Letters to the editor

I believe your Feb. 21 article "Compounding R.Ph.s cash in on bioidentical hormones" was full of controversial quotes but void of much factual information. Larry Sasich and Sarah Sellers make some very generalized statements that seem to indicate that pharmacists practice pharmacy in a reckless fashion and are not concerned with the patient's welfare. One can only wonder how many days Mr. Sasich and Ms. Sellers have actually spent in a pharmacy listening to patients, working with prescribers, and helping patients resolve drug therapy problems. Sasich's statement that "these people all belong in jail" is really quite comical. I'm also not sure how Sellers knows what motivates me, or other pharmacists, in the practice of pharmacy. Such broad statements really hinder her credibility.

I cannot disagree with the comments made by Ms. Hansen from the University of Colorado Health Sciences Center. She indicates that the risks of synthetic hormones and bioidentical hormones may not be the same. I agree. She also implies that there are no large-scale clinical trials proving that bioidentical hormones are safer. I also agree. However, there are numerous articles highlighting the metabolic differences between bioidentical or endogenous estrogens and synthetic estrogens. These articles indicate that bioidentical hormones and their metabolites may have a superior safety profile.

Here are some key facts about various hormone replacement therapy products:

It is wise to adhere to our scientific background and question accepted principles. Arthur Schopenhauer once stated, "All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident." It appears that the use of bioidentical hormones is in phase two of this process. However, if we keep an open mind and continue to pursue the answers for hormone replacement therapy, we will find that the benefits of bioidentical hormones will become self-evident!

Kudos to Dale Bartel for helping patients to the best of his ability rather than counting, pouring, licking, and sticking!

Michael F. Stein
Iowa City, Iowa

As a woman who has just gone through menopause and who works on a daily basis with women struggling with menopause, perimenopause, and PMS, I think your article shows a lack of understanding of how desperate some of these women are. Menopause is more than just a few hot flashes. It is depression, migraines, mental fuzziness, memory loss, anxiety, low libido, vaginal dryness, and insomnia as well. Women are desperate for help.

Granted there are no studies on natural hormones. The studies have been done on Premarin and medroxyprogesterone. I wish someone would take the initiative to do such studies. In the meantime, many women, myself included, are willing to take the risk in order to be able to function normally and are thankful to pharmacists who are willing to compound these medications.

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