Jul 7, 2010 · "It is important that women understand what bioidentical hormones are and the differences between those that are FDA-approved and those that are compounded or "mixed" at the pharmacy level," said ... Any hormone can be made to be “bioidentical,” and there are many FDA-approved hormone preparations that are “bioidentical.”. However, the term has also been used to describe compounded formulations containing estrogens, progesterone, and androgens (cBHT). Administration of estrogen and progesterone (in women with a uterus) is an ...Any hormone can be made to be “bioidentical,” and there are many FDA-approved hormone preparations that are “bioidentical.”. However, the term has also been used to describe compounded formulations containing estrogens, progesterone, and androgens (cBHT). Administration of estrogen and progesterone (in women with a uterus) is an ...Jun 27, 2023 · Biote is a company that specializes in hormone optimization using bioidentical hormone pellets, explains David J. Watson, M.D., an OB-GYN at Littleton Gynecology and Wellness in Littleton ... Jul 1, 2020 · The U.S. Food and Drug Administration (FDA) has approved dozens of hormone therapy products for men and women, including estrogen, progesterone, testosterone, and related compounds. These products have been reviewed for safety and efficacy and are indicated for treatment of symptoms resulting from hormonal changes associated with menopause or ... In October 2005 Wyeth Pharmaceuticals, a manufacturer of both FDA-approved bioidentical and non-bioidentical HRT preparations, filed a citizen petition with the FDA asking for enforcement action against compounding pharmacies that dispensed BHT and to investigate labelling and advertising guidelines. Soon after, the FDA took a number of ...compounded drugs, and then it reviews key regulatory issues related to the U.S. compounded drug market. 2 FDA-APPROVED DRUG PRODUCTS. FDA approves a new drug for public use only after careful review of data from preclinical studies in animals and human clinical trials that determine whether the benefits of the drug outweigh its known and potential risks. Apr 29, 2011 · The term CBHT refers to hormone preparations that (1) have exactly the same chemical and molecular structure as the estrogens and progesterone produced within the human body, (2) are plant derived, and (3) are specifically compounded for an individual patient. Custom CBHT is not FDA-approved for treatment of menopausal symptoms. 16. Feb 18, 2022 · The Food and Drug Administration (“FDA”) is currently considering placing eleven hormones used in Compounded Bioidentical Hormone Therapy (“cBHT”) on a “difficult to compound list”, effectively banning the compounding of these ingredients. The “difficult to compound list” is a list of drug products and categories of drug ... The cost of hormone pellet therapy can vary depending on the provider, but an average cost may be close to $1,536 each year. Healthcare insurance may cover FDA-approved hormone therapy, but the extent of the coverage may vary among plans. Most insurance companies are unlikely to cover compounded bioidentical hormone therapy because it is not ...Group Tells the FDA to Restrict the Use of Compounded Hormones. That is the message this group is using to convince the FDA to make prescribing compounded products a very restricted field. The use of compounded bioidentical hormone therapies (cBHTs) — an increasingly popular approach to relieve symptoms of menopause and male hypogonadism ...Given the lack of well-designed and well-conducted clinical trials of these compounded hormones, ACOG recommended that all of them should be considered to have the same safety issues as those hormone products that are approved by the FDA and may also have additional risks unique to the compounding process.Source: goodtoknow.co.uk. On the other hand, many of these points may be directly treated with bioidentical hormone alternative therapy. Hormone preparations specially tailor made for patients by compounding pharmacies, often known as bioidentical hormones, are extensively touted as being safer and more natural than Food and Drug Administration (FDA) approved variations of hormones.The following lists some basic information about the FDA-approved hormone medicines for menopause. Use this information to help you talk to your healthcare provider about whether hormone... To learn more, review the BIJUVA Patient Information and talk about BIJUVA with your healthcare provider or pharmacist. The FDA-approved product labeling, including Patient Information, can be found here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch or call 1-800-FDA-1088.May 13, 2016 · The author, an AP medical writer, might be horrified to know that these non-FDA approved bioidentical hormones, (estradiol, progesterone, estriol and testosterone), are floating around in her blood stream right now, and have been since she was born. So, please, don’t do anything impulsive or crazy, like trying to remove these non-FDA approved ... Bioidentical hormone therapy used to treat menopausal symptoms typically contains estradiol which is, in fact, identical to the estradiol used in traditional hormone therapy. Thus, the term bioidentical hormone therapy can be confusing; there are bioidentical hormones approved by the FDA, but there are also compounded bioidentical hormone ...The cost of hormone pellet therapy can vary depending on the provider, but an average cost may be close to $1,536 each year. Healthcare insurance may cover FDA-approved hormone therapy, but the extent of the coverage may vary among plans. Most insurance companies are unlikely to cover compounded bioidentical hormone therapy because it is not ...However, there are also commercially available FDA-approved products that fit the definition of “bioidentical,” and some bioidentical hormones are derived from animal sources or made synthetically (Cirigliano 2007). These products are seldom marketed or prescribed by anti-aging and other alternative health practitioners, who instead favor ...Companies that make bioidentical hormone therapy use the term “bioidentical” to suggest that their products are exactly the same as natural hormones. Many of these companies also claim that their products are safer than menopausal hormone therapy. However, the FDA does not recognize this term or regulate these products. No studies have been ...These days, there are FDA-approved versions of bioidentical hormones, and there are alternative, custom-prepared varieties — like the one Foster uses — made in specialized "compounding ...Bioidentical hormones are broadly categorized, as either tested and reviewed by the FDA or not. Products approved by the FDA have undergone extensive testing and quality control.FDA-approved. FDA does not have evidence that compounded “bioidentical hormones” are safe and effective, or safer or more effective than FDA-approved hormone therapy. FDA has approved drugs ...The term "bioidentical hormone therapy" is used to describe hormones that are identical or nearly identical to the molecular structure of hormones produced naturally by your body. Technically, your body cannot tell bioidentical hormones from the ones your ovaries produce. Bioidentical hormones come from plants like soy or yams, but still need ...The gap between a need for effective menopausal treatment and available therapies with a perceived acceptable risk/benefit ratio vastly expanded the use of non-Food and Drug Administration (FDA)-approved compounded hormone therapy (CHT), 6,7 which has been marketed as safer than HT and has been promoted as a superior alternative to HT. 6,8-10 ...by DonnaWhite | Oct 11, 2019. The quick answer is yes, bioidentical hormones are FDA approved but hold on, this is a very controversial and somewhat complex topic that requires more explanation. Some bioidentical hormones are manufactured by drug companies, are approved by the FDA, and sold in standard doses.Aug 11, 2020 · FDA Approved Bioidentical Hormones Preparations: All the hormones used in compounded preparations have been FDA approved and are used OFF-Label in compounded preparations. Here is a partial list of FDA approved hormone preparations for Estradiol, Progesterone and Testosterone: Hormone Product Year of FDA Approval Manufacturer Aug 11, 2020 · FDA Approved Bioidentical Hormones Preparations: All the hormones used in compounded preparations have been FDA approved and are used OFF-Label in compounded preparations. Here is a partial list of FDA approved hormone preparations for Estradiol, Progesterone and Testosterone: Hormone Product Year of FDA Approval Manufacturer The Food and Drug Administration (“FDA”) is currently considering placing eleven hormones used in Compounded Bioidentical Hormone Therapy (“cBHT”) on a The Food and Drug Administration (“FDA”) is currently considering placing eleven hormones used in Compounded Bioidentical Hormone Therapy (“cBHT”) on a “difficult to compound list”[1],effectively banning the compounding of ...Apr 14, 2021 · not currently available as an FDA-approved drug product” (p. 195). “The term ‘bioidentical hormone’ generally refers to sex steroid hormones, usually an estrogen, an androgen or progesterone, that has the same chemical and molecular structure [and Mar 11, 2021 · Bioidentical hormones are available as FDA-approved hormone formulations. Nonapproved custom-compounded preparations are marketed as bioidentical, but content is uncertain. The widespread use of compounded bioidentical hormone therapy despite the lack of evidence to support its safety and efficacy is concerning. Bioidentical hormone therapy used to treat menopausal symptoms typically contains estradiol which is, in fact, identical to the estradiol used in traditional hormone therapy. Thus, the term bioidentical hormone therapy can be confusing; there are bioidentical hormones approved by the FDA, but there are also compounded bioidentical hormone ...Jul 1, 2020 · The U.S. Food and Drug Administration (FDA) has approved dozens of hormone therapy