All Commonly Asked Questions - Belmar Pharma Solutions

Some patients report gradual changes over time rather than immediate results. Sleep and mood are often among the first changes described, with libido, energy, and focus sometimes following. Changes in muscle tone and bone density, when reported, tend to emerge over a longer timeline.

Neither is universally “better”; the right choice depends on the patient. BHRT pellets are designed to provide steady, long-acting delivery without a daily routine, appealing to patients who want convenience. BHRT cream suits those seeking localized relief or who prefer to avoid implants or injections. Matching delivery to patient preference improves regimen adherence.

Menopause is actually just one day in a woman’s life that marks 12 consecutive months without a period. The time leading up to menopause is perimenopause, and the rest of a woman’s life beyond menopause, is postmenopause.

Yes. To see our compounded thyroid medications, our most commonly prescribed compounded medications and hormones are available for your review. Contact us and we can provide the information you need about formulary, pricing, and applications.

Belmar’s 503A pharmacies ship to all 50 states, Washington, DC, Puerto Rico, and Guam. Belmar’s 503B Outsourcing Facilities ship to 48 states and Washington, DC.

There are a number of factors that affect turnaround time. Most 503A prescriptions are prepared within 3 to 5 business days of order verification and payment. Please consider compounding time when choosing shipping options. 503B orders are often shipped the day after you submit your order when all medications are in stock.

Yes. All six of our 503A locations ship directly to a patient’s home. Find your preferred Belmar Pharmacy location.

Belmar Pharma Solutions Preferred Provider webinar series is free to clinicians and we do not offer credits for attending. We offer monthly webinars as part of our commitment to education. For providers interested in CEUs, we recommend you check out our professional clinical educational resources.

Belmar Pharma Solutions Preferred Provider webinar series is free to clinicians and we do not offer credits for attending. We offer monthly webinars as part of our committment to education. For providers interested in CEUs, we recommend you check out our professional clinical educational resources.

Confirm the location where your prescription has been filled by looking on your label. Call or email during business hours.

Our pharmacists are happy to refill the compounded medication your healthcare provider has prescribed for you.

Please look at the upper lefthand corner of the label on your medication to determine which Belmar Pharmacy to contact for a refill, and contact the pharmacy directly.

We do not bill your insurance. Most insurance companies do not cover personalized medications. You may find this article helpful in finding alternatives to insurance for compounded medications: “Ask the Pharmacist: Does My Insurance Cover Compounded Medications?“.

If you are paying for the medication yourself and require NDC information to submit to your insurance company for possible reimbursement, contact our Customer Experience Team by calling the number on your prescription label.

For patients paying the pharmacy directly, most medications take 3 to 5 business days to compound after we receive payment. You will receive status notifications and updates about your prescription. You will receive an email with tracking information when your medication is ready to ship. For most orders, our standard shipping method is UPS 2-day delivery.

For patients paying the pharmacy directly for their prescription, 2-day shipping is included in the price. If faster shipping is required, you may request your shipping preference for an additional cost.

Tracking information is sent via email. If you would like to track your orders, let our pharmacy know and provide a valid email address. We encourage you to sign up for alerts from UPS.com as well.

Storage requirements are as personalized as our medications. Please review the information on your prescription label or contact the pharmacy with any questions using the phone number on the label.

If your tracking information shows your medication is delayed or delivered incorrectly or you have any other concerns regarding stability, speak to one of our pharmacists. We also encourage you to sign up for notifications from UPS.com.

Your prescription label contains dosage administration information. If you have additional questions, please call the pharmacy and ask to speak with a pharmacist.

Shipping addresses can be changed by speaking with a customer service representative as soon as you are aware of the change. Once the order arrives in our shipping department, the address cannot be changed.

The best way to stay up to date on prescription status is to allow email and text messaging from the pharmacy. Contact the pharmacy to ensure this is set up. You can order a refill up to three weeks in advance. Please allow for additional processing time to ensure everything goes smoothly, and in the event that your doctor needs to be contacted for any reason regarding the prescription. If you are paying the pharmacy directly, new orders are estimated to ship within 3 to 5 business days after we’ve received payment.

To cancel an order, please speak directly with one of our representatives who will evaluate where your customized prescription is in the compounding or shipping process, and determine whether or not the prescription can be canceled. Please contact the pharmacy as soon as possible if you need to cancel a prescription.

Place an order here.

Belmar Pharmacy has been shipping personalized compounded medications to all 50 states since 1985. We are best known for expertise in women’s hormonal health, and also compounding for men’s health, age management, longevity, and wellness.

While any one pharmacy cannot be both 503A and 503B, Belmar Pharma Solutions consists of six 503A pharmacies and two 503B outsourcing facilities.

Ordering from a 503B outsourcing facility enables clinicians to maintain a supply of medications, including hormones that are not commercially available. This allows clinicians the flexibility to provide care that meets their patients’ needs.

A compounding pharmacy prepares customized medications for individual patients based on a healthcare provider’s prescription. Unlike traditional pharmacies that dispense mass-produced drugs, compounding pharmacies create personalized formulations by adjusting dosage, removing allergens, combining medications, or changing forms to better meet a patient’s specific needs.

There are two types of compounding pharmacies. 503A pharmacies compound medications for individual patients. 503B outsourcing facilities produce medications for healthcare practices and facilities.

Learn more about what compounding pharmacies do and how they may benefit you.

503A pharmacies are state-regulated compounding pharmacies that make individualized formulations following a prescription written for a specific patient by a specific prescriber. This designation refers to section 503A of the Food, Drug, and Cosmetic Act, which specifies requirements for the compounding of drug preparations for individual patients.

503A pharmacies are the “traditional” type of compounding pharmacy, producing individualized prescriptions. Medications, including hormones, prepared by a 503A compounding pharmacy, are intended for patient-specific use.

503B outsourcing facilities are large-scale, FDA-regulated facilities that produce compounded medications, including hormones. This designation refers to section 503B of the Food, Drug, and Cosmetic Act, which describes the requirements that must be met for drug products compounded by or under the direct supervision of a licensed pharmacist in an outsourcing facility. The 503B designation was created with the passage of the Drug Quality and Security Act (DQSA) in 2013.

Belmar Pharma Solutions is designated as both a 503A compounding pharmacy and as a 503B outsourcing facility. Both 503A pharmacies and 503B outsourcing facilities play an important role in meeting the needs of clinicians and patients when it comes to delivering personalized medicine. So which is the correct choice for your healthcare practice? The answer depends on what you are trying to accomplish. When you need an individualized prescription compounded for a specific patient, a 503A pharmacy is the right choice.

When you need non-patient-specific compounded medications, including hormones for office use without a patient prescription, a 503B outsourcing facility is the right solution. This option enables clinicians to maintain a supply of customized formulations in quantity, allowing administration to patients during an office visit.

Yes, contact us and we can provide the information you need about formulary, pricing, and applications. Our most commonly prescribed compounded medications and hormones are available for your review.

Contact us and we can provide the information you need about formulary, pricing, and applications for both 503A and 503B. If you have immediate questions and would like to speak to a Solutions Engineer, someone is available to help you Monday through Friday during business hours.

After your account is set up, you can begin submitting prescriptions at our 503A pharmacies or placing office-use orders at our 503B outsourcing facilities. If you have questions about your account, our Onboarding Team can help you.

Yes, Belmar Select Outsourcing and Belmar Pharmacy offer testosterone pellets. Contact us and we can provide the information you need about formulary, pricing, and applications. Our most commonly prescribed compounded medications and hormones are available for your review.

Yes, contact us and we can provide the information you need about formulary, pricing, and applications. Our most commonly prescribed compounded medications and hormones are available for your review.

Yes, Belmar Select Outsourcing offers 503B office-use vials of injectable testosterone blends. Contact us and we can provide the information you need about formulary, pricing, and applications. Our most commonly prescribed compounded medications and hormones are available for your review.

Yes, Belmar Select Outsourcing offers hormone pellets for office use and Belmar Pharmacy offers patient-specific hormone pellets. Contact us and we can provide the information you need about formulary, pricing, and applications. Our most commonly prescribed compounded medications and hormones are available for your review.

Yes, contact us and we can provide the information you need about formulary, pricing, and applications. Our most commonly prescribed compounded medications and hormones are available for your review.

Belmar Pharma Solutions is designated as both a 503A compounding pharmacy and as a 503B outsourcing facility. Both 503A pharmacies and 503B outsourcing facilities play an important role in meeting the needs of clinicians and patients when it comes to delivering personalized medicine. So which is the correct choice for your healthcare practice? The answer depends on what you are trying to accomplish. When you need an individualized prescription compounded for a specific patient, a 503A pharmacy is the right choice.

When you need non-patient-specific compounded medications, including hormones for office use without a patient prescription, a 503B outsourcing facility is the right solution. This option enables clinicians to maintain a supply of customized formulations in quantity, allowing administration to patients during an office visit.

While any provider licensed to prescribe medications can prescribe compounded medications and hormones, those trained specifically in compounded medications do it with the most ease and confidence. Belmar Pharma Solutions offers free educational webinars. For professional CME training, we recommend you visit two of our preferred educational resources.

Belmar Pharma Solutions Preferred Provider webinar series is free to clinicians and we do not offer credits for attending. We offer monthly webinars as part of our committment to education. For providers interested in CEUs, we recommend you check out our professional clinical educational resources.

We have over 100 pharmacists available to support providers during business hours. If you are looking for comprehnsive education you may find success through these training organizations.

We source ingredients exclusively from FDA-registered facilties, and while each personalized prescription is not approved by the FDA, Belmar Pharma Solutions strictly follows the guidance of all required federal and state regulating bodies.

We like to use the analogy of going to a restaurant. The customized sandwich you order has not been approved by a federal, state or local regulating body, but the restaurant orders food from approved sources, and is subject to inspection at any time by the city and state, and the chef is highly educated in food quality, handling, and safety.

Learn about the benefits of a compound pharmacy here.

Belmar Pharma Solutions sources (APIs) ingredients exclusively from FDA-registered facilities.

We have over 100 pharmacists available to support providers during business hours. Often questions can be answered by the 300+ pharmacy technicians who are also available during business hours.

Storage and shipping requirements are as personalized as our medications. Factors including season, shipping location and destination, and storage requirements all help determine whether or not a product is shipped on ice and how quickly it is shipped. For specific questions about each medication, speak to a pharmacist for assistance.

Beyond use dates (BUDs) vary based on medication and dosage form, speak to a pharmacist for specific questions.

In the footer of our website you will find badges for NABP and LegitScript. By clicking on them, you will find our quality standards and certifications are verified.

We help ensure consistent quality by: Sourcing ingredients exclusively from FDA-registered facilities, performing independent testing from sourcing through distribution, meeting all applicable cGMP guidelines (for 503B) and USP guidelines (for 503A), and maintaining key industry certifications, including those shown in the footer of this page.

There are a number of factors that affect turnaround time. Most prescriptions are prepared within 3 to 5 business days of order verification and payment. Please consider compounding time when choosing shipping options.

Yes. We ship to all 50 states and even local patients often choose to have their medications shipped for convenience. For those who would like to pick up prescriptions in person, all 503A locations have a pick-up option.

Yes, you can place a patient-specific prescription direcly through your EMR. Once you have determined which Belmar Pharmacy location you want to use, you will find all the details you need on the Submit a Patient Prescription Page.

There are numerous differentiators between Belmar Pharmacy and other national and local compounding pharmacies. You will find our experince, quality, and compliance details when you read “Why Belmar?”

You do not need an account to submit 503A patient-pay prescriptions. 503B office-use orders do require an account with us.

Providers can submit prescriptions in several different ways at Belmar Pharmacy. Requirements to write a compounded prescription may vary by state, medication class or your chosen method of submission.

Perimenopause is the stage in a woman’s life leading up to menopause. It’s when the ovaries stop releasing eggs, hormone production decreases and fluctuates, and women may experience a variety of symptoms that range from unpleasant to disruptive to quality of life. The perimenopausal stage ends with menopause: when you haven’t had a period for 12 consecutive months.

Perimenopause can last a few months to several years, leading out of childbearing years into menopause and the period after (postmenopause) when you can no longer become pregnant.

Bioidentical hormones are chemically and structurally the same as those naturally made by the human body. Bioidentical hormones are designed to bind to the same receptors as the body’s own internal hormones and undergo similar enzymatic breakdown. Belmar Pharmacy compounds with USP-grade bioidentical hormones like estradiol, testosterone, and progesterone that are sourced from plants.

This drug trio is thought to provide a promising and well-tolerated erectile dysfunction intervention. Combining three therapeutic options allows multiple mechanisms of action to work simultaneously, with increased potential for sexual satisfaction.
This multimodal formulation may improve sexual outcomes with lower individual medication strengths, limiting the potential for side effects.

An intracavernosal injection (ICI) is a sterile medication administered directly into the penis, allowing the active ingredients to reach the target area immediately. By delivering the drug straight into the cavernosal tissue, ICI therapy may produce a faster and more reliable response compared to oral options.

