Bio-Identical Hormone Replacement
Hormone pellets have been available since the late 1930s. While their usage in the US has declined since the 1970s, they are still widely used in Europe and Australia. They are a very effective way to release small, physiologic doses of hormones into the system to achieve consistent levels. This can avoid the fluctuations in hormone levels often seen with other types of hormone therapy. Since they are bio-identical, they have the same chemical structure as those produced naturally by the human body.
Because pellets are absorbed from the fatty layer under the skin, they bypass the liver and do not impact blood pressure, lipid levels, blood sugar, or have an adverse impact on clotting factors. The most common pellets are estradiol and testosterone. Some benefits of pellet therapy include relief of hot flashes and night sweats, improved libido and sexual function, improvement in vaginal dryness, relief of migraines, relief of insomnia, improvement in mood changes, anxiety and irritability, decreased joint aches, improved bone density, improved memory and ability to concentrate, as well as cardiovascular health. Testosterone can also improve lean muscle mass and aid in weight loss or maintenance.
Pellets are very easy to insert in the office under a local anesthetic. They are generally inserted every 3-5 months subcutaneously in the upper buttock using a very small incision. The pellets usually cannot be felt under the skin and do not need to be removed as they will dissolve entirely. They are similar in size to a large grain of rice. It is recommended that patients avoid vigorous exercise for 48 hours following insertion. Complications are generally minor and can include bruising, bleeding, infection and extrusion of the pellets. The risk of complications is rare, however, and this is a well-tolerated procedure. Infrequently, a patient may develop a localized area of redness and itching with insertion of a testosterone pellet. This may be managed with oral Benadryl and can sometimes indicate adrenal insufficiency. Antibiotics may be necessary for patients with diabetes or a history of joint replacement.
Hormone levels are tested prior to insertion of the pellets to determine what medication and strength are appropriate for each patient. Levels are repeated 4 weeks following insertion and then again 3 months following insertion to determine appropriate timing for replacement. After the first year of therapy, it is generally not necessary to repeat the hormone levels more than once or twice per year unless there are other changes in health history or symptoms. It is extremely important that annual examinations, yearly breast examinations and mammograms are kept up to date while being treated with any hormone therapy, including pellets.
Potential side effects related to hormone therapy include fluid retention, breast tenderness, resumption of menses or vaginal bleeding, and increased hair growth or acne. Most of these side effects are minor and will resolve on their own. Dosage adjustments may also be made to minimize them if necessary. If you are experiencing the symptoms discussed in this review, you may have a hormonal imbalance. Dr. White has been prescribing bio-identical hormones for many years and is now happy to offer hormone pellet therapy as an additional option in Frisco, TX.