
dissolves under the tongue in less than one minute.
Sublingual tablets can be compounded using hormones
such as progesterone, testosterone, DHEA, estradiol,
estriol, Triest, Biest, and pregnenolone, either singly or in
combination.
Customized Transdermal Patch
This is not a standard-dose, one
size fits all patch, but one that is
created and dosed just for you. The
innovative patented matrix of our
transdermal patch acts as a reservoir
for continuous delivery of individual
or combined hormone therapy.
s Customized Transdermal Patch
Our patented gel delivery system allows the natural
matrix of the skin to deliver continuous, consistent
absorption of individual hormones or hormone
combinations with the convenience of once a day dosing.
When deciding between oral, vaginal cream,
transdermal patch, or transdermal cream estrogen,
here are a few points to keep in mind:
G
This breakthrough progesterone delivery system introduced
in 1986, combines slow, Even-Release of medication with
the convenience of dosing once or twice daily.
Percutaneous Gel
Points to keep in mind
• The skin patch may be a good choice for you if your
triglyceride levels are abnormally high. Transdermal
estrogen does not raise triglyceride levels. Oral estrogen
appears to increase triglyceride levels somewhat because
it passes through the liver.
Even-Release Oral Tablet
Oral and Chewable Tablets
Oral tablet dosages can be compounded using single
or a combination of hormones including progesterone,
estradiol, estriol, DHEA, pregnenolone, testosterone,
Biest, and Triest. Chewable tablets can be formulated for
those who have difficulty swallowing medication.
Micronized “In Oil” Oral Capsule
These oral capsules can be compounded with a single
or combination of hormones including progesterone,
estradiol, estriol, Triest, Biest, DHEA, liothyronine,
thyroid, and pregnenolone.
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| 14
ORI
PA
NAL
GI
M
ORI
PA
NAL
GI
M
ORI
PA
NAL
GI
Creams and Ointments
Hormone creams and ointments offer complete strength
and dosage flexibility. Studies show that wild yam and
hormone creams available over the counter vary widely in
content, effectiveness, potency, quality, and price. Prescribed
hormone creams assure you a quality therapeutic product,
often at a lower price than those products available without a
prescription, and are subject to insurance reimbursement.
Anti-Aging Facial Serum
Estriol, the mildest of all estrogens, has been shown to
reverse the signs of skin aging and wrinkling in perimenopausal and menopausal women. With a prescription from
your healthcare provider, Madison Pharmacy Associates can
compound an estriol facial cream just for you.
Suppositories and Vaginal Tablets
A variety of hormones can be compounded in suppository
form for vaginal or rectal use. Using specialized vaginal
tablet disintegrant systems, we compound a variety of
vaginal hormone tablets that require no special storage
conditions and need limited vaginal moisture to dissolve.
M
Conventional Estradiol Patch
Low-dose, commercially prepared, bioidentical estradiol
patches such as Climara® and Vivelle® are also available
from our pharmacy.
When to take it
There are two regimens to choose from when individualizing
your hormone therapy: cyclical and continuous combined.
CYCLICAL is recommended for women still cycling because
it mimics a menstrual pattern. Using this regimen, you take
progesterone on days 14-28 of a 28-day cycle; estrogen (if
needed) days 1-21; and testosterone (if needed) daily. When
you finish taking progesterone each month, you experience
bleeding as your body “withdraws” from the hormone
progesterone, and the endometrial lining sloughs away.
Step 3:
Step 3: Follow-up Testing
According to Dr. Wulf H. Utian, Executive Director of
North American Menopause Society:
1) No single hormone “recipe” exists that will fit every woman. The first regimen you try may not work for you, but don’t give
up. Your doctor should fine-tune your hormone regimen to your
individual needs, your risk factors, your symptoms and your
lifestyle, before and during therapy.
2) The therapy must be evaluated at least annually by both you
and your doctor, sooner if you experience side-effects or problems.
Follow-up testing is the most scientific and accurate way to
take the guesswork out of finding the right “hormone recipe”
for you and for evaluating your therapy. A follow-up hormone
test and NTx urine test
will show your healthcare
provider exactly how your
body has responded to
the hormone medications
you are taking. Test results
can than be used to help
determine any adjustments
that may be needed.
s NTx Testing
Follow up Testing
After three months of
therapy, it’s time to measure your hormone levels again to see
how they have changed, and if they are now within the desired
therapeutic range. The results of this test, along with your
symptom chart, will help you and your healthcare provider
decide if any change to your medication is advised.
After six months of therapy, it’s time to measure your rate of
bone loss again. If advisable, medication changes can be made.
An annual evaluation thereafter will let you and your
healthcare provider know if your hormone levels are within the
desired therapeutic range.