products for men and women, including estrogen, progesterone, testosterone, and related compounds. These products have been reviewed for safety and efficacy and are indicated for treatment of symptoms resulting from hormonal changes associated with menopause or ... The cost of hormone pellet therapy can vary depending on the provider, but an average cost may be close to $1,536 each year. Healthcare insurance may cover FDA-approved hormone therapy, but the extent of the coverage may vary among plans. Most insurance companies are unlikely to cover compounded bioidentical hormone therapy because it is not ...In addition to this, these drugs used estriol, a weaker form of estrogen which does not have FDA approval. The Benefits and Risks of Bioidentical Hormone Therapy. As with any health treatment, bioidentical hormones come with benefits and risks. The benefits of FDA-approved bioidentical hormone therapy stem from the nature of their creation."It is important that women understand what bioidentical hormones are and the differences between those that are FDA-approved and those that are compounded or "mixed" at the pharmacy level," said ...In recent years, CBHT has emerged as a popular alternative to manufactured, FDA-approved hormone therapy—despite concerns within the medical community and the availability of new FDA-approved “bioidentical” products. This study investigated the motivations for choosing and using CBHT in a U.S. sample of ordinary midlife women.The Endocrine Society has defined bioidentical hormones as “compounds that have exactly the same chemical and molecular structure as hormones that are produced in the human body.” 11 This broad definition does not address the manufacturing, source, or delivery methods of the products and thus can include non–FDA-approved custom-compounded ... Feb 22, 2022 · October 17, 2019 | Filed under: Health, Menopause. I’m so thrilled to have Dr. Barbie Taylor a.k.a. “Menopause Taylor” with us today! She’s a retired OB/GYN who’s dedicated her 2nd half to educating women about menopause! If you’re a woman (of any age), this is a must watch video! I was a typical aging woman who had NO …. A list of FDA-approved testosterone products can be found by searching for ... Testosterone is a hormone essential for the growth and development of male sex organs and maintenance of secondary ...Bioidentical hormones have the exact same chemical and molecular structure as hormones that are produced in the human body. Bioidentical hormones are available as FDA-approved hormone formulations. Nonapproved custom-compounded preparations are marketed as bioidentical, but content is uncertain. FDA Approved Bioidentical Hormones Preparations: All the hormones used in compounded preparations have been FDA approved and are used OFF-Label in compounded preparations. Here is a partial list of FDA approved hormone preparations for Estradiol, Progesterone and Testosterone: Hormone Product Year of FDA Approval ManufacturerA wide variety of FDA-approved bioidentical hormones are currently available. New transdermal biodentical estradiol gels have been approved by the FDA for menopausal symptoms. In the future, new ...Mar 10, 2021 · Source: goodtoknow.co.uk. On the other hand, many of these points may be directly treated with bioidentical hormone alternative therapy. Hormone preparations specially tailor made for patients by compounding pharmacies, often known as bioidentical hormones, are extensively touted as being safer and more natural than Food and Drug Administration (FDA) approved variations of hormones. In contrast to FDA-approved drug products, compounded bioidentical hormone therapy (cBHT) preparations lack standardized production methods, potentially leading to state-by-state and even pharmacy-by-pharmacy variability in the medications dispensed to patients.14 uses of U.S. Food and Drug Administration (FDA) approved hormone therapies include 15 replacement during menopause, oncology therapies, and for endocrine or genetic disorders. 16 Although oral contraceptives are a common use of hormones, their primary use for the prevention 14 uses of U.S. Food and Drug Administration (FDA) approved hormone therapies include 15 replacement during menopause, oncology therapies, and for endocrine or genetic disorders. 16 Although oral contraceptives are a common use of hormones, their primary use for the preventionMay 25, 2023 · Bioidentical hormones. These hormones come from plant sources. The term "bioidentical" implies the hormones in the product are chemically identical to those your body produces. There are some commercially available bioidentical hormones approved by the Food and Drug Administration (FDA). Compounded drugs have long been part of the medical armamentarium. Through drug compounding, compounders may offer therapeutic alternatives for patients with unique medical needs that cannot be met by U.S. Food and Drug Administration (FDA)-approved drug products (FDA, 2017a). The Federal Food, Drug, and Cosmetic Act (FDCA) of 1938 is the primary source of FDA's authority over prescription ...14 uses of U.S. Food and Drug Administration (FDA) approved hormone therapies include 15 replacement during menopause, oncology therapies, and for endocrine or genetic disorders. 