Patients with conditions that raise the risk of priapism—such as sickle cell disease, leukemia, multiple myeloma, Peyronie’s disease, bleeding disorders, or a history of recurrent priapism—should consult a medical provider before using injectable erectile‑dysfunction medications. Those at higher risk may also need guidance on safety measures, including the possible use of rescue agents like injectable phenylephrine for emergency situations. Other health factors may influence candidacy as well, making a provider’s evaluation essential.

Sermorelin acetate may be given as a subcutaneous injection, which means it is placed into the fatty layer just beneath the skin for absorption into the bloodstream. To inject, the needle is injected into the fatty tissue—commonly the abdomen or thigh—at a shallow angle and delivers the dose as instructed by your provider.

When taking low dose naltrexone, it may be recommended to avoid opioid pain medications because LDN briefly blocks opioid receptors and can interfere with how those drugs work. Those with liver or kidney disease, bleeding disorders, or individuals using immunosuppressive therapy may also need to discuss LDN use with their trusted prescriber.

Taking low dose naltrexone at night may be beneficial because its short receptor blockade occurs during sleep, allowing the natural rise in endorphins to happen the next morning. This timing may help support immune regulation and overall daytime well‑being, based on how LDN briefly interacts with opioid and immune receptors.

Belmar Pharmacy has been compounding low dose naltrexone (LDN) since 1985, and with a prescription from a medical provider, will ship to all 50 states, Washington, DC, Guam and Puerto Rico.

In Hashimoto’s Thyroiditis, the body’s own specialized white blood cells attack the thyroid gland, which can result in underproduction of thyroid hormone. LDN’s therapeutic targets are immune activity—by aiming to calm the overactive immune response, LDN may improve thyroid function and autoimmune-related symptoms. However, it is not a replacement for thyroid hormone therapy like levothyroxine sodium (T4) or liothyronine sodium (T3).

Low dose naltrexone (LDN) can benefit Hashimoto’s thyroiditis patients by addressing the autoimmune component of the disease. As an immune modulator and an anti-inflammatory agent, LDN can upregulate endorphins and decrease inflammation. Its unique mechanism of action has been shown to limit autoimmune flares and fatigue, impacting patients’ overall quality of life.

Contact us and we can provide the information and pricing you need about LDN and other compounded medications. If you have immediate questions and would like to speak to a Solutions Engineer, someone is available to help you Monday through Friday during business hours.

ULDN is different from LDN mainly because of the dose and how it works: ULDN uses an extremely small dose of naltrexone, about 1 to 2 micrograms, that may slightly stimulate opioid receptors and support pain control. LDN uses naltrexone doses of 1 to 5 milligrams that can briefly block opioid receptors and influence immune and endorphin activity. This means ULDN may be used in conjunction with pain medications with minimal receptor blocking, whereas LDN is often used for broader immune modulating effects.

Glutathione is generally well‑tolerated, but some side effects may occur, including nasal irritation or nosebleeds with nasal formulations, headache, digestive upset such as gas or diarrhea, or mild skin reactions like itching or redness. These effects often lessen as the body adjusts, but any severe symptoms—especially signs of an allergic reaction such as swelling, dizziness, or trouble breathing—require medical attention.

When taking glutathione, it may be helpful to avoid substances that can interfere with its activity, including alcohol, smoking, caffeine, and certain medications like acetaminophen or aspirin. Excess dairy and heavily processed or fried foods may not be recommended while taking glutathione. These factors can increase oxidative stress or compete with glutathione pathways, potentially limiting its intended benefits.

Methylcobalamin and cyanocobalamin are two different forms of vitamin B12 that the body uses in similar ways but processes differently. Cyanocobalamin is a synthetic form that the body must convert, while methylcobalamin is already in an active form that is thought to directly support nerve and methylation pathways. The main difference is that methylcobalamin may be more readily used in neurological functions.

Methylcobalamin and cyanocobalamin are both forms of vitamin B12, but they work a little differently in the body. Cyanocobalamin is the most common and stable form, while methylcobalamin is already in an active form that may be more easily used by the body for nerve and methylation processes.

Yes, methylcobalamin is generally considered well‑tolerated by most people because it is a natural, active form of vitamin B12 that the body recognizes. It is also water soluble, meaning excess amounts are typically excreted. As with any supplement, people with medical conditions or those taking medications should check with a healthcare provider before use.

An NAD+ supplement is a product designed to support levels of NAD+, a coenzyme involved in energy production, cellular repair, and other key metabolic processes. Adults may use NAD+ in various forms to support overall cellular health, especially as natural NAD+ levels appear to decline with age.

Nicotinamide adenine dinucleotide (NAD+) appears to be generally well-tolerated. Its use can be associated with mild, temporary side effects such as fatigue, headaches, or digestive discomfort. Speaking with a healthcare provider is recommended before starting any prescription therapy.

Patients with a sensitivity to niacin should seek medical advice before starting NAD+ therapy. Niacin, Vitamin B3, is a precursor to NAD+. In addition, patients with a history of liver disease or dysfunction may not be good candidates for NAD+ therapy and should consult with a healthcare provider.

There may be other conditions that may affect candidacy for compounded NAD+ medications. Connecting with a medical provider for more clinical information is recommended to discuss appropriate therapies.

Liraglutide is a GLP-1RA (glucagon-like peptide-1 receptor agonist) that mimics the body’s natural gut hormone GLP-1. This hormone is naturally released after eating to reduce appetite and food cravings, increase satiety, and prevent overeating. A medication like liraglutide can alter food preference and reward pathways in the brain by activating the GLP-1 receptor more powerfully over time than the body’s natural hormone, helping address insulin resistance and weight management.

L-carnitine is an amino acid derivative that acts as a cofactor for fatty acid oxidation, the process of breaking down fatty acids for energy and fuel for the body. By assisting with fat metabolism, L-carnitine supplementation may help promote weight management in combination with diet, exercise, and other therapies. It has also been shown to positively impact exercise recovery and muscle fatigue.

Liraglutide, combined with L-carnitine, is a sterile injectable medication given subcutaneously (SQ) on a daily basis. A subcutaneous (SQ or SC) injection delivers medicine into the fatty layer between skin and muscle. Typical injection sites include the upper arm, abdomen, and thigh.

For all injectable preparations, it is very important to rotate injection sites to optimize medication absorption and minimize injection site complications. Properly disinfecting the dosing site using alcohol swabs prior to injection, and using new, clean injection supplies for each administration will limit the risk of infection.

Alprostadil is a prostaglandin and vasodilator. It may relax the smooth muscle of the penis, dilating local arteries to increase blood flow and promote an erection.

Alprostadil may be a promising alternative for patients that do not succeed with oral phosphodiesterase type 5 inhibitors (PDE5i), like sildenafil citrate, tardenafil, or vardenafil.

Estradiol vaginal cream may be used to support vaginal tissue health in women with low estrogen levels, helping improve moisture, elasticity, and overall comfort. It may be recommended for symptoms such as vaginal dryness or discomfort that can occur after menopause.

Estriol (E3) is a much weaker, short‑acting estrogen that becomes the dominant form during pregnancy, while estradiol (E2) is the strongest and most active estrogen produced before menopause. Estradiol binds more strongly to estrogen receptors and affects more tissues, whereas estriol has gentler effects and a lower potency overall.

Progesterone is a sex steroid hormone that plays an important role in the menstrual cycle, pregnancy, and lactation for women. It is also a precursor hormone that is used to make other hormones, like estradiol and testosterone. As a neurosteroid, it has brain and nervous system effects for both men and women.

Yes, progesterone therapy is often used to help with difficulty sleeping. As a neurosteroid, progesterone’s metabolite allopregnanolone affects GABA receptors that induce relaxation and sedation. This effect is most common when taken orally versus applied topically or vaginally like with progesterone cream.

Supplementing pre-menopausal women with progesterone may help restart menstrual periods that unexpectedly stop (amenorrhea), address abnormal uterine bleeding due to hormonal imbalance, and combat severe symptoms of premenstrual syndrome (PMS). Progesterone therapy can also help perimenopausal and postmenopausal women experience better sleep outcomes and improved mood stabilization in addition to endometrial protection.

Oxytocin supports sexual function in both men and women by influencing arousal, orgasm, and bonding during intimate interactions. It also plays a major role in emotional regulation by reducing stress responses and supporting social connection, including trust, empathy, and mood stability. Additionally, oxytocin may impact appetite, impulse control, and overall well‑being, making it relevant to weight management and other areas of health.

Yes, oxytocin is a hormone produced in the hypothalamus and released by the posterior pituitary, where it supports key reproductive functions such as sexual activity, childbirth, and lactation. Often called the “love hormone”, it also acts as a neurotransmitter in the brain, influencing bonding, trust, emotional connection, and other social behaviors.

Oxytocin levels can be supported through medical evaluation and targeted therapy when low levels are tied to rare conditions such as panhypopituitarism or symptoms related to bonding, mood, or social functioning. Because excessively high oxytocin may cause problems—such as uterine overactivity in women or prostate enlargement in men—any attempts to increase oxytocin should be guided by a healthcare provider. Working with a clinician ensures levels are raised safely without increasing the risk of oxytocin toxicity.

Gonadorelin is a synthetic form of the body’s natural GnRH and may help stimulate the release of LH and FSH, two hormones involved in reproductive function.

Gonadorelin acetate may support normal hormone signaling, help maintain testicular activity, and offer an option for men who want to avoid fertility suppression from certain hormone therapies.

Yes, in some cases, clinicians may consider combining gonadorelin acetate with testosterone, depending on the patient’s goals and hormone‑signaling needs.

Sildenafil citrate and tadalafil are both oral phosphodiesterase 5 inhibitors (PDE5) inhibitors. Sildenafil effects usually start within 30–60 minutes and may last about 4–6 hours, while tadalafil may take longer to initiate effects but tends to have a longer duration of action. Tadalafil also offers daily low‑dose options and tends to provide more flexibility due to its prolonged activity.

Tadalafil works by inhibiting the PDE5 (phosphodiesterase 5) enzyme, which may increase levels of cGMP and support smooth muscle relaxation and blood flow in specific tissues. It is used for erectile dysfunction and may also be used in certain off‑label situations, such as female sexual dysfunction.

Yes, tadalafil may slightly lower blood pressure because it relaxes and widens blood vessels, which can cause a mild drop in pressure. For most healthy adults this effect is usually small, but the drop can be more significant when tadalafil is combined with nitrates or certain blood pressure‑lowering medications.

Sildenafil citrate is used to support erectile function in men by helping increase blood flow to penile tissue during sexual stimulation. It may also be used in women when compounded into topical “scream creams,” which can help enhance genital blood flow, sensitivity, and overall sexual comfort. In both men and women, its effects rely on promoting smooth‑muscle relaxation and improving local circulation in targeted tissues.

Sildenafil citrate typically begins to take effect in about 30 to 60 minutes, with some men experiencing a delayed onset if taken with a high‑fat meal. Its effects for erectile dysfunction generally last about 2 to 4 hours, although this can vary based on individual factors.

Liothyronine is the synthetic bioidentical form of T3 (triiodothyronine), the body’s active thyroid hormone that works quickly at the cellular level, while levothyroxine sodium is the synthetic bioidentical form of T4 (thyroxine), a storage hormone that the body must convert into T3 before it becomes active. Liothyronine is typically shorter acting than levothyroxine.

Never underestimate the impact stress has on thyroid function. High stress leads to high cortisol levels, potentially preventing the conversion of T4 to T3. In times of illness or inflammation, the stress put on the body can suppress TSH, the primary diagnostic tool in hypothyroidism. This may lead to unreliable lab results; levels of TSH appear within normal range, when in fact there is likely a lack. In aging patients, this may contribute to underdiagnosing hypothyroidism.

An under-functioning thyroid gland is the most common cause of hypothyroidism. Hypothyroidism is a condition in which the thyroid gland, a small butterfly-shaped gland at the base of the neck, doesn’t produce enough T3 and T4. In the autoimmune disease Hashimoto’s Thyroiditis, the body attacks its own thyroid hormone producing cells. The outward signs and symptoms of thyroid imbalance are extensive and may include fatigue and unexplained weight gain.

Sermorelin and other growth hormone releasing hormones should be used with caution in cancer patients, or patients that have a history of cancer. Connect with your oncologist to discuss current recommendations.
There may be other conditions that may affect your candidacy for compounded sermorelin medications. Please reach out to your medical provider for more clinical information and to discuss therapies appropriate for you.

Clinical studies show anastrozole does not typically cause significant weight gain. However, some adults—especially those under 60, smokers, or those who had a mastectomy—may be more likely to gain weight during therapy. Any weight gain that occurs is usually small and most often happens within the first year.

No, anastrozole is not a chemotherapy drug; it is a nonsteroidal aromatase inhibitor used as hormone therapy, lowering estrogen rather than killing cancer cells directly. Studies have shown that testosterone combined with a low dose of anastrozole may help relieve menopausal symptoms when estrogen therapy is not appropriate for breast cancer survivors or women at high risk for the disease. By reducing estradiol production, anastrozole may also be used in postmenopausal women with estrogen‑dependent breast cancer.

Anastrozole’s major side effects should be discussed with your medical provider. Some adverse effects include decreased bone mineral density which may increase the risk of osteoporosis and fractures, as well as musculoskeletal symptoms such as joint pain, stiffness, and back discomfort.