Continuous combined is recommended for women
who are no longer having menstrual cycles. Using this
regimen, you take estrogen and progesterone every day.
This eliminates breakthrough bleeding though there may
be some initial spotting in the first one to three months.
Women also experience fewer side-effects with this regimen.
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| 15
Restore
Restore® Clinical Services
Makes It Simple
Individualized, low-dose hormone therapy is the wave of the future, but
it is new for many healthcare providers. Fortunately Women’s Health America
and Madison Pharmacy Associates have successfully used this approach for
more than twenty years. Our Restore® Program was the first and remains the
only comprehensive hormone therapy program of its kind to provide testing,
individualized prescriptions, and on-going evaluation. Our Restore nurses
and pharmacists work with you and your healthcare provider to make the best
therapeutic decisions for your unique needs.
The Restore Program includes:
1. Baseline testing. We provide analytical measurement of saliva to determine
your levels of estrogen, progesterone, testosterone, DHEA, and cortisol. NTx
urine is used to measure rate of bone resorption.
2. Individualized bioidentical prescriptions. We work with your
healthcare provider to customize your prescription at the lowest effective dose
recommended for your symptoms and medical history.
3. Follow-up saliva hormone and NTx urine testing. At three and six
months, free follow-up testing helps maintain hormone levels in a therapeutic
range, avoiding the side-effects of overdosing and the consequences of
underdosing.
And Restore offers a revolutionary fourth step — FREE annual follow-up
testing. Our Restore clinical team assists in evaluating and adjusting your ongoing
plan of care to assure optimal therapeutic outcomes at the lowest effective dose for
as long as your hormone prescriptions are filled through our pharmacy, Madison
Pharmacy Associates.
“The Restore
program from Women’s
Health America provides
customized dosing for
individual patients, merging
the patient clinical needs with
supporting laboratory data. It’s
the future of hormone therapy.”
- Claude Hughes, M.D.,Ph.D.,
Duke University
Medical Ctr.
Getting Started
Getting started in the Restore program is easy. Simply have your healthcare provider
complete a Restore enrollment form and fax it to us at Women’s Health America.
We’ll take care of the rest — from mailing your sample collection kit to faxing
results to your healthcare provider.
Please call our Restore Specialists at 800.558.7046 if you would like more
information for you or your healthcare provider.
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| 16
Real Life
Real Life Success Stories
Thousands of women have used saliva hormone testing as part of an individualized hormone
therapy program. The following stories illustrate the success of this revolutionary approach.
Jane Ann Jane Ann is a 49 year-old financial planner who relied on a self-care program that included a
healthful diet, a regular workout, and ProCycle™ Gold vitamin-mineral supplement to manage
her occasional hot flashes. Gradually, in spite of everything she was doing on her own, Jane
Ann’s hot flashes became a daily (and nightly) occurrence. A person who prides herself on
keeping details within her grasp, Jane Ann also noticed a few gaps in memory that concerned
her. She would call a client on the phone and, right after saying hello, forget why she called.
Or, plucking a report from her shelf, she would search through it and suddenly forget what she
was looking for.
Jane Ann decided to discuss her concerns with her doctor during her routine annual
physical exam. She told him she had not had a period for quite a few months. During their
conversation, she admitted that, along with her other symptoms, she was also feeling close to
tears more frequently, often without any reason she could identify. Jane Ann’s doctor listened
intently and then explained to her that her symptoms, combined with her age and the fact
that her cycles seemed to be waning, led him to believe she was entering menopause and her
estrogen level was low. He gave her a prescription for Premarin® and Provera®, a commonly
prescribed combination of conjugated estrogens and a synthetic progestin.
A week later, Jane Ann was on the phone with her doctor, reporting that her symptoms seemed
worse. Her normally cheerful outlook was bleak, her breasts were very tender, and she felt
bloated. She didn’t understand what was happening. Having just returned from a seminar on
saliva hormone testing, Jane Ann’s doctor suggested running a saliva hormone test to measure
her free hormone levels. After reviewing the results of the saliva measurement, he could see
that her estradiol level was now above the expected range of 3 to 5pg/ml for a woman who is
still having her menstrual cycle. Jane Ann’s estradiol level was 18.7 pg/ml. Her doctor correctly
surmised that her symptoms were being exacerbated by the excess amount of estrogen she was
getting from her prescription.
“... many women
find “bioidentical”
hormones —
which are
molecularly
identical to the
hormones a
woman’s body
produces — easier
to tolerate ...”
To find the right dose of hormone for Jane Ann, her doctor consulted with a Madison Pharmacy
Associates pharmacist knowledgeable in saliva hormone test interpretation and individualized,
bioidentical hormone dosage. Knowing that many women find “bioidentical” hormones —
which are molecularly identical to the hormones a woman’s body produces — easier to tolerate,
the pharmacist suggested changing Jane Ann’s prescription from Premarin® and Provera® to
bioidentical estradiol and oral micronized progesterone. He also suggested adjusting her dosages
to 0.5mg of estradiol and 100 mg of progesterone, to be taken twice a day.
