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 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.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. Jan 24, 2022 · Not all hormones made from natural sources are bioidentical. There are two types of bioidentical hormone products: pharmaceutical products and custom-made products. Pharmaceutical Products: These products have been approved by the U.S. Food and Drug Administration (FDA). Their quality and safety are regulated so it is the same high-quality ... 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. 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 ...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% ...They have names such as Estrace, Alora, Climara, Estring and Vagifem. A woman who still has her uterus and who goes on hormone therapy for menopause symptoms should also take progesterone to reduce her risk for uterine cancer. FDA-approved bioidentical progesterone products, such as Prometrium, are available as well.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).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. For example, one study found that only 1 of 10 compounding pharmacies provided progesterone vaginal suppositories that were all within the potency range required of similar FDA-approved products. 2. This article will focus on compounded bioidentical hormone preparations aimed at menopausal and perimenopausal women.Dec 7, 2020 · Compounding pharmacies should be aware of recent developments in the law surrounding bioidentical hormone therapy (cBHT). In the field of pharmacy, compounding (performed in compounding pharmacies) is preparation of a custom formulation of a medication to fit the unique need of a patient which cannot be met with commercially available products. Compounded drugs are not FDA-approved. The Food ... The FDA has not approved these compounded hormones, and it does not regulate them. As a result, they may pose safety risks. There is little evidence supporting bioidentical hormones, particularly ...The FDA requires manufacturers of FDA-approved products that contain estrogen and progestin to include a black box warning that reflects the findings of the Women’s Health Initiative. However, compounded products (including “bio-identical hormones”) are not approved by the FDA and have been exempt from having to provide patient package 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. A 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 ...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.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 ... Most of these hormones, except progesterone, are not approved by the FDA for use in women. Purchasing FDA-approved progesterone requires a medical prescription. Scientists report that FDA-approved progesterone BHRT products also adopt the name “body-identical” to avoid confusion with compounded bioidentical hormones (cBHRT). They are ...The FDA has approved bioidentical formulations of both estrogen and progesterone. Products include (FDA) oral, transdermal, and vaginal 17β-estradiol and oral progesterone. These products are carefully controlled and regulated, allowing for improved safety and known risks. If women are interested in using bioidentical hormone therapy, considerMay 27, 2022 · There are FDA-approved bioidentical hormone products available, including estradiol ... Apr 19, 2023 · 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. Not all hormones made from natural sources are bioidentical. There are two types of bioidentical hormone products: pharmaceutical products and custom-made products. Pharmaceutical Products: These products have been approved by the U.S. Food and Drug Administration (FDA). Their quality and safety are regulated so it is the same high-quality ...A 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 ...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. 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 ...Oct 24, 2017 · See Table 1 for a list of FDA-approved bioidentical hormone preparations. Moreover, supplementation with scientifically studied herbs such as Dong quai ( Angelica sinensis ) and licorice ( Glycyrrhiza glabra ) root can further promote healthy metabolism of female hormones and complement the actions of bioidentical HRT. 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. 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 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 ... Dec 7, 2022 · The term "natural" means the hormones in the product come from plant or animal sources. They're not made in a lab. But many of these products still need to be commercially processed to become bioidentical. Traditional hormone therapies don't necessarily exclude natural hormones. Some FDA-approved products come from plants. Examples include ... The FDA requires manufacturers of FDA-approved products that contain estrogen and progestin to include a black box warning that reflects the findings of the Women’s Health Initiative. However, compounded products (including “bio-identical hormones”) are not approved by the FDA and have been exempt from having to provide patient package (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 treat A 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 ...Subscribe to Harvard Health Online for immediate access to health news and information from Harvard Medical School. Research health conditions. Check your symptoms. Prepare for a doctor's visit or test. Find the best treatments and procedures for you. Explore options for better nutrition and exercise. Learn more about the many benefits and ...Jul 10, 2020 · The benefits of FDA-approved bioidentical hormone therapy stem from the nature of their creation. They are created at a molecular level in order to be as close a match as possible for their patients. On the other hand, since no conclusive study has yet been made, it can't be concluded that bioidentical hormones are any safer than synthetic ... 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 ...Jul 10, 2020 · Bioidentical progesterone replacement therapy is commonly used by perimenopausal and postmenopausal women whose shifting hormone levels severely affect their well-being, causing symptoms such as irritability, hot flashes, difficulty concentrating, loss of libido, and more. However, women of reproductive age may also choose to take bioidentical ... A 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 ...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 ...Dec 7, 2022 · The term "natural" means the hormones in the product come from plant or animal sources. They're not made in a lab. But many of these products still need to be commercially processed to become bioidentical. Traditional hormone therapies don't necessarily exclude natural hormones. Some FDA-approved products come from plants. Examples include ... For example, one study found that only 1 of 10 compounding pharmacies provided progesterone vaginal suppositories that were all within the potency range required of similar FDA-approved products. 2. This article will focus on compounded bioidentical hormone preparations aimed at menopausal and perimenopausal women.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 ...FDA approved bioidentical hormones are intended for standard doses that are mass-produced by manufacturers. If you need a dose that is higher or lower than what a manufacturer makes, then you must have it compounded to your individual needs. There are 3 types of bioidentical estrogens. The stronger and more active estrogen against menopausal ...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. 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 ...Jul 1, 2020 · The use of compounded bioidentical hormone therapies (cBHTs) — an increasingly popular approach to relieve symptoms of menopause and male hypogonadism — should be limited to the small number of patients who cannot benefit from an FDA-approved hormone therapy product, says a new report from the National Academies of Sciences, Engineering, and Medicine. Jul 8, 2020 · Custom hormone treatments, called compounded bioidentical hormone therapies (cBHTs), are often promoted by celebrities as natural or safer than FDA-approved therapies. In many instances compounded hormones are more affordable. Estradiol vaginal cream can cost well over $300 while compounded estradiol vaginal cream may start at around $50. Some insurance companies may be more likely to cover FDA approved hormones. However, now some compounding pharmacies file insurance too.