Women’s health is one of the most frequently overlooked areas in medications that are developed for manufacturing. Many problems that are unique to women do not have FDA-approved medications available to treat them. A compounding pharmacy has the ability to customize medications to meet the unique needs of women. There are numerous medications made by a compounding pharmacy that are not made in any commercially available form.
Hormone Replacement Therapy
A compounding pharmacy is able to demonstrate its unique capabilities in the formulation of hormone replacement therapy for women. Combination creams with estrogen, progesterone, and testosterone can be made in dosages that are customized to each woman’s specific hormonal makeup. A compounding pharmacy can provide these formulations using estrogen and progesterone that is “bioidentical.” This means that the hormones behave the same as those naturally produced in a woman’s body. There are some types of bioidentical hormones that are FDA-approved, however they are in limited dosages and are not in combination creams that contain all essential hormones.
Sildenafil is sold commercially in tablets as Viagra for men. It increases blood flow to the genitals, which can be effective for women when applied topically. It can be made in various combination creams by a compounding pharmacy for application to the clitoris prior to intercourse. Nitroglycerin is also a vasodilator that helps with blood flow. Sildenafil and nitroglycerin can be combined into one cream for treating sexual dysfunction in women.
Vulvodynia is persistent pain in the vulvar region that is not associated with an infection or dermatological cause. Gabapentin is a drug that manages neuropathic pain that can be made into a gel for treating this condition. Neuropathic pain is different from other kinds of pain in that it does not respond to common pain medications like NSAIDs.
Lidocaine may be made into a topical cream for reducing the sensation of pain. This may be particularly useful for applying as needed before intercourse. Cromolyn, which is a mast cell mediator, can be made into a cream and may also be effective at treating vulvodynia.
Women with endometriosis have insufficient production of progesterone. Progesterone stops development of endometrial cells, and a lack of this essential hormone causes the cells to proliferate. Supplementation with progesterone is often required for women with endometriosis. A progesterone vaginal gel or suppository may be made by a compounding pharmacy for treating this condition. A cream can be applied to improve concentrations of the hormone in the area of application while reducing systemic effects that may come from oral administration.
For women considering weight loss aides, a compounding pharmacy can provide combinations of ingredients like phentermine and fluoxetine. This combination has been shown to be effective at suppressing appetite, but it is not an FDA-approved combination. Each of the individual ingredients is FDA-approved, however. Phentermine is found in several FDA-approved appetite suppressant combination drugs. Fluoxetine (sold under the brand name Prozac) is indicated for treatment of depression but has a synergistic effect when combined with phentermine.
Human chorionic gonadotropin (hCG) is a medication that is sometimes used in combination with a low-calorie diet. It is a hormone that is produced in high levels during pregnancy and helps metabolize fat reserves. It can be prepared in various forms by a compounding pharmacy including a troche or cream. Most frequently it is given as an intramuscular injection on a daily basis for the duration of the hCG diet, which lasts between 30-40 days.
For women who are breastfeeding, we can compound an ointment to soothe sore nipples. All Purpose Nipple Ointment (APNO) contains antibiotics and antifungals in a lanolin ointment. The combination is available only by prescription from a compounding pharmacy.
Scar Cream/Stretch Mark Cream
A scar cream with tranilast may be used to reduce the visibility of scars after surgery. Tranilast is approved in other countries for the treatment of hypertrophic scars, but is not commercially available in the U.S. in topical form. It has been used as an oral medication in the U.S. for many years to treat asthma and allergic conditions. When applied in a scar cream, it reduces the production of fibroblasts that lead to scar tissue formation.
Stretch marks from pregnancy are actually a kind of scar. Unlike a scar from a cut or burn, scars from childbirth happen in a deeper layer of the skin as the tissues are stretched beyond their capacity. As these tears heal, scar tissue is formed. Topiramate and aloe vera combined in a gel can help reduce the appearance of stretch marks. Topiramate is an anti-epilepsy drug that may be prescribed in either a capsule or a topical cream. In oral form may be effective at reducing acne scars, possibly by some mechanism of action that reduces compulsive picking of acne lesions.
Melasma is often called “the mask of pregnancy” and is common in women who are in their reproductive years. The hormonal changes of pregnancy often lead to the exacerbation of melasma in women who are predisposed to it. However, melasma can develop at any time in a woman’s life. This condition results in brown patches of hyperpigmented skin, mostly on the face. The hyperpigmentation is difficult to treat and may require multiple types of medication.
Our compounding pharmacy makes a melasma kit, which includes a mask, a maintenance cream, a peptide cream, and facial cleansing pads. Together with proper sun protection it can effectively bring a flare-up of melasma under control. This treatment regimen, like many prescription drugs, is not recommended for use during pregnancy.
Promethazine is an antihistamine sometimes prescribed to be taken orally for allergies. In the form of a transdermal gel, it can be applied to manage nausea and vomiting. Women who are pregnant may be prescribed promethazine transdermal gel to reduce morning sickness and nausea throughout the day.
Ketotifen is a mast cell mediator that can be made into a vaginal cream. It helps reduce the inflammatory response that occurs when mast cells are over-activated. Topical application can provide localized relief from vaginal itching.
Other Compounds for Women’s Health
There are hundreds of possible combinations that can be made to treat a variety of conditions that are unique to women. Compounds can also be made that are free of fillers, dyes, and sweeteners or that are free of ingredients that women might be sensitive to like gluten or soy. Woodland Hills Pharmacy works with OB/GYNs throughout the country to help women get the treatments they need.