my story

While my pharmacology coursework dove deep into the mechanisms of action and pharmacokinetics/pharmacodynamics of medications related to women's needs, it was focused primarily on treatment options that included birth control pills, antidepressant medications and synthetic, hormone-like chemicals. None of which I felt were optimal options for my mom. 

My story

So, I encouraged her to see her gynecologist.  She returned home (after declining an antidepressant medication that her doctor suggested could help her "deal" with menopause) with a prescription for a non bio-identical oral estrogen.  

Sounded reasonable enough, right? I mean, she was menopausal and her symptoms did appear to be estrogen related.  

The medication was very familiar to me.  In fact, that very day, in the pharmacy where I worked as a student intern, I had filled over 30 prescriptions for the exact same medication.  The exact same dose.  At the time, it was in the top 5 most widely prescribed medications in the United States.  

my story

In going through the motions of filling that medication thousands of times in the past for other women, I had never once stopped to think.  

How did her doctor know that she needed the amount that was prescribed? How did they know that she needed estrogen? Did anyone check her hormone levels?  Did they just assume, based on her age and menopausal status that this is what was needed?  

Question flooded my mind. 

You see, until it was my mom (the one with the strong family history of breast cancer and the one I loved so much), I had never stopped to consider. 

my story

Blood pressure medicine isn't typically prescribed without first checking the blood pressure and monitoring it along the way.

Cholesterol medicine isn't typically prescribed without first measuring the lipids and monitoring them along the way.

Thyroid medicine isn't typically prescribed without first measuring thyroid levels and monitoring them along the way.  

Yet, my mom was prescribed estrogen with a strong family history of breast cancer.  No testing.  Simply an educated guess.  A "try and see" approach.  And, while not ideal, I quickly realized this was not unusual at all.  In fact, it was the norm; the standard of care.  

my story

But, why?  Why do we measure levels for so many other things but something as intricate as hormones, we essentially guess?  

Intrigued.
I set out on a mission to find out. 

I dedicated my entire last year of pharmacy school to massive amounts of in-depth research.   I spent hours interviewing gynecologists, endocrinologists, the best of the best...the top in their field to better understand the shortcomings of testing hormones and why most chose to make educated guesses.  I meticulously combed through mounds of medical literature and studies.  

my story

my story

A few short months later, I was fortunate that one of my professors arranged for a guest lecturer to speak to our class about advances and innovations in comprehensive salivary hormone testing for DNA, HIV and... (well, you guessed it) hormones!

I was absolutely glued to the presentation.

I stayed after the lecture to ask more questions and was able to obtain contact information for the top two leading salivary hormone testing laboratories in the nation.  

I was thrilled.  
 

my story

I was on the phone with both labs the very next day requesting information, studies and education regarding the testing of sex and adrenal hormones through saliva.   

I was motivated by the information and the research that continued to mount regarding the use of saliva as a diagnostic medium to measure free hormone levels and subsequent valuable clinical utility.

In collaboration with my mom's gynecologist, we ordered a comprehensive salivary hormone panel for her.  

The results were insightful to say the least.  

 

My story

Her estrogen was completely optimal.
Her adrenal hormones were optimal. 

Her progesterone, on the other hand, was so low it barely registered on the test.  

Progesterone plays a significant role in energy, memory, mood, sleep, libido, temperature regulation, just to name a few.  It is a natural antidepressant hormone and a natural anti-anxiety hormone.  

This made so much sense.  

my story

My mom did not need estrogen.  At least not at that time.  Several years later, she did.  

With the help of her gynecologist, we worked together with a compounding pharmacy to customize a bioidentical progesterone cream to fit her needs.  

The result:  better sleep, more energy, less night sweats and improved mood.  





 

 

my story

What if she had taken the oral estrogen that was initially prescribed? It was something that she didn't need, despite her age/menopausal status.

Weight gain would be likely while also placing her at an increased risk. Not to mention that the hot flashes would most likely continue or worsen as too much estrogen can cause hot flashes, just in the same way that an estrogen deficiency can cause them.  







 

 

my story

I felt a sense of comfort in knowing that we could monitor her levels and recheck her hormones after several months of using the progesterone to gauge her progress and determine the need for any type of dosage adjustment.

This was far different than what we previously had to offer.

You may know the drill. Try it for a month. If after that month you don't see improvement in your symptoms, then 
the common strategy is to increase the dose. If the result is ineffective, change to a different form of estrogen.  The same can be said for antidepressant medications.  I see it daily. 







 

 

my story

In this particular case, (and in thousands of women that I've seen over the last 15 + years) this results in what I affectionately call "barking up the wrong tree." From a hormonal perspective, this is especially undesirable given how intra-connected these sex hormones are to thyroid, adrenals and neurotransmitters-- just to name a few. 

As you can imagine, things can get out of kilter relatively quickly creating somewhat of a "domino effect."






 

 

my story

Thinking back, it is amazing how God works things together even when we may not recognize it at the time. Oblivious to my future specialty career path and still in my last year of pharmacy school,  I flew to Houston, TX along with a handful of other pharmacy students from Samford to learn the complexities of custom pharmaceutical compounding in a specialty course at The Professional Compounding Centers of America headquarters.  

Coincidentally, (or, maybe not) much of the coursework referred to the art of individualized/personalized approach of custom compounding bioidentical hormones for women. Once again, it made so much sense.  And, once again...I was intrigued. 

my story

 When I returned from TX, I learned that one of my 8 clinical rotations was going to be (somewhat close to home) in Bristol, TN. I had just finished  a rotation that I loved in women's health at the Alabama Department of Public Health in Montgomery, AL but was excited to be a little closer to my family for the upcoming month.   Little did I know when I accepted that rotation in Bristol, that I was about to embark on a journey would lead to a long and rewarding career as a Women's Health Clinical Pharmacist.  

my story

During that rotation,  Anderson Compounding Pharmacy saw my passion and desire to help women and brought me on immediately following graduation to create and grow a thriving women's health clinical practice dedicated to the very thing I love--helping women...naturally.  I am forever grateful for the opportunity to share my knowledge with women and physicians, connect with women from all stages of life helping them and learning from them.  I am thankful to have been afforded the opportunity to work alongside some of the brightest minds in the industry.  I am grateful for the truly incredible team that helped me along the way.  They became more than coworkers,  they became family.  The ability to do what I love and be used in even a small way to help someone else is truly a gift.   

my story

After 16 wonderful years at Andersons, my fire still burns bright as I embark on a new journey as the founder of  Curated Rx. 

Curated means thoughtfully put together with expert knowledge and Rx simply means prescription or course of action.  I take pride in the formulation of thoughtfully put together individualized protocols customized specifically for you.  Curated Rxs.

It is more than a job to me.  It is my passion. I am truly thankful for the opportunity to work with you.  Come alongside you.  Help you feel your best...naturally. 

Dera