16 Although oral contraceptives are a common use of hormones, their primary use for the prevention The term "bioidentical hormone therapy" is used to describe hormones that are identical or nearly identical to the molecular structure of hormones produced naturally by your body. Technically, your body cannot tell bioidentical hormones from the ones your ovaries produce. Bioidentical hormones come from plants like soy or yams, but still need ...Jul 19, 2022 · Pharmacies that compound bioidentical hormones, though, do not have to submit paperwork since they aren’t FDA-approved. On the surface, this may make it seem as though compounded bioidentical hormones are safer since they don’t list side effects. But the reality is that they simply aren’t known. Group Tells the FDA to Restrict the Use of Compounded Hormones. That is the message this group is using to convince the FDA to make prescribing compounded products a very restricted field. The use of compounded bioidentical hormone therapies (cBHTs) — an increasingly popular approach to relieve symptoms of menopause and male hypogonadism ...Bioidentical hormones are man-made hormones derived from plants, often soy and yams, that are chemically identical to those the human body produces. As such, they bind to the estrogen and testosterone receptors in the same way as women’s endogenous hormones have throughout their lives . The U.S. FDA has approved some forms of manufactured ...Compounded bioidentical hormone replacement therapy (BHRT) products such as progesterone and testosterone, are used at times instead of FDA-approved drugs for hormone replacement therapy. Aug 12, 2020 · Patented synthetic hormones require extensive testing and funding, which helps keep the FDA in business. When looking at the safety of bioidentical hormones, several things stand out. As mentioned above, the risk of breast cancer is reduced using bioidentical hormones. Oct 11, 2019 · The quick answer is yes, bioidentical hormones are FDA approved but hold on, this is a very controversial and somewhat complex topic that requires more explanation. Some bioidentical hormones are manufactured by drug companies, are approved by the FDA, and sold in standard doses. On the other hand some bioidentical hormone preparations are made ... The first will examine the clinical utility of treating patients with compounded bioidentical hormone replacement therapy (BHRT) products. ... instead of FDA-approved drug products for hormone ...“The [widely available] FDA-approved bioidentical hormones produced in monitored facilities demonstrate a high quality of safety and efficiency in trials; therefore, there is no rationale for the routine prescribing of unregulated, untested, and potentially harmful custom-compounded bioidentical HTs.”Jul 19, 2022 · Pharmacies that compound bioidentical hormones, though, do not have to submit paperwork since they aren’t FDA-approved. On the surface, this may make it seem as though compounded bioidentical hormones are safer since they don’t list side effects. But the reality is that they simply aren’t known. Context: Since 2002, when the US Food and Drug Administration (FDA) placed a black box warning on women's hormone replacement products, women and their providers have been struggling with whether to proceed with hormone replacement therapy. Out of the controversy has grown a popular movement promoting the use of bioidentical hormones.Sep 29, 2021 · Doses should be as low as possible to help ease the symptoms, and then taken for the shortest amount of time. For some women, this may be for a few months, for others, years. If you are taking HRT for serious menopause symptoms, you may be reluctant to stop taking HRT, for fear the symptoms will return. The phrase bioidentical hormone therapy has been recognized by the FDA and the Endocrine Society as a marketing term and not one based on scientific evidence 4. Examples of compounded hormones include Biest (biestrogen) and Triest (triestrogen) preparations. The name Biest commonly refers to an estrogen preparation based on a ratio of 20% ...