When choosing a pharmacy for testosterone compounding, or any other personalized medication, there are a few questions you should ask:

Does the compounding pharmacy:

Formulate therapies with bioidentical hormones?
Use only active pharmaceutical ingredients (APIs) from FDA-registered manufacturers?
Maintain accreditation from nationally recognized organizations like the NABP?
Use only pharmaceutical grade fillers?
Limit inactive ingredients with options for chemically-sensitive patients?
Provide patient and provider education materials?

Belmar sources all active pharmaceutical ingredients from FDA‑registered facilities, and our supplier qualification program ensures each manufacturer and wholesaler we work with meets all required regulatory certifications.

Testosterone pellet therapy and testosterone injections are sterile hormone delivery methods that both bypass the digestive system, but differ in administration, drug delivery, and frequency. Both men and women can benefit from testosterone replacement therapy to replenish low testosterone levels in middle age, especially since testosterone levels naturally decline with age.

Bioidentical hormone replacement therapy (BHRT) pellets are a unique delivery form designed to closely replicate how hormones are naturally released in the body. In a simple office procedure, these rice-grain-sized pellets are inserted under a patient’s skin near the hip area via a trocar. Delivering BHRT in pellet form has multiple benefits:

Convenience — Hormone pellets may only need to be inserted 3 to 4 times per year.
Minimal side effects — Pellet therapy sends hormones into the bloodstream, avoiding potential side effects of taking medications orally.
Consistency — Pellets are designed to supply the body with a consistent level of hormonal support as they slowly dissolve into the bloodstream.

Compounded testosterone injections from Belmar Pharmacy are available as testosterone cypionate blends. Testosterone cypionate is an injectable, synthetic form of testosterone replacement therapy and injectable blends are compounded preparations that combine testosterone cypionate with DHEA (dehydroepiandrosterone) or anastrozole. Combination products offer the benefit of dual medications without the hassle of juggling separate administration.

Injectable medications from Belmar Pharmacy are dispensed in a sterile vial with injection supplies, allowing providers and patients to draw up the appropriate dose and introduce the medication into the body by breaking the skin barrier. These products are administered intramuscularly (IM), into the muscle, or subcutaneously (SC), under the skin, and are typically administered once to twice weekly.

Topical products like testosterone cream can be applied to the inner arm, upper thigh, back of the knee, tops of feet and inner wrists. It is recommended to rotate sites to ensure even retention of the hormone. With testosterone products, there is risk of secondary exposure to people in close contact, specifically children. Cover treated skin with clothes to avoid contact with people or pets. Wash hands after applying the product. Do not share this medication with others and keep out of reach of children and pets.

The main benefits of testosterone pellet therapy for men and women include convenience, a way to address symptoms systemically, and dose personalization. Since pellets release hormones slowly, and as the body needs them, testosterone pellets typically only need to be inserted every 3 to 4 months. Since hormones from pellets bypass the digestive system and are released directly into the bloodstream, it may help with more comprehensive symptom relief and fewer potential side effects.
Finally, testosterone pellets are available in a variety of strengths so providers can customize for both female and male patient needs.

Yes. DHEA serves as a precursor hormone that the body can convert into testosterone, and studies show that supplemental DHEA may increase total testosterone levels, particularly in men and others with lower baseline DHEA.

Yes. Testosterone cypionate is an anabolic steroid, as it is a synthetic form of the naturally occurring sex hormone testosterone and is classified as a controlled substance for this reason.

A testosterone cypionate injection is administered either intramuscularly or subcutaneously, depending on the instructions provided by your healthcare provider. Because testosterone cypionate/DHEA in grapeseed oil is an oil‑based medication, the dose, injection route, and technique must be determined and supervised by a licensed medical professional to ensure safe and appropriate use.

A testosterone cypionate/anastrozole in grapeseed oil injection is administered either intramuscularly or subcutaneously, allowing testosterone to release slowly while anastrozole helps limit its conversion to estradiol. Because it is an oil‑based injectable medication, the dose, route, and injection technique must be determined and supervised by a licensed medical provider.

Yes. Testosterone cypionate is an anabolic steroid, as it is a synthetic form of the naturally occurring sex hormone testosterone and is classified as a controlled substance for this reason. It may be prescribed to those who do not produce enough testosterone on their own and may be used to support symptoms related to hypogonadism.

Yes. DHEA serves as a precursor hormone that the body can convert into testosterone, and studies show that supplemental DHEA has the potential to increase total testosterone levels, particularly in men and others with lower baseline DHEA.

Enclomiphene citrate is generally considered well‑tolerated, with reported enclomiphene side effects such as headache, abdominal discomfort, and elevated estradiol levels appearing in some adults. As with any hormone‑modulating therapy use must be monitored by a professional to ensure it’s an appropriate option.

No, enclomiphene is not a steroid; it is a selective estrogen receptor modulator (SERM) that works by blocking estrogen feedback at the pituitary gland to increase LH and FSH. Unlike steroid hormones, it does not replace hormones directly but instead may stimulate the body to produce its own.

Enclomiphene citrate is the trans‑isomer of clomiphene, and it more specifically targets estrogen receptors involved in pituitary feedback, which may lead to a clearer increase in LH and FSH. Clomiphene contains both the trans (enclomiphene) and cis (zuclomiphene) isomers, the latter of which may linger longer in the body and contribute to more mixed or prolonged effects.

Estriol cream may be well‑tolerated with its weaker estrogenic activity contributing to a lower risk profile compared to stronger estrogens. Professional guidance is recommended when considering its use.

Estriol is considered the weakest of the major estrogens, but like other unopposed estrogens, it may contribute to side effects such as bloating or weight gain. These effects may improve when hormone balance, dosing, or formulation—such as the form of estriol being used—is adjusted with guidance from a healthcare professional.

Estradiol may contribute to side effects such as bloating or weight gain when used without progesterone or when hormone levels are not well balanced. These effects may improve once dosing, formulation, or hormone balance is adjusted under professional guidance.

Estradiol is one specific type of estrogen, and it is the most potent and biologically active of the three primary estrogens made in the body. While estradiol is a form of estrogen, the term estrogen refers to a broader group of hormones that also includes estrone (E1) and estriol (E3).

Chelation therapy is aimed at removing heavy metals to help the body get rid of environmental toxins. This therapy requires a prescription from a healthcare provider. The goal of chelation therapy is to use chelators like dimercaptosuccinic acid (DMSA) periodically over time to help remove dangerous accumulation of toxins that are capable of damaging the liver, brain, or other organs. During this time, patients are assessed for symptom changes and lab variations.

Chelation therapy with dimercaptosuccinic acid (DMSA) is typically cyclic over weeks or even months. Periods of rest are important to avoid overwhelming the body’s elimination processes. The duration of therapy will depend on the type of toxin, the level of exposure, and how successfully patients respond to the medication. Patients who have experienced chronic low-level heavy metal exposure may require repeated cycles of chelation therapy for up to 6 months.

Gender dysphoria often occurs in adolescents and adults who do not identify with their assigned gender. To be diagnosed with gender dysphoria, it needs to last a minimum of 6 months, and manifests with two or more of the following characteristics/experiences:

Strong desire to be rid of sex characteristics assigned at birth
Incongruence with expression of gender and those assigned at birth
Strong desire to possess sex characteristics of a different gender (often opposite of physical characteristics they were born with)
Strong desire to be treated as a different gender than what was assigned at birth
Having feelings, emotions, reactions that align with a gender other than their own

For a gender dysphoria diagnosis, these signs are associated with distress in social settings, at work, or in life in general.

Based on individual symptoms and/or diagnosis of gender dysphoria, gender-affirming hormonal therapy may be an appropriate option, along with psychotherapy, and a personalized treatment plan with an experienced healthcare provider.

Feminizing hormone therapy may help transgender female patients (assigned male at birth, identifying as female) achieve therapeutic effects like breast growth, decreased muscle mass, and other body composition changes. These therapies typically involve estrogen and may help individuals reach physiologic ranges expected in menstruating populations. Patients transitioning from male to female may also need additional support to suppress testosterone, a masculinizing hormone. It can take up to 2 years for feminizing gender-affirming hormone therapy to reach maximum potential for gender reassignment and therapeutic strategy will depend on the patient’s goals. Some GAHT effects are permanent or irreversible, including breast growth, and may also impact fertility with feminizing therapies.

Masculinizing hormone therapy may help transgender male patients (assigned female at birth, identifying as male) achieve therapeutic effects like stopping menstruation, increased muscle mass, and other body composition changes. These therapies typically involve reaching male physiologic ranges of testosterone. Patients transitioning from female to male may also want additional support suppressing estrogen levels, a feminizing hormone. It can take up to 4 years for masculinizing gender-affirming hormone therapy to reach maximum potential for gender reassignment and therapeutic strategy will depend on the patient’s goals. Some GAHT effects are permanent or irreversible, including voice changes, and may also impact fertility with masculinizing therapies.

Estrogen and progesterone balance will change throughout the stages of menopause. Individual hormone therapy needs reflect those changes and there is no universal estrogen to progesterone ratio. Many factors are involved, including menopausal phase and uterine status. In perimenopause, progesterone tends to be deficient while estrogen levels fluctuate. After menopause, both progesterone and estrogen levels are often diminished. If a postmenopausal woman has an intact uterus and is using a form of estradiol replacement, progesterone therapy can act as a counterbalance to estrogen at the endometrium in addition to its many other benefits.

Dehydroepiandosterone (DHEA) is a steroid hormone intermediate for androgen and estrogen synthesis. Testosterone is an androgen. DHEA can play an important role in patients with low testosterone because as a precursor hormone, it can help the body make more testosterone.

Hormone replacement therapy (HRT) may help with weight management for men. As men get older, the testosterone hormone naturally declines, which can be an underlying reason they may be having trouble losing weight. Low testosterone in men during midlife may also contribute to weight gain without changing eating or exercise habits, as it often causes loss of muscle mass, fatigue, and lack of motivation.

Hormone replacement therapy, or bioidentical hormone replacement therapies (BHRT) like the ones Belmar Pharmacy offers, can support men’s weight management goals by returning testosterone to optimal levels. As BHRT may help the body return to its ideal hormonal state, men’s weight management efforts may become easier.

There is not a single best weight loss medication for men. The best weight management medications for men are the ones that work best for individual needs. Belmar Pharmacy compounds weight management medications that are designed to be part of an overall health and wellness plan. For many men, addressing the underlying causes of weight gain, such as low testosterone levels, may have a positive effect on helping achieve their goals.

Many men find that addressing their declining hormones with personalized bioidentical hormone replacement therapies (BHRT) from Belmar Pharmacy, in conjunction with weight management medications, has a bigger impact than just weight management medications alone.

Knowing where to start with weight management medications can be a challenge for men wanting to lose weight. It’s a good idea to consult a healthcare provider to assess overall health, hormonal health, and weight loss goals. Weight management medications are not a quick fix or a stand-alone way to lose weight, but rather one piece of a personalized weight management and healthcare plan.

Healthcare providers may assess body mass index (BMI), hormone levels, and review health history. They should also talk about lifestyle and dietary needs and help create a comprehensive approach to reach weight goals. A provider will help determine which weight management medication may work well for each patient’s individual needs, in conjunction with any other health and lifestyle changes.

Extreme mood swings are characteristic of bipolar mood disorder (formerly called manic depression). Symptoms of bipolar mood disorder include episodes of extreme emotional highs, or mania, and extreme lows, or depression.

Mania is characterized by feelings of euphoria, irritability, and feeling energetic. During this phase of bipolar mood disorder, it may be difficult to sleep at night or think clearly during the day. Lack of judgement is also common during a manic episode. Additional symptoms include:

Distorted feeling of well-being or self confidence
Unusually talkative; fast talking
Racing thoughts
Easily distracted
Poor decision making abilities

Depression is typically characterized by feelings of sadness and hopelessness, and loss of interest in activities. Other symptoms of depression may include:

Feeling sluggish; sleeping more than usual
Lack of motivation
Feelings of worthlessness
Difficulty making decisions
Suicidal thoughts

Both phases can last several days, and mood swings are also common in between manic and depressive episodes.

Generalized anxiety disorder is a mental health condition characterized by excessive worrying about a variety of things such as health, finances, work, people, or particular life situations. Men and women with generalized anxiety disorder have a hard time controlling their habitual worrying about events, family members, and situations that may or may not seem concerning to others. Typically, to be diagnosed with generalized anxiety disorder, feelings of dread, worry, and anxiousness last longer than six months. Women are twice as likely to be affected by generalized anxiety disorder than men.

Symptoms of generalized anxiety disorder may include:

Disproportionate worrying about a circumstance or event
Focusing on worst-case outcomes
Difficulty managing uncertainty
Fear of making the “wrong” decision
Inability to relax; feelings of restlessness
Fatigue; trouble sleeping
Nervousness
Muscle aches
Irritable bowel syndrome (IBS)

Ongoing symptoms may affect daily activities and performance at work or school. While the cause of generalized anxiety disorder isn’t completely clear, genetic factors, life experiences, and personality may all be contributing factors.