Within a day or two, Jane Ann felt like herself again. A follow-up saliva test 30 days later showed
that indeed, her estradiol level was 3.2 pg/ml and her progesterone level was 0.4 ng/ml. Both
were well within the ranges that occur in a woman who is still menstruating. Jane Ann’s hot
flashes were under control, she wasn’t teary any longer, and best of all, she felt like herself again.
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| 17
Celeste
Celeste is a healthy and active
woman. When she started to have
perimenopausal symptoms at 47, she
decided to try self-help measures to
get herself through the change. She
read books on natural approaches to
menopause, adjusted her diet, began an
exercise regimen, and took nutritional
supplements and herbs. Three months later, she still found
herself crying at the drop of a hat, craving foods like pasta,
chocolate and potatoes, and having increasingly hotter hot
flashes. Both she and her husband grew frustrated. One night,
her husband even bolted upright in bed and said, “What is
it with you and the covers? One minute they’re on, the next
minute they’re flying off!”
She stopped using the progesterone cream and spent a few
more late nights on the Internet. There she found some
interesting information from Women’s Health America on
saliva hormone testing. She was intrigued enough to call her
doctor and ask if saliva testing would be appropriate for her.
Although he wasn’t familiar with saliva hormone testing, he
agreed to review the information Celeste had found. A few
days later he called back to say he was willing to order the
saliva hormone test and consider the results.
Celeste had two saliva hormone tests, 30 days apart. At first,
her progesterone levels were .03 ng/ml, well below the target
range for a woman her age who was still menstruating. After
consulting with a Madison Pharmacy Associates pharmacist,
Celeste’s doctor offered her the option of continuing to use the
over-the-counter cream she had in a lesser
amount, or he could give her a prescription
cream. In either case, it was important to
monitor the dosage more closely than Celeste
had been able to do when she applied the
over-the-counter cream in varying amounts.
Celeste chose to use the prescription cream.
She began feeling better right away.
“On top of
everything else,
her sex drive was
dwindling, and
she was becoming
increasingly
worried.”
Celeste continued her search for answers to her
perimenopausal woes. She found an over-thecounter natural progesterone cream on the
Internet. When Celeste received her cream,
she read the instructions. She assumed that
even though her periods had become irregular,
she should take the dose recommended
for a premenopausal woman who is still
menstruating. For several weeks, while Celeste
was using the cream, she had good results:
improved mood, fewer food cravings, less
frequent hot flashes, and more restful sleep.
But, within a short time, her symptoms seemed to be returning.
She wondered if she might be farther along in the change than
she had originally thought. “Maybe I’m not using enough of
the cream,” she wondered. She decided to apply more. Almost
immediately, Celeste began feeling sleepy all the time. On top
of everything else, her sex drive was dwindling, and she was
becoming increasingly worried. What if it wasn’t the change at
all? What if something was really wrong with her? She stopped
using the cream and made an appointment with her doctor.
Celeste told her doctor what was happening and he ordered a
blood test to measure her hormone levels. The results showed
that her estrogen and progesterone levels were what you would
expect in a woman who is still menstruating. “Your hormones
look fine,” her doctor told her. “Maybe you are just having
a hard time adjusting to your body changing.” Celeste was
puzzled and frustrated. She intuitively knew this wasn’t just in
her head — something was going on with her hormones.
After another month of using her new
prescription progesterone cream, Celeste was
feeling quite well. However, her follow-up
saliva test showed that her progesterone level
was slightly above the expected range. This
information indicated that her dosage could be decreased. Her
doctor lowered her dosage again, this time recommending that
she use only 10 mg of cream a day, in two doses of 5 mg each.
Celeste felt terrific using this amount, and 30 days later her
saliva test showed her progesterone level at .4 pg/ml — right
within her target range.
Three very important things were accomplished in Celeste’s case:
• First, she and her doctor were able to obtain a precise
picture of her free hormone levels using saliva testing.
• Second, together with a pharmacist knowledgeable in
individualized, bioidentical hormone therapy, Celeste’s doctor
was able to adjust her dosage to exactly what she needed.
• Third, Celeste and her doctor have an ongoing means
of monitoring her progress with follow-up testing and
dosage adjustment as needed. As Celeste’s body continues
to change, her hormonal level requirements may change,
too. When they do, she and her doctor can respond with
more information and less guesswork.
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| 18
Frieda and Sam
Having too much of a hormone can cause uncomfortable side-effects, but as
Frieda experienced, too little of a hormone can cause discomforts as well. Frieda
and her doctor used saliva testing to determine which hormones she needed to
help with her declining sex drive.
