The INSIDER Newsletter-April 2025
My monthly round up of timely topics
I don’t even know where to begin.
The defunding of critical research, the criminalization of doctors managing pregnancy complications and miscarriage, disinformation on government health websites, the dismantling of the FDA… Women’s health is in jeopardy. Your health is in jeopardy.
My post next week will address the history of the FDA and why firing the majority of FDA staff will impact both drug safety and approval of new drugs.
But today, top of mind is the possibility that due to tariffs, you may no longer be able to fill prescriptions for hormone therapy and other drugs commonly used by menopausal women.
As outlined in this article, most pharmaceutical products manufactured and packaged in the US source ingredients from countries that are now required to pay large tariffs. Therefore, in the very near future, expect many commonly prescribed drugs to become unavailable or exorbitantly expensive.
It’s very difficult to figure out which products will be impacted, but as best as I can tell, examples of drugs that depend on other countries for production include estradiol patches (India) estradiol vaginal tablets ,(China), oral estradiol (India, China) , Fezolinetant/Veozah™ (Japan), topical minoxidil (China), Vivelle™ (Canada), DHEA/Intrarosa™ (Canada), Conjugated Estrogens/Premarin™ (Canada), and Estring™ (Netherlands).
Many women rely on less expensive generic equivalents of trade name drugs. Most are sourced from India and China.
It’s one thing to have your hair fall out because minoxidil is unavailable. It’s another thing to no longer have access to the products that reduce or eliminate menopause symptoms like bone loss, hot flashes, and insomnia which if untreated, not only impact quality of life, but also length of life.
And your vaginal estrogen products that not only allow pain free sexual activity, but prevent recurrent urinary tract infections? Most manufacturers source ingredients from other countries.
Speaking of recurrent UTIs- the majority of antibiotics used to treat urinary tract infections are manufactured in China. Ditto, antibiotics prescribed to treat sexually transmitted infections, which mid-life women are particularly vulnerable to.
But not to worry, because the department in the CDC that tracks antibiotic resistance has just been defunded.
And no, US companies are not going to magically start producing these ingredients. It takes years to build and staff factories capable of doing so.
Compounded drugs might be an option, but compounding pharmacies don’t manufacture hormones—they just mix them. Which means compounding pharmacies also depend on ingredients from outside the US.
Since compounding pharmacies are unregulated, this represents a huge opportunity for shady, unscrupulous companies.
With limited access to ingredients, compounding pharmacies can substitute oregano for estrogen and you will have no way of knowing.
And even if they use “real” estradiol, there is nothing to stop a dishonest compounding pharmacy from using half as much as the label says. Even before supply chain issues, there have been documented issues with variability in quality control, purity of the product, and consistency of dosages in compounded drugs.
While some compounding companies do an excellent job, others you shouldn’t trust with making cookies much less your medications. Even if it is a trustworthy compounding company, many products such as rings and patches can’t be compounded. Also, insurance generally will not cover compounded drugs.
I don’t have a great solution other than to hold your elected representatives accountable. The reality is, your state representatives , not your doctor, control your medical care.
On a lighter note, I recently joined the masses of pickle ball enthusiasts! So much fun and a great way to get your mind off the worries of the world.
Warmly,
Lauren Streicher, MD
March Episodes
Dr. Streicher’s Inside Information: Menopause, Midlife, and More
The Dark History of the Pelvic Exam LISTEN
COME AGAIN: Episodes1 and 2-LISTEN
Teeth Talk LISTEN
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A NEW EPISODE EVERY WEEK- 32+ EPISODES TOTAL
Episode 1 Welcome to COME AGAIN LISTEN
Episode 2 Do YOU Having Good Sex? LISTEN
Episode 3 Sex: a Word With Many Meanings LISTEN
Episode 4 What Could Go Wrong? LISTEN
Episode 5 Is It Menopause or Mid-Life? LISTEN
Episode 6 I’d Like to Buy an “O” Please LISTEN
Episode 7 The View From My Side of the Stirrups LISTEN
Episode 8 Requirements to Get the Job Done LISTEN
Episode 9 Why Orgasm Tanks in Menopause-COMING THURSDAY
The most downloaded post
The Case For Seeing a Gynecologist- No Matter How Old You Are
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All paid subscribers are invited to attend this 1 hour live Q and A.
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What about the ingredients for men’s “little blue pill”? Maybe Congress would pay more attention if that supply was threatened.