Anxiety is classified as an anxiety disorder, which is not the same as a mood disorder. The two can overlap, and often do. Anxiety disorders center around focusing on intense fear, worry, and apprehension toward people or situations. These feelings are usually disproportionate to the actual perceived threat, and last six months or more. Symptoms of anxiety disorders include difficulty concentrating, panic, shortness of breath, and rapid heart rate.

Mood disorders are characterized by persistent shifts in overall mood and emotional state. They often include long periods of depression, sadness, hopelessness, and loss of interest in activities that were once pleasurable (i.e., hobbies, spending time with friends, etc.). Extreme mood swings are also signs of a mood disorder vs. an anxiety disorder.

Some medications that are prescribed to address common health conditions, like high blood pressure, can cause hair loss in men. Most medication-related hair loss is temporary, but it is possible to experience more permanent hair loss from medications that trigger male pattern baldness. Medications that may contribute hair loss in men include:

Isotretinoin for acne
Cholesterol lowering medications
Antidepressants
High blood pressure and heart medications
Testosterone
Steroids
Ulcer medications
Blood thinners/anticoagulants
Epilepsy medications
Chemotherapy drugs
Amphetamines
Antifungals
Thyroid medications
Anti-inflammatory drugs for pain and swelling

Higher doses of vitamin A may also lead to men’s hair loss.

Several types of medical conditions may cause temporary or permanent hair loss in men. The natural decline in testosterone as men age (a life stage also known as andropause) can be an underlying reason for permanent hair loss and balding. Additionally, thyroid disorders and autoimmune diseases (although more common in women) can also contribute to men’s hair loss. Alopecia areata is an immune-related condition that can affect both men and women, which causes patchy hair loss and scalp infections.

Genetics are a major factor in men’s hair loss. Men can be genetically predisposed to a condition called androgenic alopecia, or male-pattern baldness. Male-pattern baldness is especially prominent in men where baldness runs in either their mother’s or father’s side of the family. This condition can be inherited from both, and typically leads to gradual, permanent hair loss. For many men, male-pattern baldness begins with a receding hairline from the forehead or on the back of the head, and becomes more pronounced with age and the natural loss of testosterone.

Other health conditions, such as prolonged periods of stress or traumatic events may cause temporary hair loss in men. Rapid, significant weight loss may also lead to men’s hair loss.

One of the most common sleep disorders for millions of American adults, including men, is insomnia – the inability to easily fall asleep at night, or to be able to stay asleep. Insomnia affects more women than men and can be short-lived (lasting a few nights or weeks due to stress or a major life event) or long term (chronic insomnia). For men, insomnia often begins with andropause during midlife, work-related pressures, or difficult relationships with partners and family members.

Symptoms of insomnia include trouble falling asleep at night, waking up too early, waking up multiple times a night, and feeling tired during the day. Fatigue, low energy, and anxiety may also be symptoms of chronic insomnia.

Over time, low testosterone levels in midlife can lead to depression, which is often highly disruptive of sleep quality. When sleep quality is poor, men often find themselves lacking motivation to exercise, participate in hobbies, and other things that once were enjoyable. Hormone replacement therapy may help improve sleep disorders and insomnia in men by restoring low testosterone levels. With testosterone replacement therapy, it’s possible for men to feel like their “old selves” again, and therefore, improve their sleeping habits and suffer less from insomnia.

Melatonin, produced naturally in the body, helps promote a quiet, calm state at night that helps with sleep. As the brain releases melatonin, levels should rise a couple hours before bedtime so the body can begin to relax and prepare for sleep. However, men suffering from sleep disorders and insomnia may be melatonin deficient. Taking small doses of melatonin may help reduce the time it takes to fall asleep and help promote a deeper sleep with fewer instances of waking in the middle of the night.

Signs that men are not getting enough sleep or the good sleep quality they need include:

Feeling tired all day; lack of energy
Difficulty concentrating
Lack of motivation at work or home
Irritable or easily angered
Falling asleep during meetings or other times during the day

Autism spectrum disorder (ASD) is a neurodevelopmental condition related to differences in brain development. While many people are diagnosed in childhood, growing awareness has led to more adults receiving diagnoses as well. Autistic individuals may experience differences in communication, social expectations, sensory experiences, routines, or repetitive behaviors, and these vary widely from person to person.

ASD includes a broad range of traits and support needs. Some autistic people navigate social settings, workplaces, and daily life independently, while others may be nonverbal or benefit from assistance with everyday tasks. The spectrum also encompasses diagnoses that were once separate, such as autism, Asperger’s syndrome, and certain nonspecific developmental disorders. Many traits appear within the first 18 to 24 months of life, though some individuals are identified later.

There is no cure for autism, nor should one be expected. However, for those who seek it, various therapies, strategies, and medical support may help address specific goals, sensory needs, or co-occurring conditions.

There is no single known cause of autism spectrum disorder (ASD). Autism is complex, and research suggests that both genetic and environmental factors may contribute to an individual’s traits and support needs. Genetic variations – whether inherited or spontaneous – are thought to play a role, and differences in early brain development may also influence how autism presents.

Researchers continue to explore a range of influences, including prenatal or medical factors such as viral infections, certain medications, environmental exposures, or complications during pregnancy. Some patterns have been observed in diagnosis trends: males are diagnosed more often than females, and children born before 26 weeks in pregnancy may have a higher likelihood of receiving an ASD diagnosis. However, these associations do not predict outcomes for any individual, and many autistic people do not share these factors.

Belmar Pharmacy compounds low dose naltrexone (LDN) and other therapies in a variety of dosage forms and strengths. LDN is thought to influence natural endorphin activity, which may support stress regulation, mood, or overall well-being for some autistic individuals.

Melatonin may help with sleep, and oxytocin is sometimes explored for its potential effects on social connection, bonding, or managing anxiety and stress. These options may address specific needs or co-occurring experiences based on individual preference and clinical guidance.

Post-traumatic stress disorder (PTSD) is a mental health condition that results from witnessing or being part of a terrifying life event. It could be the result of being in military combat, witnessing a natural disaster, seeing a loved one suffer a fatality, or any other event or situation that leads to long-term fear, stress, and anxiety, among other symptoms. For some people with post-traumatic stress disorder, they are unable to function at work or at home because of negative thoughts, depression, or emotional issues.

Symptoms of PTSD typically begin within the first 3 months of a traumatic event, but sometimes don’t appear until as long as a year after. Symptoms may include intrusive thoughts, memories, and nightmares about the tragic event, and avoidance behaviors, such as not being able to be in a certain location or with people who remind you of the event.

Negative changes in thinking and mood are also common for people diagnosed with PTSD. They may have daily negative thoughts about people and the world in general, or ongoing emotions of fear, blame, anger, guilt, or shame. PTSD can lead to feelings of doom, loneliness, and no longer being interested in activities or hobbies that once brought pleasure. Some people with PTSD describe feeling “emotionally numb” in their daily lives.

Other PTSD symptoms may include sleep disorders, self-destructive behaviors, alcohol or drug abuse, and irritability or aggressive outbursts.

Treatment for post-traumatic stress disorder often includes a combination of psychotherapy (talking to a licensed professional) and exposure therapy. Exposure therapy is a way to safely face the fears and memories of the traumatic event so it becomes manageable in daily life.

Additionally, treatment for PTSD may involve medications like antidepressants and anti-anxiety drugs, or a compounded form of low dose naltrexone (LDN). Low dose naltrexone can help address depression and anxiety, chronic fatigue, anger outbursts, nightmares, and sleep problems related to post-traumatic stress disorder.

Chronic pain associated with autoimmune conditions like RA can be challenging to address for both patients and providers. Arthritis is an inflammatory pain and can often be improved with anti-inflammatory drugs. These include steroids like prednisone, NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen, and low dose naltrexone (LDN). Overall, RA pain can be associated with worsening disease that requires mainstay therapy, like methotrexate or another disease modifying antirheumatic drugs (DMARDs).

No, like most autoimmune conditions, there is no cure for RA. But early identification and therapy has been shown to significantly reduce disabling joint damage and progression of the disease into other organ systems. Many patients can reduce flares and even achieve disease remission with appropriate medical support.

Mood disorders are mental health conditions that affect emotional well-being and sometimes physical well-being, too. A mood disorder often means persistent feelings of extreme sadness, extreme happiness, or irritability for weeks at a time, or longer. It’s normal to experience mood changes as a result of life’s ups and downs, but when a feeling of depression lasts more than a few days, it could be the sign of a mood disorder. Mood disorders can also interfere with the ability to perform daily tasks at work, school, or in the home.

Mood disorders are classified into the main categories of depression, bipolar disorder, disruptive mood dysregulation disorder, and premenstrual dysphoric disorder. Each of these has more specific disorders, such as postpartum depression (common in women after giving birth), seasonal affective disorder, and disruptive mood dysregulation disorder, or DMDD (common in children and adolescents).

Anxiety disorders are different from mood disorders and include generalized anxiety disorder, panic disorder, agoraphobia, and social anxiety disorder. Mood and anxiety disorders can occur together, and some symptoms may be overlapping.

Extreme mood swings are characteristic of bipolar mood disorder (formerly called manic depression). Symptoms of bipolar mood disorder include episodes of extreme emotional highs, or mania, and extreme lows, or depression.

Mania is characterized by feelings of euphoria, irritability, and feeling energetic. During this phase of bipolar mood disorder, it may be difficult to sleep at night or think clearly during the day. Lack of judgement is also common during a manic episode. Additional symptoms include:

Distorted feeling of well-being or self confidence
Unusually talkative; fast talking
Racing thoughts
Easily distracted
Poor decision making abilities

Depression is typically characterized by feelings of sadness and hopelessness, and loss of interest in activities. Other symptoms of depression may include:

Feeling sluggish; sleeping more than usual
Lack of motivation
Feelings of worthlessness
Difficulty making decisions
Suicidal thoughts

Both phases can last several days, and mood swings are also common in between manic and depressive episodes.

Generalized anxiety disorder is a mental health condition characterized by excessive worrying about a variety of things such as health, finances, work, people, or particular life situations. People with generalized anxiety disorder have a hard time controlling their habitual worrying about events, family members, and situations that may or may not seem concerning to others. Typically, to be diagnosed with generalized anxiety disorder, feelings of dread, worry, and anxiousness last longer than six months. Women are twice as likely to be affected by generalized anxiety disorder than men.

Symptoms of generalized anxiety disorder may include:

Disproportionate worrying about a circumstance or event
Focusing on worst-case outcomes
Difficulty managing uncertainty
Fear of making the “wrong” decision
Inability to relax; feelings of restlessness
Fatigue; trouble sleeping
Nervousness
Muscle aches
Irritable bowel syndrome (IBS)

Ongoing symptoms may affect daily activities and performance at work or school. While the cause of generalized anxiety disorder isn’t completely clear, genetic factors, life experiences, and personality may all be contributing factors.

Anxiety is classified as an anxiety disorder, which is not the same as a mood disorder. The two can overlap, and often do. Anxiety disorders center around focusing on intense fear, worry, and apprehension toward people or situations. These feelings are usually disproportionate to the actual perceived threat, and last six months or more. Symptoms of anxiety disorders include difficulty concentrating, panic, shortness of breath, and rapid heart rate.

Mood disorders are characterized by persistent shifts in overall mood and emotional state. They often include long periods of depression, sadness, hopelessness, and loss of interest in activities that were once pleasurable (i.e., hobbies, spending time with friends, etc.). Extreme mood swings are also signs of a mood disorder vs. an anxiety disorder.

Everyone ages differently, impacted by a unique combination of genetics, lifestyle, environment, and health habits. These factors shape how we experience the effects of aging, both inside and out.

Longevity medications may be appropriate for:

Women and men experiencing early signs of aging or chronic fatigue
Individuals with chronic inflammatory diseases
Adults experiencing poor sleep quality
Patients seeking to improve cognitive clarity or immune resilience
Anyone looking to proactively support their healthy aging journey

Sermorelin is a growth hormone releasing hormone (GHRH). A GHRH, also called a growth hormone secretagogue, may help stimulate the pituitary gland to release endogenous growth hormone. Growth hormone is vital to many cellular pathways within the body, and its reduction over time is thought to have a meaningful influence on the aging process.

When it comes to brain health, sermorelin may support cognition by improving problem solving and memory skills in older adults. Additionally, growth hormone medications also increase insulin-like growth factor 1 (IGF-1), which could mean changes in body composition. How fat is distributed and metabolized affects overall cardiovascular and metabolic health, which may help with longevity.

People who take sermorelin may find they have increased strength and energy levels, influencing their athletic endurance. They also report deeper stages of sleep, which may help patients achieve better rest and recovery.

Compounded longevity medications are available in a variety of forms to suit different patient needs and preferences. Each form offers different advantages in terms of absorption and convenience. Longevity and age management medications are available as:

Oral tablets
Sublingual tablets
Capsules
Injectables
Nasal sprays
Topical creams

Women undergo sometimes dramatic changes in hormones during perimenopause and menopause (when the menstrual cycle hasn’t occurred consecutively for a year). As a result of these abrupt hormonal fluctuations, women may experience hair loss. Additionally, hair follicles shrink as you get older, so hair may appear thinner than it once was. Optimizing hormones with personalized hormone therapy may help reverse thinning hair and hair loss related to menopause.

