The Daily Compounder

There are so many advatnages to testing your hormone balance. Here are the advantages of doing the blood spot test to find you hormone balance.

• No phlebotomist or centriguging required
• Collection times can be optimized – very important for determining early morning baseline hormone levels, testing of hormones multiple times of the day, and the assessment of HRT dosing.
• Nearly painless finger prick, simple and safe (stress of conventional blood draw can alter test results)
• Private (home collection) and convenient for both patient and doctor)
• Hormones are stable in dried bloodspot at room temperature for weeks allowing for worldwide shipment of home-completed kits.
• Less expensive than conventional blood draws
• Ease of collection allows for routine monitoring and adjustment of hormone supplementation as needed.

Why do we use the blood spot test?

• Identify hidden hormonal deficiences associated with aging and disease, thyroid dysfunction, and symptoms of menopause and andropause.
• Maintain optimal health and prevent disease through early detection of hormonal imbalance
• Link clinical symptoms to specific hormone imbalances flagged in testing
• Restore hormonal balance and patient quality of life using test results as a rational basis for treatment
• Monitor patient hormone levels for individualized, physiologic dosing of hormone replacement
• Track patient progress with compartitive history reports provided with follow-up testing

Doing the saliva test is another way to test your hormone balance. Here are some of the advantages of doing the saliva test.

• Saliva measures the free, “bioavailable,” fraction of steroid hormones that have moved out of the bloodstream and into the tissue (Blood and urine measure the total levels of all hormones)
• Saliva is the most reliable measurement of tissue uptake with topical hormone supplementation
• Painless, noninvasive, and needle-free (stress associated with blood tests can alter test results)
• Private (home-collection kit) and convenient for both patient and doctor to allow for optimal collection time
• Hormones are stable in saliva at room temperature up to three weeks allowing for worldwide shipment.
• Transport of saliva samples to laboratory requires no special handling.
• Less expensive than conventional blood testing
• Ease of collection allows for routine monitoring of hormone levels and adjustment of hormone supplementation as needed.

Understand more on why you would use the saliva test.

• Can help identify hidden hormonal imbalances (deficiency or excess) associated with patient symptoms of menopause and andropause as well as reproductive disorders, chronic illness, and diseases of aging
• Will link clinical symptoms to specific hormonal imbalances
• To maintain your health and prevent disease through early detection of any hormonal imbalance
• To establish treatment options to restore hormonal balance and patient quality of life
• Allows physicians to monitor patient hormone levels for “individualized” bioidentical hormone replacement therapy
• Physicans can track each patients’ progress with comparative histroy reports provided with follow-up testing

Both are great ways to test find your hormone balance. Some people prefer using the blood test. Some would much rather use the saliva test.There isn’t exactly a better or worse procedure. Make sure that you understand and know which one would work best for your bennefit.

If you are not comfortable with the injection therapy used to treat ED, don’t worry, there are alternatives. Intraurethral Gels are another method that many patients may be happier using. Here is an overview of what you need to know about this method. Talk to your doctor if you think it’s something that you would want to try.

The same medications used in injection therapy to treat ED (alprostadil, papaverine, and phentolamine) are all available in gel form for intraUrethral application. Prior to intercourse, the easy to apply gel is inserted into the urethra. IntraUrethral gels are a great alternative for those who are not willing or cannot inject the medications with a needle to treat erectile dysfunction.

Like the injections, the medication should take effect within 10-15 minutes. An erection that lasts for approximately 60 minutes will occur if this form of treament is effective for you.

Are there any side effects for the partner?

Unless your partner is allergic or responsive to the medications used within the gel (experience minor vaginal itching or burning), there have been no reported instances of negative side effects for the partner.

Ensuring your success.

Occassionally but rarely the men using this medication do not get the desired results. If this medication does not work for you, please inform our pharmacists so that they may discuss with you the proper technique of injecting. If this still does not work, we will consult with your physician in regards to alternative medication combinations that may be more effective.

The most commonly prescribed ED therapy – ED oral pills, called PDE-5 Inhibitors, are only effective in 60% of men with ED. Just because one method does not work for you, doesn’t mean there aren’t other methods that can help. Intracavernosal injections take advantage of the latest scientific discoveries in order to help you and your partner restore sexual intimacy in a discreet, convenient, and most importantly, effective manner.

What is Injection Therapy?

