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Men's Health Compounding

MEN'S HEALTH COMPOUNDING

At Agewell we customize each prescription formulation specifically to each patients' individual requirements.  We strive to provide the utmost in customer care on every order.  Please call us with any questions pertaining to your compounding request, we are here to discuss any questions or concerns you may have pertaining to your prescription.

 

Compounded Medications:

  • Androstenedione SL Troches 10 – 100mg
  • BArginine SR Caps
  • Chrysin Cream (aromatase inhibitor) 25 -  50mg
  • DHEA SR Caps 5 -25mg
  • DHEA SL Rapid Dissolve Tablets 5 -25mg
  • DHEA Cream 0.125 – 12.5 mg/ml
  • Testosterone Implantable Pellets 50-100mg
  • Testosterone SL Troches 2 – 20mg
  • Testosterone Cypionate PF 100 – 200 mg/ml (Injectable)
  • Testosterone  Enanthate PF 100 – 200 mg/ml (Injectable)
  • TRIMIX
  • SILDENAFIL TROCHE
  • FINASTERIDE HAIR SPRAY

 

GOALS AND THERAPY:

 

Below you will find the goals of Testosterone Replacement Therapy in Adult Hypogonadal Men (age 50 or older)

  • Improvement in psychological well-being and mood

  • Improvement in erectile dysfunction

  • Improvement in libido

  • Increased muscle mass

  • Increased strength and stature

  • Preservation of bone mass

  • Possible decrease in cardiovascular risk

Men may be considered hypogonadal at any age if total testosterone is less than 200 ng/dl, or bioavailable testosterone is less than 60 ng/dl. Basaria and Dobs of Johns Hopkins University recommend that elderly men with symptoms of hypogonadism and a total testosterone level < 300 ng/dl should be started on hormone replacement

 

 

 
MINOXIDIL TREATMENTS :

Treatment: In most instances, topical minoxidil is intended to be applied directly to the scalp twice daily. Some suggest that minoxidil is dose dependent, meaning that patients may have to increase the concentration of minoxidil over time in order to sustain the results. Consequently, it is recommended that people should start using a lower strength formula and gradually move up the scale to the super strength 12% version over time.

Minoxidil Products: The current trend is for doctors or pharmacists to include additives to the formula in an attempt to enhance the treatment's effectiveness and potency. Below are some of the more common ones physicians use for hair loss.

  • Super Strength Minoxidil 12% - Some suggest that minoxidil is dose dependent so it is recommended that people should start using the lower strength formula before they switch to 12%.
  • Propylene glycol free Minoxidil  - this is appropriate for those who developed scalp inflammatory conditions such as scalp itch and flakes as a result of regular minoxidil. Perfect for those whose scalp is sensitive.
  • Minoxidil with Corticosteroids  - Corticosteroid is an anti-itch, anti-inflammatory agent that  can alleviate scalp irritations such as scalp itch, flakes and redness commonly associated with topical minoxidil.
  • Minoxidil with Retin-A  - Retin-A or Tretinoin are commonly used to exfoliate dead skin cells. Also, studies have shown that Retin-A or Tretinoin by itself may stimulate hair growth. When used in conjunction with topical minoxidil, the exfoliatory properties of Retin A or Tretinoin can also enhance penetration of minoxidil into the follicles.
  • Minoxidil with Finasteride  - Probably the most synergistically ideal solution for hair loss. Minoxidil works as a hair regrowth stimulant while 5-alpha reductase inhibitor finasteride is known to halt further hair loss. Targeting hair loss at both angles.
  • Minoxidil with Azelaic Acid - DHT is commonly suggested to be the main cause for hair loss. Studies have shown that azelaic acid may function as a DHT inhibitor and may work synergistically together with minoxidil to stimulate hair regrowth while halting further hairloss.
  • Minoxidil with Nicotinate - Nicotinate is a blood vessels dilator. This additive when used in conjunction with minoxidil may enhance the penetration and potency of minoxidil.
  • Minoxidil with Progesterone - Progesterone is a female hormone added in very small quantities to neutralize the local action of DHT. Not a lot of studies on the effect of topical progesterone on hair loss but some people think this may be beneficial for women pattern baldness.

