Posts made in March, 2009

There’s no business…

Posted by Liz on Mar 6, 2009 in general | 14 comments

[youtube=http://www.youtube.com/watch?v=icr71H1nb3Q]

The other day, a screenwriter friend of mine told me that her script had been rejected. The primary reason: Hollywood does not love middle-aged women; they’re a tough sell. In fact, the general belief among the studio mogols is that women moviegoers don’t make movies successful.

Okay, I’m not entirely surprised because our society doesn’t particularly like or admire or respect middle-aged women, instead, espousing the benefits of youth in just about every area of commerce. But let me clue the studios and marketers to something:

• There are currently 38 million women in this country who are between the ages of 40 and 58
• Women account for about 83% of all consumer buys
• About 2.5M of these women have combined assets of $4.2B

Have I got your attention yet?

A recent article in the New York Times cites data that suggest that Americans are starting to return to the movie theatre in droves. If this is true, then the paradigm defining the typical moviegoer, i.e. teenage boys, is about to change. And will more than likely include middle-aged women.

Moreover, according to an article in Entrepreneur Online, women between the ages of 35 and 55 “make the majority of purchasing decisions in married households, and more than a quarter of U.S. households are single women making buying decisions without any men involved at all.  Middle-aged women are looking for any type of service that will simplify their lives, says, author of Marketing to Women: How to Understand, Reach and Increase Your Share of the World’s Largest Market.”

So, let’s the do the math:

Women, including middle-aged women, have the buying power in the United States + Americans, including women are returning to the movie theatres in droves = middle-aged women are a primary audience and deserve films (and services) that address their needs.

I don’t harbor any illusions that Hollywood or society for that matter, are going to change their ways. Middle-aged women are accustomed to being discarded for their younger counterparts. But what I do say is that it’s time to leverage the power of the pocketbook (even though it might be a wee bit lighter these days) and make sure that marketers, including Hollywood, are listening.

What do you think?

(Special thanks to my friend Yvonne DiVita, blogger extraordinaire over at Lip-sticking.com, who pointed me to some of these statistics. If you’ve not visited the site, please show her and her fellow bloggers some love.)

Wednesday Bubble: two thumbs down!

Posted by Liz on Mar 4, 2009 in sexual desire, sexual health | 2 comments

[photo credit: Kristian Olsen, photo.net]

There’s a whole lotta buzz going on around testosterone these days…testosterone patches, that is.

The March online edition of the British Medical Journal’s Drug Therapeutics Bulletin has given two thumbs down to Intrinsa, a testosterone patch developed to boost sex drive in women with hypoactive sexual disorder (i.e.  who enter menopause due to removal of their wombs and ovaries).  Interestingly, the US Food and Drug Administration had enough questions about Intrinsa to refuse marketing approval. However, the European Union gave it’s safety approval rating in 2006, paving the way for launch in the UK last March.

So, what are the concerns?

According to the article’s authors, testosterone patches should not be recommended to address low sex drive in women. Although research has indicated a slight increase in sexual desire/drive  among women using the patch, the patches have primarily been tested in a small group of women who are taking HRT and not in other populations. What’s more, questions have been raised about study methodology; e.g. diagnosis was made on short, unvalidated questionnaires and some participants were already having sex regularly at the time they entered the trial, which begs the question – where was the improvement?

Concerns have also been raised about the long-term safety of the patches, which researchers say is unknown. Two pivotal trials demonstrated side effects rates in about 75% of women, mostly relating to sites on the body where the patches were applied. But 1% of women also experienced acne, excess hair growth, hair loss, breast pain, weight gain, insomnia, voice deepening and migraine headaches.  Testosterone can also increase cholesterol levels, which potentially prevents their use in women who have an increased risk of heart disease.

Although no firm conclusions have been made, the researchers do say that they “cannot recommend Intriansa for use in women with sexual dysfunction.”

So, the jury’s out. Avoid testosterone patches.  And focus on other methods to improve sexual desire and drive if it becomes problematic as hormone levels drop. Personally, I like Dr. Christina Northrup’s approach to boost nitric oxide levels — natural, empowering, pleasurable!

Bioidentical Hormones versus HRT: Guest post from Compounding Pharmacist Peter Koshland

Posted by Liz on Mar 2, 2009 in bioidentical hormones | 5 comments

I’ve written  a number of posts lately about bioidentical and synthetic hormones. Hence, I am very happy to feature a guest post by compounding pharmacist and blogger Peter Kushland, on the distinction between the two.