Certain commonly prescribed medications can cause hair loss in women – most of it temporary. However, it is possible to experience more permanent hair loss from medications that trigger female pattern baldness. Some of these medications that can lead to women’s hair loss include:

Isotretinoin for acne
Cholesterol lowering medications
Antidepressants
High blood pressure and heart medications
Birth control pills
Testosterone
Steroids
Ulcer medications
Blood thinners
Epilepsy medications
Amphetamines
Antifungals
Thyroid medications
Anti-inflammatory drugs for pain and swelling

There are several medical conditions that can cause both temporary and permanent hair loss in women. Hormonal changes during pregnancy, childbirth, and perimenopause and menopause can be an underlying reason for hair loss. Additionally, thyroid disorders and autoimmune diseases can contribute to hair loss. Alopecia areata is an immune-related condition that causes patchy hair loss and scalp infections.

Genetics play a role in women’s hair loss, as well. Both men and women can be genetically predisposed to a condition called androgenic alopecia, or male-pattern and female-pattern baldness. This leads to gradual, permanent hair loss in most cases.

Other health conditions, such as prolonged periods of stress or traumatic events may cause temporary hair loss in women. Rapid, significant weight loss may also lead to thinning hair in women.

Generally, hair solutions are applied topically to the scalp at bedtime, left to soak overnight, and then washed out in the morning. Hair solutions can be applied topically to the hair and scalp up to twice daily, depending on practitioner instruction. These formulations are designed to sit for longer periods of time to better penetrate the hair follicles and scalp tissue. Apply the product as directed and style hair normally. For all hair formulations, consistent application is important for results.

Depending on the active ingredient(s) in the preparation, a pea-sized amount as a thin layer is applied topically to the affected area once or twice daily. Most creams that are designed to address age management or other skin health issues are used before or during the moisturizing step, prior to sunscreen. Refer to the prescriber’s specific instructions and always rub in to clean, dry skin.

It’s always important to talk to a medical professional about whether a particular medication is a good fit. Some active ingredients like finasteride are not recommended if patients are pregnant or planning to become pregnant. Be sure to discuss any current health conditions and medical history to help identify the best therapeutic option.

Nail infections can appear on hands and feet but are most common on toenails. They usually begin as a few white spots, and can gradually make nails thick, brittle, and discolored. Compounded antifungals can be formulated to target challenging infections.

One of the most common sleep disorders for millions of American adults is insomnia – the inability to easily fall asleep at night, or to be able to stay asleep. Insomnia affects more women than men and can be short-lived (lasting a few nights or weeks due to stress or a major life event) or long-term (chronic insomnia). For women, insomnia often occurs during the hormonal changes that come with perimenopause and menopause in the 40s and 50s, but may begin as early as the late 30s.

Symptoms of insomnia include trouble falling asleep at night, waking up too early, waking up multiple times a night, and feeling tired during the day. Fatigue, low energy, and anxiety may also be symptoms of chronic insomnia.

Hormone replacement therapy may help improve sleep disorders and insomnia in perimenopausal and menopausal women by stabilizing fluctuating hormones. Replenishing naturally declining hormones, a symptom of the natural transition from childbearing years into menopause, can help reduce night sweats, balance mood, and reduce joint pain so women are able to fall asleep easier and stay asleep at night. Many women find that replacing declining estrogen and progesterone so they’re back in balance is a crucial part of regulating their sleep-wake cycles and promoting nighttime relaxation.

Melatonin, produced naturally in the body, helps promote a quiet, calm state at night that helps with sleep. As the brain releases melatonin, levels should rise a couple hours before bedtime so the body can begin to relax and prepare for sleep. However, women suffering from sleep disorders and insomnia may be melatonin deficient. Taking small doses of melatonin may help reduce the time it takes to fall asleep and help promote a deeper sleep with fewer instances of waking in the middle of the night.

The natural aging process and decline in testosterone levels by about 1.5% each year from age 30 on may cause low sex drive in men. A man’s physical health, emotional well-being, stress levels, and lifestyle may all contribute to low libido, as well. Men with diabetes, high blood pressure, sleep disorders, or anxiety and depression may also find that they think about and desire sex less than usual. Alcohol and drug use can also cause low sex drive in men, and tobacco use may damage blood vessels and suppress testosterone levels over time.

Lifestyle changes, such as improving sleep habits, reducing stress, regular exercise, and eating a healthy diet may help increase sex drive in men. However, low testosterone levels don’t replenish themselves; they only continue to decline naturally with age. For men in andropause, bioidentical hormone replacement therapy (BHRT) that includes a combination of testosterone, DHEA, and even oxytocin, may help boost male sex drive long term.

Belmar Pharmacy offers a variety of dosage forms and customizable strengths for medications that address men’s sexual dysfunction. Bioidentical hormone replacement therapy (BHRT) is available in the form of oral medications, topical creams, and injectable combinations. Oral medications like sildenafil citrate, vardenafil, and tadalafil, are designed to help men get and maintain an erection for satisfying sexual intercourse. Injectable testosterone therapies help increase hormone levels, and intracavernosal injections are injected directly into the penis to produce a more immediate result than other types of sexual dysfunction medications.

Hormone pellets are a unique delivery form created to replicate how hormones are naturally released in the body as closely as possible. In a simple office procedure, these rice-grain-sized pellets are inserted under a patient’s skin near the hip area.

Delivering hormone replacement therapy in pellet form has multiple benefits:

Convenience: No need to worry about remembering to take daily medication. Hormone pellets may only need to be inserted 3 to 4 times per year.
Minimal side effects: Pellet therapy sends hormones into the bloodstream, avoiding potential side effects of oral medications.
Consistency: Pellets are designed to supply a consistent level of hormones in the bloodstream.

Bioidentical hormones, like the ones Belmar Pharmacy compounds, are used to treat men (and women) with low hormone levels. Bioidentical hormone pellets have the same molecular structure as natural human hormones, so they work the same way and are readily absorbed by the body.

Replenishing testosterone through pellets may improve men’s sexual wellness, including increasing libido and helping with erectile dysfunction.

A medical provider will likely begin by asking questions about current symptoms, as well as a medical and sexual history. Given the topic, the questions will get personal, but don’t sink into embarrassment. Answering truthfully is important.

A physical exam can follow that could include an examination of the penis and testicles, a rectal exam to check the prostate, a blood pressure check, as well as blood tests for hormone levels, blood sugar, and cholesterol. Depending on the results, the prescriber may recommend medication(s) or coordinate a consultation from a specialist such as a urologist, endocrinologist, sex therapist, or other counselor to address any underlying physical or psychological problems.

Testosterone levels drop roughly 1% each year after age 30, for many men. This can lead to lower libido and a decrease in nitric oxide (N.O.) production, which is needed for an erection.

But low testosterone may only play a small role in ED. Testosterone is connected to a man’s desire for sexual activity (libido), which in turn triggers dopamine and oxytocin release from the brain to increase N.O. for an erection. In most cases there are other underlying causes for ED. As patients get older, disease states are often the primary culprit for ED, with decreased testosterone being just one contributing factor.

Many conditions can be connected to ED, such as diabetes, high blood pressure, depression, high cholesterol, and cardiovascular disease. These health issues affect blood flow, nitric oxide production, and nerve signaling necessary to stimulate an erection. Improving the underlying causes that relate to erectile dysfunction, may also help restore sexual function. If the patient is generally considered healthy and ED is the only complaint, it’s a sign to the provider to look deeper for cardiovascular issues. ED can be a precursor to cardiovascular events down the road.

Patients with an increased risk of priapism – erections lasting 4 hours or more – should seek medical advice before starting injectable medications for erectile dysfunction. Conditions like sickle cell disease, leukemia, and multiple myeloma can be predisposed to priapism and are encouraged to discuss appropriateness of therapy with a provider. Use is contraindicated for those with Peyronie’s disease, bleeding disorders, or recurrent priapism.

Patients with higher likelihood for priapism should also discuss risk management, such as rescue medications, for emergent situations. Injectable phenylephrine can serve as a therapeutic option for these cases.

There are other conditions that may affect candidacy for compounded erectile dysfunction injectable medications. Reach out to a medical provider to discuss appropriate therapies.

Prescription drugs such as antidepressants, high blood pressure medicines, or antihistamines, may cause or worsen sexual dysfunction symptoms. If there are concerns that current medications may be negatively affecting sexual wellbeing, contacting a medical professional is recommended.

Low sex drive in men is especially common during andropause. Compounded hormone replacement therapy (HRT) can target libido changes and support sex drive. Consultations with a compounding pharmacist will explain the hormonal challenges of advancing age and share therapeutic options, like testosterone and oxytocin.

Low sex drive and erectile dysfunction can both be consequences of aging and andropause, but they are not the same thing. Having low sex drive means experiencing little to no desire for sex, whereas erectile dysfunction is difficulty achieving or maintaining an erection sufficient for sexual intercourse.

They can be connected, though. As men get older, hormone levels begin to drop. For many men, testosterone levels drop roughly 1% each year after age 30. This can lead to lower libido and a decrease in erectile function.

Low sex drive can happen at any time and it’s easy to misplace blame. Both women and men can experience it, though embarrassment and shame can prevent partners from talking about it. The goal is to build intimacy and foster connection so couples can address low sex drive together, whether the cause is psychological or physiological (or both).

Since the steady testosterone decline typically begins at age 40, men may find themselves in andropause anytime after that. Because symptoms vary from person to person, it may or may not be noticeable. However, when symptoms like low libido, erectile dysfunction, low energy, or depression/anxiety interfere with daily life and relationships, it’s likely a sign that a man over the age of 40 is experiencing andropause.

The most common symptoms of andropause include:

Low libido/loss of interest in sex
Erectile dysfunction
Fatigue
Loss of muscle mass
Depression, anxiety or mood changes

Men may also experience bone density loss, hot flashes or sweating, breast tenderness, and infertility.

Often talked about as the male version of menopause, andropause is a real stage of life that men naturally go through as they age. Male menopause typically refers to the effects of decreasing testosterone levels that can lead to unpleasant or even life-changing symptoms, such as depression, lack of motivation, and erectile dysfunction (ED). Andropause is different from menopause because it’s much more of a gradual decline of hormones, rather than the more sudden experience of the end of ovulation for women.

Andropause looks different for every man, but common symptoms include lower libido (loss of sex drive), fatigue, depression or anxiety, among others. Men go through andropause as an expected part of the aging process, but don’t have to accept these physical and emotional changes as their new normal. The severity and duration of symptoms of andropause are highly personal and unique. Therapies that promote restorative sleep, sex drive, and metabolic health can make a difference early on.

Andropause in men can last 15-20 years, or longer. Because testosterone declines gradually about 1.5% each year after age 40, symptoms can persist, as the hormone decline is permanent. During andropause and beyond, the body will no longer produce the amount of testosterone needed to help men feel their best physically, emotionally, and sexually. Over time, the gradual decline in testosterone may warrant further intervention with low testosterone therapy.

Andropause is an expected aging process associated with declining androgen levels, whereas low testosterone is a measurable hormone deficiency. During andropause, testosterone levels may stay within normal limits for an extended period and may not warrant immediate intervention. It is also true that andropausal patients can have low testosterone and seek symptom support from bioidentical hormone replacement therapy (BHRT).

TRT or testosterone replacement therapy in the form of bioidentical testosterone comes from plant sources (yams) and is chemically engineered to have the same makeup as the testosterone the body produces naturally. Belmar Pharmacy offers bioidentical hormone replacement therapy (BHRT) that can be personalized for each patient’s needs. Hormones and medications are available in a variety of dosage forms and strengths, such as sublingual tablets, injectable blends, topical creams, and hormone pellet implants.

Compounded sterile injectables provide a way for patients to benefit from medications that may not be optimally absorbed orally or topically. Injectable preparations bypass bodily roadblocks, like liver digestive enzymes, that can negatively impact drug bioavailability. Sterile injectables can be administered subcutaneously (SQ), intramuscularly (IM), or via intracavernosal injection (ICI).

Injectable medications from Belmar Pharmacy are dispensed in a sterile vial with injection supplies. Injection supplies allow providers and patients to draw up the appropriate dose and introduce the medication into the body by breaking the skin barrier. Prescribed needles and syringes may vary in size and length to match the administration technique.

Testosterone cypionate blends with DHEA or anastrozole can be injected intramuscularly (IM) or subcutaneously (SQ). An intramuscular (IM) injection delivers medicine into the muscle tissue. Typical injection sites include the muscular tissues of the deltoid, thigh, hip, or buttocks. A subcutaneous (SQ or SC) injection delivers medicine into the fatty layer between skin and muscle. Typical injection sites include the fatty areas on the upper arm, abdomen, and thigh.

For all injectable preparations, it is very important to rotate injection sites to optimize proper medication absorption and minimize injection site complications. Properly disinfecting the dosing site using alcohol swabs prior to injection, and using new, clean injection supplies for each administration will limit the risk of infection.