(See Table for a list of FDA-approved bioi-dentical HT products.) Another hormone, testosterone (shown to improve sexual desire), is not currently available as an FDA-approved bioidentical product. Confusion and unsubstantiated claims surround the custom-compounded bioidentical hormone therapy products used to treatCustom hormone treatments, called compounded bioidentical hormone therapies (cBHTs), are often promoted by celebrities as natural or safer than FDA-approved therapies. UConn toxicologist José Manautou, who heads the department of pharmaceutical sciences, served on the committee that wrote the National Academies report.Oct 7, 2022 · by DonnaWhite | Oct 11, 2019. The quick answer is yes, bioidentical hormones are FDA approved but hold on, this is a very controversial and somewhat complex topic that requires more explanation. Some bioidentical hormones are manufactured by drug companies, are approved by the FDA, and sold in standard doses. Given the lack of well-designed and well-conducted clinical trials of these compounded hormones, ACOG recommended that all of them should be considered to have the same safety issues as those hormone products that are approved by the FDA and may also have additional risks unique to the compounding process.These days, there are FDA-approved versions of bioidentical hormones, and there are alternative, custom-prepared varieties — like the one Foster uses — made in specialized "compounding ...Compounded “Bioidentical” Hormone Therapy (cBHT), particularly estrogen and progesterone, have been promoted by some as safer and more effective alternatives to manufactured FDA-approved hormone therapies (HT) for relief of symptoms of the menopause. In fact, little or no scienti˜ c evidence exists to support suchA wide variety of FDA-approved bioidentical hormones are currently available. New transdermal biodentical estradiol gels have been approved by the FDA for menopausal symptoms. In the future, new ... Bioidentical or body-identical hormones are estradiol and progesterone that are molecularly identical to human hormones. Most (not all) modern menopause hormone therapy is bioidentical. Keep reading for a list of brands. The difference between “bioidentical” and “body-identical” is that body-identical is the preferred conventional term ...Bioidentical or body-identical hormones are estradiol and progesterone that are molecularly identical to human hormones. Most (not all) modern menopause hormone therapy is bioidentical. Keep reading for a list of brands. The difference between “bioidentical” and “body-identical” is that body-identical is the preferred conventional term ...The gap between a need for effective menopausal treatment and available therapies with a perceived acceptable risk/benefit ratio vastly expanded the use of non-Food and Drug Administration (FDA)-approved compounded hormone therapy (CHT), 6,7 which has been marketed as safer than HT and has been promoted as a superior alternative to HT. 6,8-10 ...Menopause is a normal, natural change in a woman’s life when her period stops. That’s why some people call menopause “the change of life” or “the change.”. During menopause a woman’s ...Context: Since 2002, when the US Food and Drug Administration (FDA) placed a black box warning on women's hormone replacement products, women and their providers have been struggling with whether to proceed with hormone replacement therapy. Out of the controversy has grown a popular movement promoting the use of bioidentical hormones.BIOIDENTICAL HORMONE THERAPY WHAT ARE BIOIDENTIcAL HORMONES? “Bioidentical” means identical in molecular structure to endogenous hormones. Howev-er, as we will see, a better distinction should be made between products that are approved and regulated by the US Food and Drug Ad-ministration (FDA) and those that are not.Background In recent years, compounded bioidentical hormone therapy (CBHT) has emerged as a popular alternative to manufactured, FDA approved hormone therapy (HT)—despite concerns within the medical community and the availability of new FDA approved “bioidentical” products. This study aims to characterize the motivations for using CBHT in a U.S. sample of ordinary midlife women. Methods ...October 17, 2019 | Filed under: Health, Menopause. I’m so thrilled to have Dr. Barbie Taylor a.k.a. “Menopause Taylor” with us today! She’s a retired OB/GYN who’s dedicated her 2nd half to educating women about menopause! If you’re a woman (of any age), this is a must watch video! I was a typical aging woman who had NO ….Bioidentical or body-identical hormones are estradiol and progesterone that are molecularly identical to human hormones. Most (not all) modern menopause hormone therapy is bioidentical. Keep reading for a list of brands. The difference between “bioidentical” and “body-identical” is that body-identical is the preferred conventional term ...Bioidentical hormones are broadly categorized, as either tested and reviewed by the FDA or not. Products approved by the FDA have undergone extensive testing and quality control.FDA Approved Drugs. The following database contains a listing of drugs approved by the Food and Drug Administration (FDA) for sale in the United States. Drug information typically includes the drug name, approval status, indication of use, and clinical trial results. A. "It is important that women understand what bioidentical hormones are and the differences between those that are FDA-approved and those that are compounded or "mixed" at the pharmacy level," said ...Sep 12, 2012 · A long list of FDA-approved hormone products contain 17-beta estradiol and, therefore, are bioidentical. Examples include oral esterase, estradiol transdermal patches (Climara®, Vivelle®) and the vaginal ring (Estring®). Prometrium® is