Intracavernosal injection treatments were first discovered in the 1980s when it was found that certain drugs could be injected into the penis to stimulate an erection. This discovery not only led to a greater understanding of how an erection happens, but also offered an effective treatment for men with ED. To have this effect in a very controlled way, the drug should be delivered directly into the erectile penis. The most effective way of doing this is by an injection.

How does it work?

Intercavernosal injections will be injected into one of the two corpus cavernosum that run the length of the penis. Avoid visible blood vessels. With each use of the injections, alter the side of the penis, and vary the site of injection. Injection therapy normally uses drugs that will relax the blood vessels feeding blood into the penis allowing the blood flow to increase. At the same time, relaxation of the muscle layers surrounding the erectile penis allows them to expand preventing the flow of blood out of the penis, and helping to maintain an erection.

If this sounds complicated to you, dont worry, there are various injections systems available to help you to prepare and inject your treatment. Injection therapy is usually dispensed as a dry sterile power and diluent, which needs to be mixed before use. It is important that you take time to learn how to administer your injection. Your doctor, nurse, or specialist can help you with this. Most patients find that performing the injection is fairly easy and not painful.

If needed, there are various systems available to assist you with the injection process. At Pallimed, we recommend the Owen Mumford brand Autoject El which is a simple solution for self-injection. Autoject injects the needle to a pre-set depth and delivers the contents of the syringe. It comes equipped with an external indicator which provides confirmation that the full dose has been delivered.

If you are interested or have any questions please give us a call. We are happy to help you. You can reach us at 781-937-3344.

Pallimed Solutions is an active member of the pharmaceutical and healthcare industries. We value the relationships that we have built and strive to acquire new partners within our community.

Below is a list of organizations that Pallimed is affiliated with:

Many of our effective treatments for erectile dysfunction at Pallimed are administered through injections. You can learn more about Injection therapy to see how it help you. You can also discuss more with your doctor to see if this is the right treatment for you.

What medication is used in injection therapy?

The most commonly used drug is alprostadil. This is identical to a substance called prostaglandin – E1, that occurs naturally in the penis and is involved in the natural erection process. Alprostadil relaxes the blood vessels and muscles in the erectile tissue of the penis allowing increased blood flow, the basis of a normal erection. Other medications that maybe used are papaverine and phentolamine.

How soon after using an injection will an erection occur and how long will it last?

An erection will normally develop in 10 to 15 minutes after injection and should be hard enough for penetration for you and your partner to enjoy normal sexual activity again. An erection that lasts for approximately 60 minutes will occur if this form of treatment is effective for you.

What side effects might be associated with injection therapy?

Some men experience penile pain after injecting. In rare cases, a prolonged erection might occur. Some men develop a nodule in the penis, however, this may disappear with a short break from injections. Permanent nodules may occur in a small percentage of men with long term usage. This can sometimes be avoided by alternating the injection site.

Are there any side effects for the partner?

No side effects have been reported in the partner. Alprostadil is naturally eliminated quickly in the penis.

What conditions prevent a man from using injection therapy?

Injection therapy should not be used in the following conditions: known hypersensitivity (allergy) to alprostadil, an abnormally formed penis, Peyronie’s Disease, angulation, cavernosal fibrosis, patients with a penile implant, in patients with diseases that might result in prolonged erections (sickle-cell anemia, leukaemia, or multiple myeloma), or in patients in whom sexual activity is inadvisable.

Ensuring your success.

Occassionally but rarely the men using this medication do not get the desired results. If this medication does not work for you, please inform our pharmacists so that they may discuss with you the proper injection technique. If this still does not work, we will consult with your physician in regards to alternative medication combinations that may be more effective.

How can I get injection therapy?

You should discuss this form of treatment with your doctor and then call Pallimed Solutions Pharmacy at (781) 937-3344 in order to fill your prescritpion medication.

If you don’t think pills, injections, or other methods are suitable for you, Vacuum Therapy might be it! Here’s how it works and what you need to know about it. Even if you are comfortable with using pills or injections, try this out anyway, maybe you’ll find it even more efective!

Along with prescription pills and injections, Vacuum Therapy is one of the most effect ways to treat ED. Vacuum Therapy is one of the safest ways to deal with impotence and has a 84-95% success rate of producing and maintaining an erection.

Because it does not require you to take any drugs, there are no risks of interactions with other medications or harmful side effects. Vacuum Therapy is sometimes recommended as a compliment to oral or injectable regimens.

How does it work?

A pump is used to create a vacuum around the penis which draws in blood and creates a firm erection within minutes. A penile ring is slipped over the base of the penis and the pump is removed to allow for full sexual intercourse to take place. The ring maintains an erection and must be removed within 30 minutes.