Both conditions are autoimmune thyroid disorders. Hashimoto’s thyroiditis is a form of hypothyroidism where antibodies damage the thyroid gland and cause underproduction of thyroid hormone. Graves’ disease is a form of hyperthyroidism where antibodies also damage the thyroid gland, but cause overproduction of thyroid hormone.

Mast Cell Activation Syndrome (MCAS) is a collection of immune system issues where mast cells become hyper-reactive and unstable. Normally, mast cells activate and release chemical mediators like histamine in response to foreign invaders. In MCAS, mast cells respond in a dysregulated manner to a combination of triggers that may appear benign to the average immune system. As a result, patients experience inconsistent flares of reactivity that are difficult to predict and control.

MCAS diagnosis involves an expert evaluation of symptoms, clinical exam, and lab tests. Symptoms of mast cell activation syndrome can vary patient to patient, and other conditions usually need to be excluded beforehand. Lab tests can be a challenging diagnostic tool because some need to be drawn soon after a flare and compared to baseline, like with specific marker serum tryptase.

MCAS and postural orthostatic tachycardia syndrome (POTS) are often connected. Mast cells release chemical mediators that impact blood vessels and nerves, making it harder for the body to regulate heart rate and blood flow while standing. These autonomic signaling problems are characteristic of POTS. Patients can be diagnosed with both and experience overlapping symptoms. It’s important to investigate the presence of MCAS in patients diagnosed with POTS, because underlying mast cell dysregulation can exacerbate POTS symptoms and make it harder for patients to experience symptom relief.

POTS stands for postural orthostatic tachycardia syndrome. Postural relates to standing upright from a seated or lying position. Tachycardia is defined as a rapid increase in heart rate. Syndrome is typically defined by a collection of symptoms that happen together.

Postural orthostatic tachycardia syndrome (POTS) is a complicated condition with a range of symptoms that reflect difficulty regulating temperature, blood pressure, and heart rate. When patients shift from lying down to an upright position, or tilt their head more than 60 degrees, their bodies cannot compensate and heart rate increases in response. Postural orthostatic tachycardia syndrome symptoms are a result of autonomic functions malfunctioning, such as blood pressure, heart rate, digestion, and respiration.

There are three main types of POTS that have different root malfunctions. In hyperadrenergic POTS, the sympathetic (adrenergic) nervous system is overactivated by an excess of norepinephrine. In hypovolemic POTS, it is a lack of circulating blood volume that causes heart rate disruption. In neuropathic POTS, nerve damage causes blood supply issues to the core and legs, making it hard for patients to maintain proper blood pressure against the pull of gravity.

Hypermobile Ehlers-Danlos syndrome (hEDS) is a heritable connective tissue disorder marked by joint hypermobility and instability, Most patients also experience chronic musculoskeletal and neuropathic pain. Because it affects many body systems and lacks a single diagnostic test, hEDS is often misdiagnosed or overlooked. Symptoms are widespread and fluctuating, making medication management a challenge for patients and providers.

A hEDS diagnosis involves lax connective tissue, which affects blood vessels. In neuropathic POTS, nerve damage causes blood supply issues to the core and legs, making it hard for patients to maintain proper blood pressure against the pull of gravity. When patients stand their blood vessels don’t constrict the way they should and blood pools in their lower extremities and abdomen. This venous pooling can be exacerbated by weak blood vessel support common in hEDS.

Mast Cell Activation Syndrome (MCAS) is a disease where mast cells become hyper-reactive and unstable. hEDS is a connective tissue disease, and mast cells reside in connective tissue. It is possible for hEDS patients to experience overlapping symptoms with MCAS such as GI problems, flushing, and dermatologic sensitivities. But one condition does not cause another, nor are MCAS related symptoms always present in hEDS.

Graves’ disease is an autoimmune disease that results in hyperthyroidism, a state of thyroid hormone excess. Not all hyperthyroidism is caused by Graves’ disease. In this condition, the immune system produces autoantibodies that malfunction by constantly activating the thyroid stimulating hormone (TSH) receptor. When the body targets its own TSH receptor via autoantibodies, the thyroid gland grows and excess thyroid hormone is produced.

Medical professionals like endocrinologists or thyroidologists receive specialized training to clinically support patients with Graves’ disease. General practitioners like primary care physicians are important for routine monitoring and functional medicine providers offer a holistic approach to autoimmune disease management. If surgery is required, an ENT (ear, nose, and throat) surgeon is an appropriate fit.

Graves’ disease is an autoimmune form of hyperthyroidism that may go into remission, but there is no cure for autoimmunity. Remission means the autoimmune overstimulation of the thyroid has decreased enough that thyroid hormone production has normalized. The other determining factor is maintaining this state without requiring medication for 12 months or more. Other causes of hyperthyroidism may resolve depending on the cause.

Multiple sclerosis (MS) is a neurodegenerative disorder characterized by attacks on the central nervous system by antibodies, damaging myelin and resulting in brain signaling issues. It is a chronic and complex autoimmune disease requiring lifelong management with multiple sclerosis medication to mitigate symptoms and slow disease progression.

If one or more family members has an autoimmune condition, genetic preposition may put an individual at increased likelihood for developing one as well. However, it doesn’t definitively dictate if or how autoimmunity will present and impact daily life. Environmental factors play an important role in establishing risk, such as viral infections, smoking, and low vitamin D that can influence the development of MS.

No, like most autoimmune conditions, there is no cure for MS. But early identification and therapy during the early inflammatory stage can significantly reduce lasting disability, like neurodegeneration. Medical intervention can also limit disease progression, and promote better quality of life. Many patients can reduce flares and even achieve disease remission with appropriate medical support.

Systemic lupus erythematosus (SLE) is a chronic autoimmune condition, where inflammation is prevalent across the body as a result of a dysregulated immune system response. Symptoms like extreme fatigue and joint pain tend to fluctuate over time and there is no cure for the disease. Medication management focuses on reducing inflammatory pain and disease progression, while improving quality of life.

Many patients initially present with generic symptoms of fatigue, general discomfort, weight loss, and occasional fever. Since these symptoms often come and go and mimic many other conditions, recognizing them as a sign of a greater diagnosable disease can be challenging for patients and providers alike.

If one or more family members has an autoimmune condition, genetic preposition may put an individual at increased likelihood for developing one as well. However, it doesn’t definitively dictate if or how autoimmunity will present and impact daily life. There are many other environmental triggers like infections that may influence whether or not an autoimmune condition like SLE develops.

An immune system gone awry is generally the root cause of all autoimmune diseases. The white blood cells (WBCs) that normally fight foreign invaders such as viruses, bacteria, and cancer, begin to attack the body’s own healthy cells. In rheumatoid arthritis, the immune system targets and attacks the body’s own joint linings causing joint pain, swelling, and stiffness in its early stages.

Chronic vulvar pain is complex and warrants a complete evaluation by a trusted healthcare professional. Sharing details about how and when the pain presents can help guide the conversation. Relief may not be immediate, but seeking care will offer options to decrease pain and strengthen sexual function.

Dyspareunia is characterized by pain during vaginal intercourse. It can feel like burning discomfort within the vaginal opening or deeper. For perimenopausal and postmenopausal women, hormonal imbalances are often the source of the problem.

A lubricant for dyspareunia or a vaginal moisturizer can temporarily increase comfort and pleasure if they are free of irritating chemicals. Both can be used with other therapies, but these alone will not address the underlying cause if related to hormonal changes.

Yes, they are often connected. Many postmenopausal women experience vaginal symptoms that lead to sexual discomfort. Hormone replacement therapy for menopause can address vaginal dryness and may improve lubrication while repairing delicate tissue. Vaginal compounds applied locally target the area and offer symptom support.

The thyroid gland and the hormones it produces is complex. The thyroid-stimulating hormone (TSH) is a hormone that the pituitary gland releases to prompt the thyroid gland to release its own hormones: T3 (triiodothyronine) and T4 (thyroxine). These two thyroid hormones control the body’s metabolic rate, or how well the body converts food into energy. T3 and T4 are also responsible for heart and digestive function, bone health, and brain development.

In order for thyroid-stimulating hormones to function optimally, they work together with other systems, including the brain (the hypothalamus) to create a complete “feedback loop.” This helps the pituitary gland know how much and when to release T3 and T4 into the bloodstream. When levels of T3 and T4 hormones become lower in the bloodstream, the TSH then triggers the thyroid to produce more of these hormones. If TSH levels become too low, it can lead to an overactive thyroid, or hyperthyroidism. If TSH levels become too high, it can lead to an underactive thyroid, or hypothyroidism.

Thyroid disease is any condition that prevents the thyroid from producing the right amount of hormones the body needs for optimal metabolic health. The two most common types of thyroid disease are hypothyroidism (an under-functioning thyroid) and hyperthyroidism (an over-functioning thyroid gland). Hypothyroidism is more common in women than men, and is often characterized by unexplained weight gain, feeling sluggish, and constipation. The most common type of underactive thyroid disease is Hashimoto’s thyroiditis.

Early warning signs of thyroid problems depend on whether the thyroid is underactive (not producing enough hormones) or overactive (producing too much of the hormones T3 and T4). Signs of an underactive thyroid (hypothyroidism) often include fatigue, weight gain, intolerance to cold, depression, and dry skin. Early warning signs of an overactive thyroid (hyperthyroidism) may include rapid heart rate, sweating, unexplained weight loss, and anxiety.

Another sign of a potential thyroid problem is a change in the thyroid gland itself. Located at the base of the neck, this butterfly-shaped gland may become swollen to the point that it is visibly enlarged.

Depending on the specific thyroid disease, most thyroid conditions can be successfully managed long term with thyroid medications and hormone therapies. Liothyronine is a medication that replaces T3 hormones if the body isn’t making enough T3 on its own. Levothyroxine is a medication that replaces natural T4 hormones if the body isn’t making enough of those. Natural desiccated thyroid (DTE) is made from dried pig thyroid glands.

Thyroid medications, including desiccated thyroid and levothyroxine, are available from Belmar Pharmacy in customizable dosage forms and strengths, to address hypothyroidism, hyperthyroidism, and other common thyroid disorders.

No, there is no cure for hypothyroidism. Therapeutic options are focused on disease management and many patients experience great improvement. Thyroid hormone replacement options like levothyroxine sodium (T4), liothyronine sodium (T3), or desiccated thyroid support the body’s hypothyroidism needs and, in turn, limit symptoms. If a hypothyroid state is due to a temporary condition or deficiency, then it may resolve in time.

The thyroid is considered the engine of the body as it controls metabolism and energy. When thyroid hormone levels are low, like in hypothyroidism, regulation of these important weight management factors declines. The best way to lose weight with hypothyroidism is to address the lack of thyroid hormone with appropriate thyroid hormone replacement, combined with recommended diet and exercise.

This stage can indicate a pre-hypothyroidism state. A slightly elevated TSH indicates that the pituitary gland is putting in extra effort to make enough T4, but T4 levels remain within range. Subclinical patients can experience light hypothyroidism symptoms and may eventually develop hypothyroidism.

Hyperthyroidism is a condition where the body either produces or secretes an excess of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). When they are too high, otherwise known as thyrotoxicosis, it can kick the body into an overactive state which can have negative consequences if left untreated. Hyperthyroidism symptoms can include exercise intolerance, insomnia, and heart palpitations: a reflection of a hypermetabolic state.

It is more common for hyperthyroidism to result in weight loss, as opposed to weight gain. This condition results in a hypermetabolic state, which can rapidly deplete the body of its energy reserves. Weight loss is common because the metabolism is in overdrive, eventually breaking down the body’s own muscle tissue as a source of energy.

Yes, there can be a cure for hyperthyroidism depending on the cause. If a hyperthyroid state is due to a singular malfunctioning thyroid nodule, such as a toxic adenoma, removing the nodule via surgery or radioactive iodine can restore proper functioning of the thyroid. Using similar methods to address a toxic multinodular goiter will correct the hyperthyroidism, but often will result in a hypothyroid state requiring supplemental thyroid replacement therapy. Temporary thyroiditis may also resolve in time without intervention. Graves’ disease is an autoimmune form of hyperthyroidism that may go into remission, but there is no cure for autoimmunity.

No. Fibromyalgia is not classified as an autoimmune disease, but it’s possible that a dysfunctional immune system is a contributing factor. Fibromyalgia can sometimes seem like an autoimmune disease, as it’s a chronic painful condition that can affect many parts of the body accompanied by fatigue.

The cause of fibromyalgia is complicated, but it’s thought that nerves are affected in a way that signals pain to the brain, even if there’s no specific or obvious cause of that pain. Certain illnesses and health conditions, including nutrient deficiencies and hormone imbalances, seem to trigger fibromyalgia. Stress or a traumatic life event may also cause flare-ups.

Fibromyalgia is more common in women than in men. Immune diseases like rheumatoid arthritis and lupus can increase the risk of developing fibromyalgia.

If the immune system errantly targets the hair follicles, it’s called alopecia areata. With this disorder, both women and men often experience sudden patches of hair loss. If untreated, this can lead to total scalp or body hair loss (alopecia universalis).