 

 

 

SUPPORTING LITERATURE :

 

Low Free Testosterone as a Potentially Treatable Cause of Depression in Older Men
 
Arch Gen Psychiatry. 2008 Mar;65(3):283-9
Low free testosterone concentration as a potentially treatable cause of depressive symptoms in older men.

 

In order to access the PubMed abstract of this article, visit this website link.

Low Testosterone Increases Mortality Risk in Men
 
A population-based cohort study followed 1954 men aged 20 to 89 years for an average of 7.2 years, and has demonstrated a link between low levels of testosterone and increased risk for mortality in adult men of all ages.
 
http://www.medscape.com/viewarticle/576267   (accessed 10/08)

Administration of a transdermal testosterone (T) gel formulation to hypogonadal men provided dose-proportional increases in serum T levels to the normal adult male range. Testosterone 1% gel (50 or 100 mg/day) was compared to the permeation-enhanced T patch. After 180 days, skin irritation was reported in 5.5% of subjects treated with T gel and in 66% of subjects in the permeation-enhanced T patch group. This research at UCLA concluded that T gel replacement improved sexual function and mood, increased lean mass and muscle strength (principally in the legs), and decreased fat mass in hypogonadal men with less skin irritation and discontinuation compared with the recommended dose of the permeation-enhanced T patch.

J Clin Endocrinol Metab. 2000 Aug;85(8):2839-53


Transdermal testosterone gel improves sexual function, mood, muscle strength, and body composition parameters in hypogonadal men.

 

In order to access the PubMed abstract of this article, visit this website link.

 

The below mentioned  study concluded that replacing testosterone in hypogonadal men increases bone mineral density of the spine and hip, fat-free mass, prostate volume, erythropoiesis, energy, and sexual function. The full effect of testosterone on bone mineral density took 24 months, but the full effects on the other tissues took only 3-6 months.

J Clin Endocrinol Metab 2000 Aug;85(8):2670-7
Effects of testosterone replacement in hypogonadal men.

In order to access the PubMed abstract of this article, visit this website link.

 

Am J Med 2001 May;110(7):563-72
Hypogonadism and androgen replacement therapy in elderly men.

In order to access the PubMed abstract of this article, visit this website link.

 

Drugs Aging 1999 Aug;15(2):131-42
Risks versus benefits of testosterone therapy in elderly men.

In order to access the PubMed abstract of this article, visit this website link.

 

The findings below suggest that low levels of testosterone and SHBG play some role in the development of insulin resistance and subsequent type 2 diabetes.

Diabetes Care 2000 Apr;23(4):490-4
Testosterone, sex hormone-binding globulin, and the development of type 2 diabetes in middle-aged men: prospective results from the Massachusetts male aging study.

In order to access the PubMed abstract of this article, visit this website link.

Manifestations of testosterone deficiency have included depression, anxiety, irritability, insomnia, weakness, diminished libido, impotence, poor memory, reduced muscle and bone mass, and diminished sexual body hair. Although testosterone levels decline with age, there is great interindividual variability.

Am J Psychiatry 1998 Oct;155(10):1310-8
Age-associated testosterone decline in men: clinical issues for psychiatry.

In order to access the PubMed abstract of this article, visit this website link.

Massive obesity in males is associated with decreased total and free testosterone levels as well as elevated estradiol levels.

Med Hypotheses 1999 Jan;52(1):49-51
The hypogonadal-obesity cycle: role of aromatase in modulating the testosterone-estradiol shunt-a major factor in the genesis of morbid obesity.

In order to access the PubMed abstract of this article, visit this website link.

