Andropause and Your Patient
Tuesday, March 01, 2011
While men and women share many health issues, there are a number of conditions unique to the male patient.
Compounding pharmacies often prepare medications specific to these conditions. In the discussion below, we will examine a number of these health conditions and some unique compounded medications used to treat them.
For many years, physicians have recognized the benefits of hormone replacement therapy for their peri-menopausal and menopausal female patients. And just as female patients can suffer from hormone deficiencies and imbalances, so too can male patients. The condition is referred to as andropause, hypogonadism or, simply, as male menopause. It is caused by the decrease in testosterone and dehydroepiandrosterone (DHEA) and an increase in the sex hormone binding globulin.
Common symptoms of andropause can be loss of muscle mass, increased body fat, fatigue, lowered libido and erectile dysfunction. Some men also experience impaired cognitive functioning, depression and even hot flashes. These symptoms are often decreased by treating the patient with testosterone or DHEA hormone replacement therapy.
Compounding pharmacies have worked with physicians for years preparing testosterone, USP and other hormone medications. Injections, sublinguals and topicals are common compounded preparations. Recently, commercially available testosterone pharmaceuticals have become available, however, at much lower concentrations. Many patients prefer compounded testosterone, as the higher concentration (up to 20%) topicals reduce the volume needed for each dose, thus reducing the surface area needed to apply the hormone dose. This, in turn, can reduce the accidental exposure to children, spouses and other individuals to the testosterone. Compounded testosterone also has good absorption qualities, resulting in improved testosterone levels in male patients.
Erectile dysfunction is another common condition affecting millions of men. Commonly, oral vasodilators such as sildenafil citrate are prescribed. However, for many men, such as postprostate surgery patients, these medications are ineffective or cause undesirable side effects, such as headache. For these patients, compounded medications such as Tri-Mix (prostaglandin E1, phentolamine mesylate and paparerine HCl) can be injected at the base of the penis. These types of compounded injections work locally, increasing blood flow into the penis with greater efficiency and fewer systemic side effects. Most men find the injections easy to use and very effective.
Men with sports-related injuries can also benefit from compounded medications. Injuries to muscles and joints respond very well to compounded topical NSAID therapy. Other drugs such as gabapentin, lidocaine, ketamine, cyclobenzaprine HCL and others can be used alone or in combination to treat a variety of painful conditions. Applied locally to the site of pain or to trigger points, the compounded medications in specialized bases effectively deliver the drug and provide relief to the patient. In addition, undesirable gastrointestinal and systemic side effects can often be avoided through the use of topicals.
Talk with a compounding pharmacist today and find out what unique treatment options exist for your male patients.
Stanley Apothecary is a custom compounding pharmacy located in Charlotte, NC. For more information, visit www.stanleyrx.com or call (704) 370-6612.
MD News March/April 2011, Greater Charlotte