Hormone pellets are manufactured to be bio-identical to your own body’s hormones. They mostly come from extracts of natural sources e.g. soy, yam. Using bioidentical hormones in this way are reported to be effective in augmenting levels or replacing what a patient does not make any more. The hormone is implanted in the subcutaneous skin and releases small, physiologic doses of hormones regulated by a patient’s cardiac output to provide optimal therapy.
One of the reported advantages of hormone pellets over typical oral and transdermal creams or patch forms of therapy — which produce “roller coaster” hormone levels, resulting in mood and energy fluctuations for the patient — Hormone Pellet Therapy is the only method of hormone therapy that provides sustained hormone levels throughout the day for up to 3 to 6 months without any “roller coaster” effect. The pellets have a physiologic pulsatile dosing effect that parallels the patients’ needs based on cardiac output and demands. For instance, during exercise, there is a greater release of the hormone from the pellet which is very similar to what a person’s body would have done naturally from ovaries, adrenals, and testicles.
Pellets consist of estrogen or testosterone and are compounded from a plant source e.g. soy, yam. The simple, relatively pain-free procedure is done in the office under local anesthesia. These pellets, which are about the size of a grain of rice or “tic-tac”, are placed in the fatty tissue underneath the skin around the buttock, hip or abdominal area through a small incision which requires no sutures or stitches and it just closed with butterfly style bandages.
Since the late 1930s, pellets have been used in humans. There is more data to support the use of pellets than any other method of delivery of hormones. Pellets are not patented and not marketed in the United States. They are frequently used in areas of the world such as Europe and Australia where pharmaceutical companies manufacture hormone pellets.
Most of the research on pellets is out of:
Some of the most exciting data on hormone implants in breast cancer patients are out of the United States showing a reduction of breast cancer incidence in patients doing testosterone pellets.
In studies and even routine patient reporting, when compared to conventional hormone replacement therapy, pellets are far superior.
We still recommend trying pellets because patients who have a poor outcome with other types of hormone therapy have a very high success rate with pellets. Besides, there is no other method of hormone delivery that is as convenient for the patient as pellets since the patient does not have to worry about taking pills or applying creams 1-3 times per day but can just let the pellets work on their own.
Rare complications from the insertion of pellets include trivial bleeding, bruising, discoloration of the skin, infection, and extrusion of the pellet aka it “pops back out”. Extended exposure to moisture (swimming, hot tubs, bathtubs) is avoided for 4 to 5 days, and vigorous physical activity is avoided for 48 hours in women and up to 5 to 7 days in men. Sometimes a patient who is diabetic or just had a recent joint replacement may need antibiotics as a precaution after the pellet insertion.
When a patient first starts hormone therapy there may be mild, temporary breast tenderness; which gets better on its own. Hormone receptors may be very sensitive and take time to adjust. There may be a temporary water weight gain which will also resolve on its own. The body will tone up, as bone density and muscle mass increase and fatty tissue decrease. Patients may experience a mild form of “puberty” as their hormonal levels come up into normal ranges and the body “wakes up” from its hibernation.
After pellets are inserted, patients may notice being more energetic, enhanced sleep, more sex-drive, improved mood, and overall physical health. Muscle mass is expected to increase while the percentage of body fat diminishes. Bone density should improve and even normalize. Patients may feel stronger, notice better coordination as well as physical stamina and performance. Many patients note an improvement in skin tone and hair texture. Often Brain speed increases and thus enhancing concentration and memory.
Some patients begin to notice the effects within 24-48 hours while others may take 1-2 weeks to notice a change.
The pellets usually last between 3-5 months in women and 5-6 months in men. High levels of stress, physical activity, advanced age, some prescriptions, and poor sleep may change the rate at which the pellet absorbs and may require that pellets are inserted sooner or later in those cases.
No, the pellets do not need to be removed. They completely dissolve on their own.
Testosterone levels begin to decline in men in the late 20s or early 30s. Many men maintain “normal” levels of testosterone into their mid-40’s to mid-’50s and then slowly start to decline over the years. Men should get a lab test when they start to notice symptoms or signs of low testosterone. Even men at age 30 can have low T and show signs of bone loss. A man is never too old to benefit from hormone therapy.
Any time estradiol is prescribed, progesterone is also prescribed. There are progesterone (not synthetic progestin) receptors in the bone, brain, heart, breast, and uterus. Progesterone can be used as a topical cream, a vaginal cream, oral capsule, or sublingual drops or lozenges. If a patient is pre-menopausal she may use the progesterone the last two weeks of the menstrual cycle or as directed by the physician.
Hormone therapy with pellets is not just used for women experiencing menopause. Women at any age may experience hormone imbalance. Levels decline or fluctuate contributing to debilitating symptoms. Pellets can improve severe PMS, depression, menstrual or migraine headaches, and sleeping issues. Pellets may also be used to improve hormone deficits induced by taking birth control pills.
Hormone lab levels are evaluated before hormone therapy begins. This will include a FSH estradiol, Sex Hormone binding globulin, and testosterone. Lab levels will be reanalyzed during hormone therapy around 6 weeks post-insertion and as needed. After 1 year of therapy hormones levels are usually followed less often.