Hashimoto’s thyroiditis (underactive thyroid disease or hypothyroidism) may also cause thinning hair and much slower hair growth, especially in women with whom this is a common autoimmune condition. Lupus may also cause thinning or hair loss in women. Additionally, any type of hormonal imbalance (like hypothyroidism) women experience during perimenopause and menopause can lead to thinning hair or hair loss.

While most autoimmune diseases affect women more than men, men can experience these disorders as well. Psoriasis and psoriatic arthritis is common among men, as is inflammatory bowel disease (IBD), type 1 diabetes, and Addison’s disease, which affects the adrenal glands and impacts hormone production.

Like women, men often have overlapping autoimmune disorders and symptoms.

Possible medications that may help with autoimmune disorders include low dose naltrexone (LDN). LDN is used for a variety of conditions and has shown potential benefits in several autoimmune or immune-related conditions, including:

Multiple sclerosis
Autoimmune thyroid disease
Adrenal autoimmune diseases
Crohn’s disease
Lupus
Rheumatoid arthritis

LDN is thought to work by briefly blocking opioid receptors, which may lead the body to upregulate endorphin production once the blockade wears off. Increased endorphins can help modulate the immune system and reduce inflammation, both of which are relevant in many autoimmune conditions.

Many women and men using low dose naltrexone for their autoimmune disease report reduced inflammation and pain, improved sleep and mood, better mobility, improved concentration, and fewer headaches. Unlike some other autoimmune therapies, LDN is generally well tolerated and may have fewer or milder side effects. It’s important to discuss all medications and therapies with a healthcare provider.

Medical professionals like endocrinologists or thyroidologists receive specialized training to clinically support patients with Hashimoto’s Thyroiditis. General practitioners like primary care physicians are important for routine monitoring and functional medicine providers offer a holistic approach to autoimmune disease management. If surgery is required, an ENT (ear, nose, and throat) surgeon is an appropriate fit.

Thyroid hormone replacement options like levothyroxine sodium (T4), liothyronine sodium (T3), or desiccated thyroid can support the body’s hypothyroidism needs and address Hashimoto’s symptoms. Low dose naltrexone (LDN) is an immune modulator and anti-inflammatory agent that may positively impact the autoimmune nature of the thyroid disorder. For many patients, dietary changes can also help decrease disruptive symptoms.

Yes. It’s possible to get pregnant during perimenopause. While your ovaries are producing less estrogen and progesterone, fertility and egg quality decline, and your periods may become irregular, you can still get pregnant. Even if you don’t have a period for several months in a row, it doesn’t mean that pregnancy will not occur. If you do not want to become pregnant, contraception is still necessary. Notably, perimenopause symptoms such as missed periods, fatigue, and mood swings, are often similar to early signs of pregnancy.

On average, perimenopause lasts about four years. However, some women experience perimenopause symptoms for just a few months, while others endure unpleasant symptoms that last up to 10 years. Typically, without addressing symptoms with hormone medications or therapies such as bioidentical hormone replacement therapy (BHRT), most women endure perimenopause symptoms for two to eight years before they reach menopause (12 consecutive months without a period).

Weight gain during perimenopause is common, especially around your midsection. This is usually the result of hormonal shifts, including decreased estrogen production, which can lead to fat storage around your belly. Sometimes known as “the menopausal middle,” this weight can be difficult to lose, but it is possible.

During perimenopause, your body often stores fat, burns fewer calories, and can become resistant to insulin. This complex chain of events can make you gain weight even when you don’t change anything about your diet or lifestyle. For perimenopausal women, it’s not typically just a matter of taking the “exercise more, eat less” approach.

Addressing the root cause of weight gain during perimenopause “hormonal deficiencies,” may help you lose weight. Bioidentical hormone replacement therapy (BHRT) is one way to optimize your hormones to help boost metabolism, regain muscle tone, and lose unwanted pounds. Personalized BHRT helps bring your hormones back to an ideal level and can therefore make it easier to prevent unwanted weight gain.

Many women aren’t aware of perimenopause, or that their experiences could be linked to hormonal imbalance. Being familiar with the signs and symptoms of perimenopause will help patients identify early and act. Symptoms can start years before the final menstrual period (FMP). Tracking menstrual cycles manually can be helpful, as is connecting with a healthcare provider if perimenopause is possible.

The decision of when to start HRT depends on the perimenopause symptoms, the individual patient, and the trusted healthcare provider. Many women begin HRT during perimenopause, especially if their symptoms are interrupting daily life and affecting their work, relationships, and wellbeing.

The body’s ability to produce certain hormones shifts throughout perimenopause. Discontinuing HRT may prompt some symptoms to return. Many women begin HRT during perimenopause and continue after menopause. The dose, compounded dosage form, and duration of therapy will vary patient to patient and may change throughout the experience.

Perimenopause triggers a multitude of hormonal changes. When estrogen levels drop and androgen levels rise, an imbalance occurs. That imbalance causes the body to distribute fat differently, and there can be signs patients see and feel. For many, muscle mass begins to break down and more fat starts to accumulate around the midsection. Combined with a slowing midlife metabolism, weight often fluctuates.

For women in perimenopause, menopause, and postmenopause, hormone replacement therapy (HRT) may help with weight loss. As women get older, hormones naturally decline, which can be an underlying reason they may be having trouble losing weight. Hormone fluctuations during perimenopause (in the 40s and 50s, but as early as the 30s) can also contribute to weight gain without changing eating or exercise habits.

Hormone replacement therapy, or bioidentical hormone replacement therapies (BHRT) like the ones Belmar Pharmacy offers, can support women’s weight management goals by returning hormones to optimal levels. When hormones are functioning as they did during younger stages in life, weight loss may also become easier.

A woman’s body needs estrogen, progesterone, testosterone, and thyroid hormones for optimal function of systems. When women’s hormones are out of balance, it can affect every system in the body from skin health to sleep habits, bones, heart health, emotional well-being, and weight management. BHRT can help the body return to its ideal hormonal state so weight loss efforts may become easier.

There is not a single best weight loss medication for women. The best weight management medications for women are the ones that work best for individual needs. Belmar Pharmacy compounds weight management medications that are designed to be part of an overall health and wellness plan. For many women going through perimenopause, menopause, or even postmenopause, addressing the underlying causes of weight gain, such as hormonal fluctuations, may have a positive effect on helping achieve their weight loss goals.

Many women in perimenopause or menopause find that addressing their declining hormones with personalized bioidentical hormone replacement therapies (BHRT) from Belmar Pharmacy, in conjunction with weight management medications, such as GLP-1s, has a bigger impact than just weight management medications alone.

Knowing where to start with weight management medications can be a challenge for women wanting to lose weight. It’s a good idea to consult a healthcare provider to assess overall health, hormonal health, and weight loss goals. Weight management medications are not a quick fix or a stand-alone way to lose weight, but rather one piece of a personalized weight management and healthcare plan.

Healthcare providers may assess body mass index (BMI), hormone levels, especially for women in perimenopause or menopause, and review health history. They should also talk about lifestyle and dietary needs and help create a comprehensive approach to reach weight goals. A provider will help determine which weight management medication may work well for each patient’s individual needs, in conjunction with any other health and lifestyle changes.

Yes, Belmar Pharmacy compounds GLP-1RA liraglutide as a combination sterile injectable with L-carnitine. A glucagon-like peptide-1 receptor agonist like liraglutide mimics the body’s natural gut hormone GLP-1, a hormone that is naturally released after eating to reduce appetite and food cravings. L-carnitine is an amino acid derivative that helps break down fatty acids for the body’s energy and fuel. Together, the subcutaneous daily injectable L-carnitine/liraglutide compound is designed to alter food preference and reward pathways in the brain to address insulin resistance and weight management.

A woman’s libido does not have a simple on/off switch. There is no one-size-fits-all approach to this issue. The key to increasing libido is identifying the potential reasons it’s low, which can be deeply personal. Hormonal imbalances, sexual dysfunction, problems within a partnership, and other health conditions or medications can negatively affect libido. Seeking support from a healthcare professional can open up options.

Low sex drive in women is especially common during perimenopause and after menopause. Compounded HRT can target low libido and support sex drive. Consultations with a compounding pharmacist will explain the hormonal challenges of advancing age and share therapeutic options, like estradiol, testosterone, and oxytocin.

Low sex drive can happen at any time and it’s easy to misplace blame. Both women and men can experience it, though embarrassment and shame can prevent partners from talking about it. Studies indicate that when women express the importance of sex to their partners and show a clear desire to improve their sex life, men listen. The goal is to build intimacy and foster connection so couples can address low sex drive together.

Dyspareunia, vulvodynia, and vaginismus are symptoms and conditions related to painful vaginal intercourse. A patient can experience all three, often beginning with vulvodynia, which can develop into vaginismus, resulting in dyspareunia.

Vaginismus is a pelvic floor muscle disorder that causes involuntary muscle spasms, caused by actual and/or anticipatory pain and fear of vaginal penetration. Spasms can prevent gynecological exams and vaginal penetration during intercourse.

Therapeutic tools for vaginismus may include medication, behavioral counseling, and medical devices. Compounded diazepam suppositories may be warranted to limit the involuntary vaginal spasms. Medical devices may target physical vaginismus symptoms by promoting muscle relaxation. To support the emotional component to the sexual problem, providers can refer patients to a sex therapist to decrease the fear and stress surrounding penetration.

If sharing symptoms and expressing feelings with a general healthcare provider is uncomfortable, seek a counselor or therapist, especially if the condition could be the result of trauma or abuse. Identifying the source of anxiety may pinpoint the triggers preventing patients from experiencing intimacy. Finding an individual who specializes in these conversations can create a healing space.

Most sexual conditions depend heavily on the health and support of a loving partner. Vaginismus is no different. Improving the sexual function of one will ultimately benefit the other. Emotional connection is the key. Creating space for open dialogue can shift the outcome of future intimate moments together.

Vulvodynia is a chronic pain condition described as raw, burning, tingling sensations around the vestibular and clitoral areas that can be spontaneous and/or provoked. The condition is diagnosed when a clear cause of vulvar tissue hypersensitivity cannot be found.

Belmar Pharmacy offers a variety of therapeutic options to support the body’s thyroid hormone balance. Compounded bioidentical forms of thyroid hormone replacement include synthetic T3/T4 options. Synthetic thyroid hormones are available as liothyronine sodium (T3) or levothyroxine sodium (T4). This form of thyroid hormone is biologically equivalent to the T3 and T4 in the human body, mimicking natural thyroid hormones. These active ingredients can also be compounded into combination oral formulations with both T3/T4.

There are many different reasons why women get testosterone pellets. Healthcare providers who specialize in hormone replacement therapy and women’s health know that women need testosterone for many of the same reasons men do: for energy, mood, libido, and helping to maintain muscle tone and an ideal weight.

Testosterone is an abundantly produced hormone throughout the course of a woman’s life. With age, women’s testosterone levels decline along with estrogen and progesterone. Testosterone pellets in combination with estradiol, estriol, and progesterone address the symptoms associated with perimenopause and menopause, so women can potentially sleep better, alleviate painful sex, regulate mood, and support long-term health and wellness.

Some women experience initial weight gain with testosterone pellets, but it is usually a temporary side effect. Weight fluctuations from testosterone pellets can be the result of fluid retention and muscle growth. Some women experience weight loss or regulation with testosterone pellet therapy, as it helps optimize metabolism. Proper dosing is essential when it comes to any type of bioidentical hormone pellet therapy. Too much (or too little) of a hormone can lead to side effects, but once the patient and provider find a balance that works best for a patient’s individual needs, there should be more benefits than any negative side effects like weight gain.

Hormone pellet therapy is designed to deliver steady, consistent hormones into the bloodstream for 3 to 4 months before the pellets naturally dissolve. If testosterone levels are very low upon the first pellet insertion, the body may process the hormones in the pellet at a faster rate, which could mean they don’t last as long. However, once the patient and provider determine an ideal testosterone dose, based on symptom relief and feeling, along with a blood test to measure testosterone levels in the body, pellets should be able to be reinserted every 3 to 4 months.

Lifestyle, diet, metabolism, and other factors such as body chemistry and overall health conditions may influence how rapidly or how slowly the body processes the hormones. Once implanted under the skin, pellets enter the bloodstream within 24 to 72 hours. However, patients may not begin to feel the effects of testosterone pellets or other hormone pellets until a couple weeks after insertion.

About 2 to 4 weeks after receiving the pellets, women may begin to experience relief from perimenopause and menopause symptoms, including having more energy and improved sex drive. After a couple months, the full benefits of hormone pellets may be felt as the body adjusts to optimized and consistent hormone levels.

It’s similar for men, as well. Testosterone pellets may help improve energy levels, increase libido, and improve overall mood and ambition. For both men and women, experiencing the full benefits of testosterone pellets may take up to 6 months.

Bioidentical hormone replacement therapy (BHRT) pellets are a unique delivery form designed to closely replicate how hormones are naturally released in the body. In a simple office procedure, these rice-grain-sized pellets are inserted under a patient’s skin near the hip area via a trocar. Delivering BHRT in pellet form has multiple benefits, particularly convenience and consistency. Hormone pellets may only need to be inserted 3 to 4 times per year, and they are designed to supply the body with a consistent level of hormonal support as they slowly dissolve into the bloodstream.