an oral FDA-approved bioidentical progesterone product. The next misconception is that progesterone ... The phrase bioidentical hormone therapy has been recognized by the FDA and the Endocrine Society as a marketing term and not one based on scientific evidence 4. Examples of compounded hormones include Biest (biestrogen) and Triest (triestrogen) preparations. The name Biest commonly refers to an estrogen preparation based on a ratio of 20% ...Dec 12, 2022 · The U.S. Food and Drug Administration (FDA) has approved some forms of manufactured bioidentical hormones, including bioidentical estriol (a weak form of estrogen) and progesterone. These types are approved and regulated by the FDA, and they are made by drug companies. Some bioidentical hormones are available in a compounding pharmacy. Compounded bioidentical hormones may be put into a capsule, a skin cream or gel, a tablet to dissolve under your tongue, a suppository, or a nose spray.Jul 13, 2021 · Group Tells the FDA to Restrict the Use of Compounded Hormones. That is the message this group is using to convince the FDA to make prescribing compounded products a very restricted field. The use of compounded bioidentical hormone therapies (cBHTs) — an increasingly popular approach to relieve symptoms of menopause and male hypogonadism ...
Mar 10, 2021 · Source: goodtoknow.co.uk. On the other hand, many of these points may be directly treated with bioidentical hormone alternative therapy. Hormone preparations specially tailor made for patients by compounding pharmacies, often known as bioidentical hormones, are extensively touted as being safer and more natural than Food and Drug Administration (FDA) approved variations of hormones. . Listi..
Source: goodtoknow.co.uk. On the other hand, many of these points may be directly treated with bioidentical hormone alternative therapy. Hormone preparations specially tailor made for patients by compounding pharmacies, often known as bioidentical hormones, are extensively touted as being safer and more natural than Food and Drug Administration (FDA) approved variations of hormones.Oct 7, 2022 · by DonnaWhite | Oct 11, 2019. The quick answer is yes, bioidentical hormones are FDA approved but hold on, this is a very controversial and somewhat complex topic that requires more explanation. Some bioidentical hormones are manufactured by drug companies, are approved by the FDA, and sold in standard doses. 14 uses of U.S. Food and Drug Administration (FDA) approved hormone therapies include 15 replacement during menopause, oncology therapies, and for endocrine or genetic disorders. 16 Although oral contraceptives are a common use of hormones, their primary use for the prevention Prescribers Should Restrict the Use of Non-FDA-Approved Compounded Bioidentical Hormones, Except for Specific Medical Circumstances. The National Academies of Sciences Engineering Medicine ...In addition to this, these drugs used estriol, a weaker form of estrogen which does not have FDA approval. The Benefits and Risks of Bioidentical Hormone Therapy. As with any health treatment, bioidentical hormones come with benefits and risks. The benefits of FDA-approved bioidentical hormone therapy stem from the nature of their creation.The first will examine the clinical utility of treating patients with compounded bioidentical hormone replacement therapy (BHRT) products. ... instead of FDA-approved drug products for hormone ...Aug 11, 2020 · FDA Approved Bioidentical Hormones Preparations: All the hormones used in compounded preparations have been FDA approved and are used OFF-Label in compounded preparations. Here is a partial list of FDA approved hormone preparations for Estradiol, Progesterone and Testosterone: Hormone Product Year of FDA Approval Manufacturer Menopause is a normal, natural change in a woman’s life when her period stops. That’s why some people call menopause “the change of life” or “the change.”. During menopause a woman’s ...Background In recent years, compounded bioidentical hormone therapy (CBHT) has emerged as a popular alternative to manufactured, FDA approved hormone therapy (HT)—despite concerns within the medical community and the availability of new FDA approved “bioidentical” products. This study aims to characterize the motivations for using CBHT in a U.S. sample of ordinary midlife women. Methods ...The FDA has latched onto this false conclusion from a report it commissioned, and it is another direct threat compounded bioidentical hormones’ future. The FDA’s announcement regarding bioidentical hormones came just hours after the National Academy of Sciences, Engineering, and Medicine (NASEM) released their report reviewing the ...Read on to learn the definitions of compounded and bioidentical and what being “FDA-approved” tells you about a product. Compounded hormone therapy — sometimes called compounded bioidentical hormone therapy, abbreviated as cBHT — refers to the non-FDA-approved bioidentical options (pictured on the far-right branch of the decision tree ....