These results suggest that testosterone treatment might improve depressed mood in older men who have low levels of bioavailable testosterone.

J Clin Endocrinol Metab 1999 Feb;84(2):573-7
Bioavailable testosterone and depressed mood in older men: the Rancho Bernardo Study.

In order to access the PubMed abstract of this article, visit this website link.

The following results suggest that until the age of 60 years, the mean serum level of DHEAS is lower in patients with ED than in healthy volunteers.

Urology 2000 May;55(5):755-8
Serum dehydroepiandrosterone sulfate concentrations in men with erectile dysfunction.

In order to access the PubMed abstract of this article, visit this website link.

Sublingual sildenafil in the treatment of erectile dysfunction: faster onset of action with lower dose

 Forty consecutive patients with erectile dysfunction (mean age was 55 years) for more than three months were included in this study. Sixty-five percent of patients (13/20) who received sublingual sildenafil achieved satisfying erections and coitus, whereas the rate was 15% in the placebo group (3/20). The mean onset of action with sublingual sildenafil was 15.5 minutes and lasted for an average of 40 minutes. Minimal headaches, sweating and flushing were noted as the side-effects.  The conclusion: "20 mg sublingual sildenafil is safe and effective in the treatment of erectile dysfunction. Sublingual administration has some advantages as it is not effected by food ingestion and quickly appears in the circulation. These advantages provide a faster onset of action with a lower dose when compared to oral sildenafil. Sublingual use of sildenafil may be more cost-effective and possibly provides a more predictable onset of action."

 

Int J Urol. 2004 Nov;11(11):989-92 
Sublingual sildenafil in the treatment of erectile dysfunction: faster onset of action with less dose.
 

In order to access the PubMed abstract of this article, visit this website link.

 

 The International Journal of Pharmaceutical Compounding [March/April 2007;11(2):121] reported a formula for Sildenafil 20mg Troches (flavored) with a recommended beyond-use date of 180 days.

 

 

TESTOSTERONE :

 

Testosterone USP is natural bio-identical testosterone that has been approved by the United States Pharmacopoeia and is available as a bulk chemical. Upon a prescription order, compounding pharmacists can use Testosterone USP to prepare numerous dosage forms.

 

Natural Testosterone Replacement is Central to the Treatment of All Facets of Andropause. The term "testosterone" is often used generically when referring to numerous synthetic derivatives, as well as natural bio-identical testosterone. Confusion is responsible for conflicting data in the medical literature about the benefits and risks of testosterone therapy. Studies must be reviewed carefully to determine the form of testosterone that was used. Natural testosterone must not be confused with synthetic derivatives or "anabolic steroids," which when used by athletes and body builders have caused disastrous effects. For example, administration of synthetic non-aromatizable androgens, like stanozolol or methyltestosterone, causes profound decreases in HDL-C ("good cholesterol") and significant increases in LDL-C ("bad cholesterol"). Yet, hormone replacement with aromatizable androgens, such as testosterone, results in lower total cholesterol and LDL cholesterol levels while having little to no impact on serum HDL cholesterol levels. Proper monitoring of laboratory values and clinical response are essential when prescribing testosterone replacement therapy.

 

The only absolute contraindications to androgen replacement therapy are the presence of prostate or breast cancer. "Although it is known that the clinical course of prostate cancer is accelerated by testosterone, its incidence is not increased by [testosterone] administration... There is even no clear evidence that testosterone replacement accelerates the development of BPH."

 
 

 

Men's Health Categories:

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Goals and Therapy

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Minoxidil Treatments

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Supporting Literature

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Testosterone 

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* Any health related information is for educational purposes only. None of the information provided here is to be construed as medical advice. Before applying any therapy or use of herbs, you may want to seek advice from your health care professional. The information on our website should not be a substitute for physician evaluation or treatment by a health care professional and is not intended to provide or confirm a diagnosis.