Caution on the use of saliva measurements to monitor absorption of progesterone from transdermal creams in postmenopausal women

Lewis, John G.; McGill, Helen; Patton, Vivienne M; Elder, Peter A.

doi:10.1016/s0378-5122(01)00250-x

Cited by 39 publications

(38 citation statements)

References 13 publications

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“…In addition, whereas saliva is an ultrafiltrate of the blood and in theory should be amenable to testing for ''free'' (unbound) concentrations of hormones, salivary testing does not currently offer an accurate or precise method of hormone testing (10,11). There are several problems with salivary testing and monitoring of free hormone levels.…”

Section: Hormone Level Testing and Compounded Bioidentical Hormone Usementioning

confidence: 99%

“…There is large withinpatient variability in salivary hormone concentrations, especially when exogenously administered hormones are given (11,(13)(14)(15)(16). Salivary hormone levels vary depending on diet, time of testing, and the specific hormone being tested (11,14,(17)(18)(19). Second, because the pharmacokinetics of exogenously administered compounded hormones cannot be known, it is not possible to estimate with reliability how and when to test saliva to obtain a representative result.…”

Section: Hormone Level Testing and Compounded Bioidentical Hormone Usementioning

confidence: 99%

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Compounded bioidentical menopausal hormone therapy

2012

Fertility and Sterility

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Section: Hormone Level Testing and Compounded Bioidentical Hormone Usementioning

confidence: 99%

Section: Hormone Level Testing and Compounded Bioidentical Hormone Usementioning

confidence: 99%

Compounded bioidentical menopausal hormone therapy

2012

Fertility and Sterility

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“…37 Theoretically, because saliva is similar to a blood ultrafiltrate, salivary hormone concentrations should correlate with free/unbound serum concentrations. 37,38 In practice, these correlations vary, depending on the time of day, 39 diet, 40-50 the specific hormone tested, [39][40][41][42][43][44][45][46][47][48][49][50][51] and other variables. The theory behind NHT presupposes that the results of salivary testing give the practitioner an idea of precisely which hormones are deficient and, hence, which need supplementation.…”

Section: Saliva Testing: Origins In Researchmentioning

confidence: 99%

“…24 Although on the surface this approach seems sensible, its theoretical basis is further eroded by a lack of correlation between salivary hormone concentrations and serum concentrations, as well as large within-patient variability in salivary hormone concentration. [45][46][47][48]51 Assuming a correct unbound serum concentration can be estimated from saliva, how does one adjust HT based upon these results? Based on pharmacokinetic principles, the results of unbound serum concentrations should be compared with both the expected free drug concentration as well as the clinical response of the patient.…”

Section: Saliva Testing: Origins In Researchmentioning

confidence: 99%

Bioidentical hormone therapy: a review

Boothby¹,

Doering²,

Kipersztok³

2004

Menopause

103

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Objective: The terms "natural" or "bioidentical" hormone therapy (NHT) are used to describe hormone treatment with individually compounded recipes of certain steroids in various dosage forms, including dehydroepiandrosterone, pregnenolone, testosterone, progesterone, estrone, estradiol, and estriol. Based on the results of a person's salivary hormone levels, the final composition of the compounded dosage form is individualized to that specific person. Proponents claim that NHT is better tolerated than manufactured products. This paper is intended to review the concept of NHT and to determine whether there is sufficient scientific evidence to support its use.Design: A literature search was performed in Medline using the following MeSH terms and key words: drug combinations; progestational hormones; hormone replacement therapy; endometrium; estrogen replacement therapy; climacteric; menopause; estradiol; estrogens; progesterone; drug monitoring; and drug compounding. Current Contents, International Pharmaceutical Abstracts, Cochrane Database of Systematic Reviews, Lexis Nexis, Google, Medscape, MD Consult, and clinicaltrials.gov were searched with key words.Results: There are a few observational studies and clinical trials comparing conventional hormone therapy with bioidentical hormone therapy. Studies generally lacked adequate study design, including small sample sizes and comparison of inequivalent doses, to prove safety and efficacy. Little evidence was found to support individualized hormone dosing based upon saliva hormone concentrations.Conclusion: Evidence suggests that, although individualized hormonal products may decrease some symptoms of menopause, it seems they have no proven advantage over conventional hormone therapies and their use is not supported by evidence regarding pharmacokinetics, safety, and efficacy.

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“…Bu noktada farmakokinetik açıdan tükürük örneğinde bakılan hormon düzeylerinin biyolojik olarak anlamlı olmadığı, üzerinde uzlaşılan bir görüştür. [5][6][7] Menopoz döneminde östrojen ve progestin kan dü-zeylerinin ölçümü zaten önerilen bir yaklaşım değildir.…”

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Bio-Identical Hormones: Estrogen and Progesterone: Review

Biberoğlu¹,

Biberoğlu²

2017

Turkiye Klinikleri J Gynecol Obst

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Ö ÖZ ZE ET T "Women's Health Initiative WHI" çalışmasının 2002 yılında yayımlanmasını takiben, pek çok menopozal kadın ya hormon tedavisi almayı reddetmiş ya da almakta oldukları hormon ilaçla-rını kesmişlerdir. Bunun arkasından biyo-özdeş hormon tedavilerinde bir artış baş göstermiştir. Biyo-özdeş moleküller, bitkilerin belirli ekstrelerinden konsantre edilmektedirler. Amaç, vücudun kendi endokrin sisteminin ürettiği doğal hormonları taklit etmektir. Biyo-özdeş terim, genellikle reçete edilen formüle uygun olarak ihtiyacı olan kişiye özel üretilen kimyasal formülasyon olarak tanımlanmaktadır. En sık olarak östriol, östron, östradiol, testosteron, progesteron ve dehidroepiandrosteron formları vardır. Bununla birlikte, biyo-özdeş maddeler tam olarak doğal hormonlar olmayıp, laboratuvarda birçok şekilde değişikliğe uğramaktadır. Genellikle etkinlik ve güvenirlilikleri test edilmediği gibi, herhangi bir uluslararası ilaç kurumu tarafından da onaylanmamışlardır. Son zamanlarda bazı aktif içerikler ABD Besin ve İlaç Denetleme Kurumu ve Avrupa Tıp Ajansı tarafından onaylanmaya başlanmıştır. Temel amaç, sağlığa yararlı, minimal risk taşıyan, bireyselleştirilmiş ve yaşam kalitesini artıran tedaviler oluşturmaktır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Östojen yerine koyma tedavisi; hormon replasman tedavisi; östrojenler; progesteron

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Caution on the use of saliva measurements to monitor absorption of progesterone from transdermal creams in postmenopausal women

Cited by 39 publications

References 13 publications

Compounded bioidentical menopausal hormone therapy

Compounded bioidentical menopausal hormone therapy

Bioidentical hormone therapy: a review

Bio-Identical Hormones: Estrogen and Progesterone: Review

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