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 ...May 27, 2022 · There are FDA-approved bioidentical hormone products available, including estradiol ... The FDA has approved bioidentical formulations of both estrogen and progesterone. Products include (FDA) oral, transdermal, and vaginal 17β-estradiol and oral progesterone. These products are carefully controlled and regulated, allowing for improved safety and known risks. If women are interested in using bioidentical hormone therapy, considerCompounded “bioidentical hormone therapy” (BHT) products, such as progesterone and testosterone, are used by some providers and patients instead of FDA-approved drug products for hormone therapy.FDA approved bioidentical hormones are intended for standard doses that are mass-produced by manufacturers. If you need a dose that is higher or lower than what a manufacturer makes, then you must have it compounded to your individual needs. There are 3 types of bioidentical estrogens. The stronger and more active estrogen against menopausal ...A 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 ... 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 ...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 ...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 ... Bioidentical hormones are synthetic (artificial) hormones often confused with natural hormones derived from plants. Standard BHRT is tested, approved, and regulated by the FDA, while cBHRT is not. Many people prefer BHRT because of its perceived safety and because it can be customized.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 ...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.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.Nov 8, 2022 · 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 ... 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. 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...(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 treatFDA 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. Nov 8, 2022 · 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 ... Compounded hormone products (e.g., pellets), including but not limited to compounded testosterone, estrogen, and progesterone pellets are not proven or medically necessary for any indication. Compounded drugs, including compounded testosterone, estrogen, or progesterone pellets are not FDA approved. 3. Applicable CodesThese 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 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. 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 ... 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 ...Sep 27, 2021 · The FDA wants to restrict compounded hormones to patients who are allergic to manufactured products or who need an unavailable specific dosage. People other than estrogen-deficient women use ... 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 FDA’s Pharmacy Compounding Advisory Committee (PCAC) should review select hormones for the Difficult to Compound list, including estradiol, estrone, estradiol, progesterone, estriol, testosterone, and the pellet dosage form. The federal government and State Boards of Pharmacy should expand and improve oversight of 503A “traditional ... Jun 23, 2021 · The categories of hormones gets broken down into bioidentical versus synthetic, and FDA-approved versus non-FDA-approved. FDA-Approved Hormone therapy Numerous FDA-approved hormone preparations are available for the treatment of menopausal symptoms, gender-affirming therapy, birth control, and menstrual regulation. An update in the fight to protect estriol and other hormones from an FDA ban. Action Alert! We’ve said before that the FDA is stacking the deck against bioidentical hormones; now it seems incontrovertible. Time is running out for the natural health community to mount an effective defense of estriol and other compounded, bioidentical hormones from an FDAJun 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 ... FDA approved bioidentical hormones are intended for standard doses that are mass-produced by manufacturers. If you need a dose that is higher or lower than what a manufacturer makes, then you must have it compounded to your individual needs. There are 3 types of bioidentical estrogens. The stronger and more active estrogen against menopausal ...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. Jul 9, 2020 · The agency has latched onto this false conclusion from a report it commissioned, and it is another direct threat to estriol and compounded bioidentical hormones’ future. Action Alert! 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 “clinical utility” of 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.
Bioidentical testosterone is currently not FDA approved or commercially available for women. Through compounding pharmacy technology, the product can be formulated for off-label use, but again, will not be covered by insurance. Two gels are approved in the U.S. for men only: AndroGel and Testim (1%). There are no FDA approved products for cis .... Hamlar curtis recent obituaries roanoke va
“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.”“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.”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.In many instances compounded hormones are more affordable. Estradiol vaginal cream can cost well over $300 while compounded estradiol vaginal cream may start at around $50. Some insurance companies may be more likely to cover FDA approved hormones. However, now some compounding pharmacies file insurance too.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 ...Custom hormone treatments, called compounded bioidentical hormone therapies (cBHTs), are often promoted by celebrities as natural or safer than FDA-approved therapies.They have names such as Estrace, Alora, Climara, Estring and Vagifem. A woman who still has her uterus and who goes on hormone therapy for menopause symptoms should also take progesterone to reduce her risk for uterine cancer. FDA-approved bioidentical progesterone products, such as Prometrium, are available as well.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 ... Breast tumors that contain estrogen and/or progesterone receptors are sometimes called hormone receptor positive (HR positive). Most ER-positive breast cancers are also PR positive. Breast cancers that lack ERs are called ER negative, and if they lack both ER and PR they may be called HR negative. Approximately 67%–80% of breast cancers in ...Jan 24, 2022 · Not all hormones made from natural sources are bioidentical. There are two types of bioidentical hormone products: pharmaceutical products and custom-made products. Pharmaceutical Products: These products have been approved by the U.S. Food and Drug Administration (FDA). Their quality and safety are regulated so it is the same high-quality ... 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.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 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 ...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. "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 ...Oct 24, 2017 · See Table 1 for a list of FDA-approved bioidentical hormone preparations. Moreover, supplementation with scientifically studied herbs such as Dong quai ( Angelica sinensis ) and licorice ( Glycyrrhiza glabra ) root can further promote healthy metabolism of female hormones and complement the actions of bioidentical HRT. 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. The FDA has not approved these compounded hormones, and it does not regulate them. As a result, they may pose safety risks. There is little evidence supporting bioidentical hormones, particularly ...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 ....