As a clinician, you want any therapy to be what’s best for your patients’ health and something that works with their lifestyle. Compounded bioidentical hormone pellets meet that standard; patients often enjoy great clinical results and improved quality of life with this therapy.

Belmar Pharmacy compounds a variety of wellness medications. Contact us for more information.

Patients interested in experiencing potential increases in energy, endurance, mental clarity, and sleep quality may want to consider NAD+. NAD+ dysregulation is often present in diseases related to oxidative stress or damage, such as conditions of the heart and brain. Studies investigating NAD+ support are promising, suggesting potential benefit for those with debilitating neurological disease states or metabolic issues.

Injectable medications are often dispensed in a sterile vial with injection supplies. Injection supplies allow providers and patients to draw up the appropriate dose and introduce the medication into the body by breaking the skin barrier. Needles and syringes may vary in size and length to match the administration technique.

Both NAD+ and sermorelin sterile injectable medications are administered subcutaneously (SQ). A subcutaneous (SQ or SC) injection delivers medicine into the fatty layer between skin and muscle. Typical injection sites include the fatty areas on the upper arm, abdomen, and thigh.

Methylcobalamin is generally administered intramuscularly (IM). An intramuscular (IM) injection delivers medicine into the muscle tissue. Typical injection sites include the muscular tissues of the deltoid, thigh, hip, or buttocks.

Women and men in their forties, fifties, and beyond (and sometimes in their thirties) may benefit from hormone replacement therapy (HRT) to help achieve their weight management goals. As people age, hormones naturally decline, especially for women during perimenopause and menopause. This can impact the ability to lose weight naturally, even if no changes are made to exercise routines and diet. Hormonal imbalances and deficiencies can make it harder to lose weight, get enough sleep, and a host of other unwanted symptoms.

Bioidentical hormone replacement therapy (BHRT) from Belmar Pharma Solutions can help address the underlying causes of weight gain. Testosterone therapy for both men and women can help keep muscle tone and help prevent loss of muscle mass, a common effect of low testosterone levels. Additionally, replacing testosterone may help with energy and motivation to increase daily activity, including exercise. For women, estrogen and progesterone HRT may also enhance sleep. In the long run, optimizing hormones in combination with personalized weight management medications may have the biggest impact on health, well-being, and weight management goals.

Since compounded weight management medications can be personalized for specific needs and goals, there isn’t a one-size-fits-all best option. Instead, working together with a provider to determine the optimal approach giving consideration to lifestyle, nutritional needs, desired outcome, and overall health, is the best way to manage weight long term.

Depending on the needs of the patient, benefits may be realized from a combination of hormone replacement therapy (HRT) and weight management injections in the form of GLP-1s like liraglutide. It’s best to speak with a provider, and a pharmacist, who is well-versed in hormone therapies and understands how addressing hormones and any other underlying causes of weight gain can offer the ideal results.

Some of the most common symptoms of menopause include hot flashes, night sweats, insomnia, joint pain, weight gain (especially around the belly), brain fog, fatigue, and vaginal dryness/painful sex.

Hot flashes can temporarily be relieved by making lifestyle adjustments, such as controlling room temperature at night, dressing in layers, and avoiding triggers like caffeine and alcohol. However, to address hot flashes long term, in perimenopause, menopause, and postmenopause, women may want to consider bioidentical hormone replacement therapy (BHRT). Personalized BHRT may help address the root causes of hot flashes, which during perimenopause is often due to sporadic hormonal changes.

Vaginismus, vulvodynia, and dyspareunia are symptoms and conditions related to painful vaginal intercourse. A patient can experience all three, often beginning with vulvodynia, which can develop into vaginismus, resulting in dyspareunia.

Choosing supplements or bioidentical hormone replacement therapy (BHRT), or some combination of both, along with lifestyle changes, is purely personal. A healthcare provider should take into consideration numerous factors including, current health and symptoms, health history, and personal preferences and health goals. BHRT is often an ideal option for women wanting to optimize their hormones, so they can feel their best as they age.

Bioidentical hormone replacement therapy (BHRT) is designed to optimize the body’s hormones. Bioidentical hormones are most closely matched chemically and molecularly as the hormones the body makes naturally. Compounded bioidentical hormone therapies can be customized for individual needs and preferences, and often consist of some combination of estrogen, progesterone, and testosterone. These hormones are available in many different strengths and dosage forms, including oral tablets, capsules, creams, vaginal suppositories, pellets, and injectables.

BHRT offers hormonal support when ovarian production of hormones is declining (during perimenopause) or stopped (after menopause). Bioidentical hormone replacement therapy with compounded dosage forms of estradiol, progesterone, or testosterone can help women manage menopausal symptoms. Providing symptom relief by addressing downstream effects of hormonal changes is not the same as delaying or prolonging menopause. Menopause is a biologic event that cannot be changed by the presence of HRT.

Bioidentical hormone replacement therapy (BHRT) is designed to optimize the body’s hormones during perimenopause, after menopause, or to support other hormone deficiencies, such as hypothyroidism. Bioidentical hormones are chemically and structurally the same as those naturally made by the human body. Bioidentical hormones are designed to bind to the same receptors and undergo similar enzymatic breakdown. Compounded bioidentical hormone therapies from Belmar Pharmacy are sourced from plants and can be customized to meet individual needs, often using estradiol, progesterone, and/or testosterone. BHRT is available in many different strengths and dosage forms, including oral or fast-burst sublingual tablets, topical creams, vaginal suppositories, and pellets.

Belmar Pharmacy compounds with USP-grade bioidentical hormones sourced from plants. Bioidentical hormones are chemically and structurally the same as those naturally made by the human body. Bioidentical hormones are designed to bind to the same receptors and undergo similar enzymatic breakdown. Synthetic hormones are created to mimic human hormone effects, but often have a different molecular structure and metabolism than the body’s own hormones. Differences in chemical makeup and breakdown can result in differences in biological activity.

Bioidentical hormones are chemically and structurally the same as those naturally made by the human body. Currently Belmar Pharmacy’s bioidentical estradiol and estriol are derived from soy, and bioidentical testosterone, progesterone, DHEA, and pregnenolone are derived from yams. Traditional hormone replacement therapy involves synthetic or animal-derived hormones that are not native to the human body. More importantly, traditional HRT typically lacks chemical structure similarities to the body’s endogenous hormones. For example, medroxyprogesterone is not structurally similar to the progesterone made within the human body, nor is it broken down or metabolized in the same way.

When starting any new therapy, prescribers should discuss therapeutic risks and benefits with their patients, including common signs of an allergic reaction. Bioidentical hormone pellets involve an in-office procedure for insertion that requires breaking the skin and introducing a hormone into the bloodstream. As with any medical procedure, there can be localized bleeding, bruising, or slight discomfort. Fibrous tissue at repeated insertion sites can occur over time. Pellet extrusions or infections are rare and should be reviewed with the medical team prior to the process.

Belmar Pharmacy is the leader in women’s hormonal health and BHRT since 1985.

For many women, the natural decline in hormones (particularly testosterone) during perimenopause and menopause can contribute to low sex drive. Testosterone plays an important role in libido and sexual pleasure. It’s also the hormone women most abundantly produce over the course of their lifetime, but it begins declining as early as a woman’s 30s. Other factors that may contribute to low female sex drive include physical changes, stress, fatigue, vaginal dryness, and other symptoms related to perimenopause and menopause.

Bioidentical hormone replacement therapy (BHRT) addresses the root causes of low libido in women: declining hormones, which naturally occurs with age. BHRT is personalized for individual needs and may help increase a woman’s libido and improve her overall sexual health. Personalized BHRT for women that addresses low libido may include testosterone, oxytocin, progesterone, estradiol, and DHEA.

Belmar Pharmacy offers a variety of dosage forms to enhance women’s sexual wellness and address menopause symptoms. Customized hormone therapies are available in systemic applications, such as oral tablets, capsules, troches, fast-burst sublingual tablets, topical creams and gels, and hormone pellet implants. Belmar also compounds localized therapies like vaginal creams and suppositories to target symptoms such as vaginal dryness and painful sex.

Hormone pellets are designed to release a steady, consistent dose of hormones into your bloodstream during the course of 3 to 4 months. About the size of a grain of rice, and implanted into the fatty tissue of your buttocks by a medical provider, pellet therapies address the many symptoms of perimenopause and menopause, including sexual dysfunction. Optimizing your hormones through hormone pellet therapy may improve libido, vaginal dryness, mood, and the many other symptoms women experience during perimenopause through menopause and beyond.

There are a wide variety of reasons for men to experience sexual problems. Common causes of erectile dysfunction (ED) include any combination of psychological, emotional, and physical conditions. Additionally, certain medications can lead to ED. Many men experience ED as they get older and their testosterone levels naturally decline. Testosterone plays a role in the desire for sex (libido), as well as their energy levels, mood, and ability to lose weight as you get older, which can all affect sexual desire and contribute to ED.

Low testosterone may be a contributing factor for erectile dysfunction (ED), but probably not the only cause. Research indicates that 1 in 3 men with ED also have low testosterone. Low testosterone can contribute to ED by lowering your libido (low sex drive), affecting your mood and stress levels, and causing fatigue and low energy. Persistent low testosterone may lead to decreased physical activity, weight gain, and lower self-confidence; all potential components of sexual dysfunction.

If you’re experiencing erectile dysfunction (ED), you may be wondering what the most likely drugs to cause erectile dysfunction are. Several types of drugs may contribute to ED and other types of sexual dysfunction in men, including:

Diuretics
High blood pressure medication
Anti-depressants
Anti-anxiety drugs
Antihistamines
Non-steroidal anti-inflammatory drugs (NSAIDs)
Chemotherapy medications

If your testosterone levels have declined with age, you may benefit from bioidentical hormone replacement therapy (BHRT). Testosterone replacement is a common therapy for men with erectile dysfunction, which may provide relief from many related symptoms.

Other hormones and supplements may be added to your personalized therapy, like pregnenolone, DHEA, aromatase inhibitors, chrysin, or trace minerals, to better regulate hormonal imbalances and address specific symptoms. Medications like oxytocin, may help increase your desire for sex if low libido is a concern.

If BHRT doesn’t help with ED and other types of sexual dysfunction, sterile injectable medications (intracavernosal injections) may be an option. These medications are injected directly into the penis and produce a more immediate result vs. oral medications such as sildenafil citrate, vardenafil, and tadalafil.

The thyroid-stimulating hormone (TSH), is a hormone released by the pituitary gland. It tells the thyroid how much and when to release the hormones it produces called thyroxine (T4) and triiodothyronine (T3). If TSH doesn’t trigger the release of T3 and T4 from the thyroid gland, it can adversely affect metabolic, digestive, and heart functions.

There are many factors that can contribute to thyroid problems, including the pituitary gland’s ability to stimulate the thyroid to release its hormones into the body. The two most common thyroid problems are hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid). Several conditions can cause thyroid problems, including Hashimoto’s disease, a chronic autoimmune condition that can lead to an underactive thyroid.

Other conditions that may cause thyroid problems include iodine deficiency, Graves’ disease (the most common cause of hyperthyroidism), thyroid nodules, and thyroiditis.

Depending on whether a patient has hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid), they may experience opposite symptoms. If the thyroid is underactive, the patient may feel tired and cold, have a sluggish digestive system, feel depressed, and have trouble losing weight. When someone experiences hyperthyroid symptoms, they may feel anxious, lose weight quickly, have trouble sleeping, sweat easily, and have a faster heart rate. Either condition can cause an enlarged thyroid, or goiter, in the neck.

For women, hypothyroidism can mean heavier menstrual periods, and hyperthyroidism can contribute to irregular periods, or lack of them.

Depending on the type of thyroid medication taken, such as levothyroxine sodium, which is used to address hypothyroidism (underactive thyroid), too much thyroid medication may cause transient symptoms similar to those of hyperthyroidism (overactive thyroid). In this case, the patient may experience excessive sweating, rapid heartbeat, anxiety, diarrhea, weight loss, feeling jittery, shaking hands, and trouble sleeping.

Conversely, if the medication is addressing hyperthyroidism and the dose is too high, the patient may experience the opposite feelings of lethargy, lower heartbeat, feeling cold, depression, and mood swings.

Compounded thyroid replacement therapy allows for dose flexibility, combination therapy, and formulation adjustment. Liothyronine sodium (T3) and levothyroxine sodium (T4) can be combined into a single dosage form to improve ease of administration, and their strengths can be customized to meet individual patient needs. Compounded prescriptions can also be formulated to modify the release of the drug as well as to limit unnecessary fillers.

Proper thyroid function requires the conversion of T4, the primary inactive thyroid hormone, to T3, the body’s active thyroid hormone. Levothyroxine sodium (T4) has a naturally longer half-life. Liothyronine sodium (T3) has a shorter half-life, and patients in need of T3 support may benefit from a compounded modified release formulation. It is recommended to take thyroid hormone replacement therapy roughly 30 to 60 minutes before breakfast. Absorption tends to be higher on an empty stomach (at least 4 hours apart from food or supplements).

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