Please welcome Peter. And stop by his blog – The Compounder’s Forum;  it’s terrific!

As a compounding pharmacist, I am often asked what is the difference between bioidentical hormone replacement (BHRT) and conventional hormone replacement (HRT).  BHRT, as described in my earlier post, is an approach to hormone replacement that has three key attributes:

1. All hormones used are chemically identical to human hormones
2. The dosage is individualized to a patent’s specific hormonal needs
3. The goal is to achieve a balance of activities of the hormones to improve quality of life

(See my post entitled ” Key Principles of Bioidentical Hormone Replacement Therapy (BHRT)” for a more detailed description)

Conventional HRT is best exemplified by the commercial drug Prempro.  Prempro is a combination drug that has both estrogens and a progestin.  The estrogens are derived from the urine from pregnant mares and the progestin is medroxyprogesterone, a synthetic hormone not found in nature.  Prempro comes in approx. 4 different dosages and is taken orally once daily.  It can be found at any pharmacy.

So let’s go down the list and talk about the differences between conventional hormone replacement (HRT) and bioidentical hormone replacement (BHRT):

• Hormones are identical to human hormones – HRT=no; BHRT=yes
• Dosage customized for individual patient – HRT=no; BHRT=yes
• Hormone balance goal of therapy – HRT=no; BHRT=yes
• Primary goal is improved quality of life – HRT=possibly; BHRT=yes
• Primary goal is to prevent disease – HRT=yes; BHRT=no

– there are some who claim that BHRT can prevent all types of diseases from osteoporosis to certain types of cancer, and although there is some scientific evidence supporting these statements, there is not enough good, solid research out there to back-up any definitive claim that BHRT prevents disease.

– Be very skeptical of anyone who claims that BHRT is going to prevent any type of disease.  With that said, there is lots of good evidence to support that BHRT is safe.

– furthermore, there is lots of good evidence that conventional HRT actually causes disease!

• close monitoring is regular part of treatment – HRT=no; BHRT=yes
• only available from a compounding pharmacist – HRT=no; BHRT=yes and no

– Here’s another area where people get confused.  BHRT does not necessarily have to be made by a compounding pharmacist.  Now, I don’t want to put myself out of a job and there are lots of reasons why a compounded product is superior to an off-the-shelf medication, but there are a handful of mass produced prescription drugs that are bioidentical.

There are various estradiol containing patches and an oral form of progesterone called Prometrium available.  Dosages and routes of administration (topical vs. oral) are limited, but these products are biologically identical to human hormones and therefore meet at least the first criteria of BHRT.

• The estrogen “estriol” is available – HRT=no; BHRT=yes

– I will discuss the specific hormones that are bioidentical in future posts

• Hormones can be given topically – HRT=sometimes (estradiol patches); BHRT=yes (any hormone)
• Drug manufactured with FDA oversight – HRT=yes; BHRT=no

– Here’s one of the areas that critics of BHRT pounce on.  Compounded bioidentical hormones are not regulated by the FDA.  This is true.  Compounding pharmacies are regulated by the state agencies that regulate retail pharmacies and for that reason the quality and potency of compounded medications can vary greatly.  With that said, a compounding pharmacy that is using the top of the line equipment and has the proper quality assurance procedures  in place will consistently exceed any standards the FDA might have for a mass produced medication.

It is important, however, to make sure you choose a compounding pharmacy that is using this equipment and has good quality assurance.  I will discuss specific questions to ask when evaluating a compounding pharmacy in future posts.

• Drugs covered by most insurance plans – HRT=usually; BHRT=sometimes

– in my experience practicing in Californa, about 25-30% if insurance plans will pay for compounded medications

• Clinical evidence to support its use – HRT=no; BHRT=yes

– This is where the critics get it wrong.  Many nay-sayers say that there is little scientific evidence to support the use of bioidentical hormones, when this couldn’t be further from the truth.  for example, the hormone progesterone has been available for almost 80 years now and there are reams of clinical trials that have looked at its efficacy and safety in a number of ways.  Also, estradiol, progesterone, and testosterone are available as mass produced pharmaceuticals and have passed the current FDA safety and efficacy standards.

Furthermore, there are good clinical trials that have studied HRT and they all show that it is dangerous, so the scientific evidence clearly does not support its use.