Where do I get it?

At Pallimed Solutions, we offer two types of vacuum therapy systems – The Rapport™ Classic and the Rapport™ Rings both made by medical device manufacturer specialists Owen Mumford.

The Rapport™ Classic is the conventional vacuum therapy system which consists of a tube, pump, and rings. The Rapport™ Rings are for men who need help maintaining their erections and do not require a pump to form the inital erection.

Both products are available without a prescription, but it is recommended to ask your doctor or healthcare professional for medical advice before initiating any form of ED therapy.

At Pallimed, we can prepare medications in various dosage forms that would fit every patients needs and preference. Learn more about each dosage form to know what works best for you!

Capsules: Capsules are the best option when a patient needs a specially titrated dose, is allergic to the commercial fillers such as lactors, or when more than one medication needs to be combined together to maximize compliance. Due to the oral administration and the large amount of data supporting this dosage form, capsules are a great first line option. The powdered drug is enclosed in a non-flavored, hard gelatinous shell. Capsules are easy to swallow and mask bitter tastes. We can also combine several medications so the patient only has to take one capsule.

Suppositories: Medication is imbedded in either a fatty acid base or PEG. This formulation is ideal for patients with no oral access, difficulty swallowing, or for nausea and vomitting. Rectal dosage formulations are a great way to administer medications when patients are unable to swallow, have limited gastrointestinal function, gastrophoresis, or during end-of-life stages when oral administration is very difficult.

Rapid Dissolve Tablets: Pallimed Solutions specializes in Rapid Dissolve Tablet Therapy (RDT). This is the preferred method of administration when a patient still has normal gastrointestinal function but is unable to swallow. RDTs allow medication to be administered orally which allows us to predict safety and efficacy.

Concentrate: Given by dropped onto the patient’s tongue for ingestion. Medications can be given in smaller volumes than what traditional drug forms can administer.

Liquid: Given via oral syringe or added to food for ingestion. This versatile method lets caregivers squirt a great tasting liquid into the mouth, or add to a favorite food.

Emulsions: The drug is mixed in both the squeous or oil phase and remains evenly dispersed throughout the preparation. Bitter medications can be made more palatable. The absorption of some drugs can be increased when incorporated into an oil phase.

Ointments & Transdermal Drug Delivery Systems (TDDS): Ointments and TDDSs are rubbed into the affected areas of the patient’s skin. The medication is mixed with a topical gel that promotes absorption of the drug through the skin. Gels are a preferred route of administration for patients who cannot swallow and when the rectal route of administration is not an option. Although there are several case reports and anecdotal evidence supporting the efficacy of topical drug delivery, we recommend this as a last resort because of the lack of scientific data supporting the safety and efficacy of this route of administration.

Lollipops: Pallimed prepares many medications in the form of a lollipop. The applications are endless, but lollipops are a good option when a patient has oral sores and we want to apply a topical anesthetic without swallowing the medication too quickly as one would with mouthwash or a buccal tablet.

Otics: The drug is mixed wtih an aqueous or oil base. Medications are administered directly to the ear, often increasing effectiveness and decreasing cost and potential for toxicity.

Gummie Chew: The medication is mixed in a chewable treat base and flavored to the patient’s preference. The base can also be used for a slow-release “sucker.” This form of medication is great for mouth sores, xerostoma, and other oral con ditions.

PED Troche: The medication is included in a sem-soft preparation thatis less chewy than a Gummie Chew. This is available in multiple sizes in a solid form.

Opthalmics: The drug is mixed with an aqueous or oil base using USP guidelines for sterile preparation. Sterile medications are administered directly to the eye, increasing efficacy and lowering cost and potential for toxicity.

Baby boomers are doing what ever it takes to take back a few years. Not only do they want to look younger, but also feel younger. It’s very hard for them to not get distracted by the media and the young generation. Celebreties who are now baby boomers are looking twenty years younger. 65 year old actress, Suzanne Somers openly said, “I will still have sex with my husband at 95″. Celebrity icons like her create a stronger push for baby boomers to look and feel as great as she does. The feeling of wanting to be younger is feeding the anti-aging industry $80-$120 Billion every year.