A widow at 56-year-old, Frieda had recently married Sam. Even though
they were happy and very much in love, both Frieda and Sam felt like their
relationship lacked the sexual spark they had each known in the past. Frieda
had seen headlines about testosterone’s ability to re-ignite her desire. She asked
her doctor if testosterone might help her and Sam feel more interested in
lovemaking again.
Frieda’s doctor wasn’t ready to take that step without more information. He
talked with Women’s Health America about measuring Frieda’s estradiol,
progesterone, DHEA, cortisol, and testosterone levels so he could have the most
complete picture of her hormonal profile. We suggested he also measure Sam’s
levels of estradiol, DHT, DHEA, and testosterone.
Frieda
Frieda’s baseline saliva test showed low estrogen and progesterone, but the
amount of DHEA, cortisol, and testosterone her body was producing were
fine. In Frieda’s situation, balancing her progesterone and estrogen levels was
all that was needed to restore her libido. Supplemental testosterone might have
produced unwanted side-effects. Thanks to saliva testing, Frieda didn’t have to
worry about side-effects because she was taking exactly what she needed.
Sam
Sam’s baseline saliva test showed that his testosterone level was below the
normal therapeutic range. To bring his hormones back into balance, his doctor
prescribed a 20 mg/gm testosterone gel to be applied once daily. Like Frieda,
Sam also started to feel like himself again. With Frieda and Sam’s hormones back
in balance, the newlyweds were worry-free, and began looking forward to a long
and fulfilling relationship.
“With Frieda and
Sam’s hormones
back in balance,
the newlyweds
were worry-free,
and began looking
forward to a long
and fulfilling
relationship.”
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| 19
A Note
Putting It All Together
A note from Marla Ahlgrimm, R.Ph.
Founder and CEO, Women’s Health America, Inc.
Hormones control many aspects of our lives. Hormone imbalance can be
the source of PMS and the many unwelcome symptoms of perimenopause,
menopause, and for men, andropause. The natural decline in hormone levels
as we age can also be the source of health problems like osteoporosis and
cardiovascular disease.
Self-care can go a long way toward managing symptoms of hormone imbalance
and decline. When self-care is not enough, saliva testing is a simple means
for assessing many of the variables involved in choosing a hormone therapy
program. These variables include the individuality of your own hormone profile,
the unique way you absorb and utilize hormones, and the way your needs
change over time.
With its emphasis on balance and synergy, the goal of our Restore program for
individualized hormone therapy is to put an end to overdosing and underdosing
of critical hormones. This comprehensive approach using bioidentical hormones,
saliva testing, and free follow-up is designed to take the confusion out of
hormone replacement while meeting each person’s individual needs.
Remember, there are many variables to consider in hormone therapy. Everything
from how old you are to the level of stress in your life affects what is going
on with you hormonally. Who you are and how your body works is a key
factor in the way your hormone restoration program will work for you. Our
revolutionary, individualized approach to hormone therapy is a giant leap
forward in healthcare and anti-aging.
I hope you found the information in this booklet valuable. If you still have
questions about whether hormone therapy is right for you, please call us at
800.558.7046 or visit www.womenshealth.com. We can help!
In good health,
Women’s Health America • 800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
| 20
WHA
Women’s Health America
• Madison Pharmacy Associates
From conventional to customized, our pharmacy can fill all your bioidentical
hormone therapy prescriptions.
• Madison BioDiagnostics
Our full line of laboratory services includes saliva hormone testing, NTx urine
bone loss analysis, and more.
• Restore®— Exclusively from Woman’s Health America, Inc.
This innovative program for comprehensive hormone therapy combines lowdose, bioidentical hormone therapy with baseline testing and free follow-up
testing to monitor outcomes.
• What’s My Level? Free Testing
FREE annual hormone testing and NTx bone loss analysis are provided for
anyone who’s hormone prescription(s) are filled through Madison Pharmacy
Associates.
• Health Care Provider Referral
Use our preferred provider listing to locate hormone therapy healthcare
professionals in your area.
• www.womenshealth.com
You’ll find extensive information about bioidentical hormone therapy, PMS,
menopause, perimenopause, andropause, and more on our website.
Questions about which services are right for you?
Our staff of professionals are available to answer your questions
Monday through Friday 8:00 a.m. to 5:30 p.m. CST
800.558.7046
Restore® is an exclusive program of Women’s Health America, Inc.
Madison Pharmacy Associates, LLC • Restore, LLC • Madison BioDiagnostics, LLC • Cyclin Pharmaceuticals, Inc.
1289 Deming Way • PO Box 259690 • Madison, WI 53725-9690
800.558.7046 • Fax 888.898.7412 • www.womenshealth.com
rbpdf0107