CENTRAL PHARMACY
& CENTRAL COMPOUNDING
CENTER
For more information about these community pharmacy/ education/wellness centers, contact:
Jennifer Burch, PharmD
Sejjal Patel, PharmD
Jhuvon Francis, PharmD
Erika Kelly, PharmD
Chad Palumbo, PharmD
CENTRAL PHARMACY
2609 North Duke Street, Suite 103
Durham, NC 27704
Telephone: (919) 220-5121
Fax: (919) 220-6307
www.centralpharmacync.com
CENTRAL COMPOUNDING CENTER
6224 Fayetteville Road, Suite 104
Durham, NC 27713
Telephone: (919) 484-7600
Call to schedule a consultation with our pharmacists
www.centralcompounding.com

“Any conversation about the risk of so-called ‘silent diseases,’ will inevitably lead to a discussion of hormones and hormone imbalance,” observes Dr. Jennifer Burch of Central Compounding Pharmacy in Durham. “Osteoporosis, diabetes, hypertension, heart disease—all these conditions are influenced in significant ways by our hormones, and particularly by hormone imbalances.
“Hormones affect every cell in the body,” she points out. “They work together to help regulate all the body’s processes. An imbalance—too much or not enough of one or more hormones—can cause a variety of problems.”
Hormone Replacement Therapy: Lifelong Health Support
“The benefits of hormone replacement therapy are best understood in the context of women’s life expectancy,” notes Dr. Burch. “Simply put, women are living longer—way past childbearing years. The average age of menopause is around 52, so if they live to be 100, that’s up to 50 years without the hormones that have supported them since puberty.”
And those hormones support health in many important ways, she explains. “They control many different bodily processes—not only reproduction, but metabolism, blood pressure and blood sugar regulation, sleep-wake cycles, and much more.
“For example, estrogen plays a key role in preventing cardiovascular disease—which is the number one killer in women. Estrogen decreases LDL and lipoprotein; it reduces the accumulation of plaque in your arteries; it dilates small arteries—all factors in heart disease. Estrogen also helps decrease the risk of colon cancer, and aids in maintaining memory and preventing Alzheimer’s. And it helps skin maintain its elasticity—preventing wrinkles!
Correcting Myths About Hormone Replacement Therapy
“For over 20 years,” says Dr. Burch, “an unfortunate myth has persisted—that hormone replacement therapy (HRT) increases a woman’s risk of heart disease and breast cancer. The myth originated with the 2000 Women’s Health Initiative (WHI) study, which appeared to find a correlation between HRT and these risks. The study had a huge effect: Within months, the number of women using HRT dropped by almost half; and even today there is considerable fear about the risks of HRT.
“Unfortunately, the 2000 WHI study and its conclusions were flawed; and, in fact, HRT is both beneficial and safe—something that has been affirmed by multiple research studies over the past two decades. Most recently, a study published earlier this year in the Journal of the American Medical Association (JAMA) concluded that, “Among women below the age of 60, we found hormone therapy has low risk of adverse events and [is] safe for treating bothersome hot flashes, night sweats, and other menopausal symptoms.” Additionally, says Dr. Burch, “multiple studies have repeatedly found that hormone therapy goes beyond simply treating menopausal symptoms, offering protection against bone loss, breast cancer, and heart disease.”
“There are so many examples of the benefits of maintaining healthy hormone levels,” says Dr. Burch. “Women on hormone replacement therapy have a 20 percent decreased risk of developing breast cancer. And women who get breast cancer when on HRT have a 40 percent less chance of dying than if they were not on hormones.
“Osteoporosis is another example of a health issue significantly influenced by hormone imbalances,” she adds. “With hormonal changes, bone loss can accelerate after menopause, so HRT can be beneficial not only in preventing bone loss, but for women who already have osteoporosis or are at high risk of breaking bone.
“And just because somebody’s not having a hot flash doesn’t mean they don’t need hormones. We know that estrogen helps reduce the risk of dementia and of heart disease. It also helps lower bad cholesterol, helps lower blood pressure, and works as an antioxidant. Balancing estrogen and progesterone can help improve sleep—a huge benefit for our overall health.
“These are important reasons to consider hormone replacement therapy,” notes Dr. Burch, “not just as short-term therapy for menopause symptoms, but as a lifelong program to maintain the benefits of adequate, balanced hormones. Hormone replacement therapy is not a magic bullet, but it is a valuable component of a good anti-aging longevity health plan.
Compounding:
An Individualized Approach to Hormone Balance
“The data strongly affirm the value of hormone replacement therapy,” says Dr. Burch, “However, to be effective, HRT needs to be individualized.
“Hormonal imbalances are extremely complex conditions,” she explains. “For example, while you and I might have similar symptoms, the hormones causing them might be entirely different. So, comprehensive hormone testing and monitoring—for each individual—is essential, because it allows for accurate hormone adjustments.”
Dr. Burch takes a special interest in hormone balance issues and, with her staff at Central Compounding Center, has developed a comprehensive program to evaluate hormone problems and to provide bioidentical hormone therapy (BHRT).
“In our BHRT program, we do an initial test to evaluate hormone levels. Three or four months later, we’ll test again, to make sure we’re in the ballpark, and we may fine-tune the levels. Then we’ll test annually to see how folks are doing—because hormones may change over time.
“Our tests are comprehensive,” says Dr. Burch, “measuring all hormones—estradiol, estradiol progesterone, testosterone, DHEA—as well as cortisol levels. We also use either a saliva test or a finger-stick (capillary blood) test, because these methods examine the free usable hormone available in the body. Standard serum blood tests are less precise; and as a result those patients typically end up being prescribed much higher dosages of hormones than they would be if salivary hormone testing had been used.
“Moreover—and this is important—the key to safe hormone replacement therapy is compounded bioidentical hormones. First, we use only bioidentical—not synthetic—hormones. And, by compounding the dosages, we can provide individualized adjustments for each patient. With BHRT, precise dosages are extremely important,” emphasizes Dr. Burch, “and compounding gives us the opportunity to use lower, more precise doses than is possible with commercially available products. So, if we have to change a dose, instead of having to double it, we can go up by 5 or 10 percent at a time, testing to see what works best.”
“The delivery system—how we get the hormones into your system—is also important,” says Dr. Burch. “And this is where compounding can be especially beneficial. Transdermal delivery is still my favorite way to provide hormones. It allows us to use lower doses, and there are some other benefits to bypassing the digestive system. For example, hormones taken orally, particularly estrogen, can impact your cholesterol.”