Some of the most popular methods would be taking anti-aging supplements, hormone replacement therapy, cosmetic surgery, expensive skin-care treaments, and some would do routine exercises. Hormone replacement therapy would improve energy and strentgth. Some people using this method have seen a boost in immunity and decrease in fat. For some people exercising and eating healthy just doesn’t cut it because they’re lacking testosterone. $20 Billion is spent every year on skin-care treatments. There are wrinkle creams, eye serums and rejuvenating facials. The products can cost from $19 to $450 for each product. Facials can cost from $80 to $375 for each visit. Some would take the extreme and fast route by doing cosmetic surgery. Baby boomers consider it the “quick-fix”. Botox cost about $400 for every injection, that means a proceed of $5.4 million each year. In 2010 there were 112,000 face lifts that cost between $6,000 to $15,000 each procedure. Liposuction was just right below that.

Life is short and people age quickly. There ways to slow it down to feel young and look young again! At Pallimed we provide male and female hormone replacement therapy and Meso Therapy. We can help with gorwth hormone deficiency and andropause treatment. Talk to your doctor about which methods fits you best. Growing older is inevitable but looking and feeling younger isn’t!

Knowing the status of your hormones is the first step in reaching a healthy hormone balance. Testing can help you detect imbalances and shed light on exisiting and potential health problems. It also allows you and your physician to monitor the effectiveness of supplemental hormones.

The Saliva Test is one of the tests that can show your hormonal balance. Saliva testing is a convenient, inexpensive, and above all, accurate means of testing steroid hormones. Scientific studies have shown a strong correlation between steroid hormone levels in saliva and the amount of hormone in the tissue that is active or “bioavailable.” It is this fraction of total hormone that  is free to enter the target tissues in the brain, uterus, skin, and breasts.

Saliva testing can be done anywhere, anytime. Testing that relies on blood drawn in the doctor’s office, makes it harder to obtain samples at specific times or multiple times during the day. In addition, hormones in saliva are exceptionally stable and can be stored at room temperature for up to a week without affecting the accuracy of the result. This offers maximum flexibility in sample collection and shipment.

At Pallimed, we have access to many labratories for either the testing of home-completed kits or for patients to visit for on-site testing. Tests offered in the Saliva profile include:

• Estradiol

• Progesterone

• Testosterone

• DHEA

• Cortisol

Another valuable tool would be the Blood Spot Test.Blood Spot Testing is the future of hormone testing. The process requires blood from a nearly painless finger prick and several tests can be run from a single sample. In addition, collection times can be optimized for the collection of baseline hormone levels, assessment of HRT dosing and treatment, or for diurnal hormone testing.

At Pallimed, we have access to many labratories for either the testing of home-completed kits or for patients to visit for on-site testing. Tests offered in the Blood Spot Profiles include:

Women reaching their midlife go through many changes in their body. These changes effect the body both physically and emotionally. Physically women will start to have hot flashes, pain during intercourse, frequent urination, and even changes in memory. Emotional changes will occur such as depression, anxiety, mood swings, and a loss in sex drive. What these women are going through is called menopause. Menopasue then plays a role in driving sexual desire downhill.

Menopause is defined once a woman goes a full year without a menstrual period. There are several reasons why menopause plays a role in decreased sex drive. Menopause causes hormone levels to drop up to 60%. Less progesterone and decreased amount of testosterone in the body means less desire for sex. Progesterone works in the brain to bring sexual interest, and in the genitals to create sensation. During menopause the body stops its ovulation process. Ovulation occurs 14 days after a menstrual cycle. Ovulation is the best time period to get pregnant and is also when sexual desire is at its highest. Depression is another reason for lack of sexual desire. Another reason for less desire for sex is pain during intercourse. Menopause causes the vaginal tissues to dry and shrink. Women become less inclined to have sex because now there’s more pain than pleasure.

There are treatments for men who go through sexual, but is there still hope for women? There is! Here are some ways that would help boost sexual desire in women.

• Test for Low Thyroid Function/Iron Definciency Anemia: Before treating menopause, make sure to rule out other possiblities that maybe causing a decrease in sex drive.
• Use lubricant: This would help with the dryness of the vaginal tissue and also reducess irritation.
• Scream Cream: These creams increase blood flow to the clitoris to increase sensitivity. (This cream is available at Pallimed)
• Vitamin E: Placing vitamin E locally as a vaginal suppository would help rehydrate the tissues and create an increase in sensation and decrease irritation. (Available at Pallimed)
• Hormone Replacement Therapy: HRT is often recomended to be most effective. At Pallimed Pharmacy we compound gels and creams of estrogen and progesterone for use in the body as well as the vagina. Doing HRT also has other benefits. Women who are 60 and under using this therapy have shown a 60% lower risk of coronay artery disease, risk of breast cancer, and strokes.