Hormone Therapy with Pellet Implants

 

Hormone replacement therapy by pellet implantation has been used with great success in the United States, Europe and Australia since 1938 and found to be superior to other methods of hormone delivery. It is not experimental. Pellets deliver consistent, physiologic levels of hormones and avoid the fluctuations of hormone levels seen with other methods of delivery.

            Hormones delivered by the subcutaneous implants bypass the liver, do not affect clotting factors and do not increase the risk of thrombosis. Bioidentical testosterone delivered subcutaneously by pellet implant is cardiac protective, unlike oral, synthetic testosterone.

            Testosterone and estradiol delivered by pellet implantation, does not adversely affect blood pressure, lipid levels, glucose or liver function.

            Pellets are superior to oral and topical hormone therapy with respect to relief of menopausal symptoms. Estradiol and testosterone implants have consistently been shown to improve insomnia, sex drive, libido, hot flashes, palpitations, headaches, irritability, depression, aches, pains, and vaginal dryness.

            Hormone replacement therapy with estradiol and testosterone implants is superior to oral and topical hormone replacement therapy for bone density. The consistent, adequate levels of testosterone delivered by pellet implant are important in maintaining bone mineral density while also being available as a substrate for the production of estradiol. The pellets not only prevent bone loss but also actually increase bone density.

            Testosterone implants in women have been shown to improve lethargy, depression, loss of libido, and hot flashes without attenuating the beneficial effects of estradiol on cardiac and lipid profiles. Testosterone delivered by subcutaneous implants does not increase the risk of breast cancer. Testosterone, delivered by pellet implant does not affect the menstrual cycle and has been used to treat endometriosis and uterine fibroids. Testosterone pellet implants have also been used to successfully treat severe pre-menstrual syndrome unresponsive to other forms of therapy, without adverse effects.

Testosterone, delivery by subcutaneous pellet implant has been shown to improve hot flashes, heart discomfort, sleep problems, depressive mood, irritability, anxiety, physical fatigue, memory loss, sexual problems, bladder problems (incontinence), vaginal dryness, joint and muscular discomfort in both premenopausal and postmenopausal patients without adverse drug events.

            Pellets do not have the same risk of breast cancer as the synthetic progestins or synthetic Methyltestosterone. In fact, studies show a reduction in the incidence of breast cancer with the implantation of testosterone pellets, with or without estradiol pellets.

            Even after over 20 years of therapy with hormones implants, the risk of breast cancer is not increased. In breast cancer survivors, hormone replacement therapy with pellet implantation does not increase the risk of cancer recurrence or death as does estrogen in combination with the synthetic progestins.

            Hormone replacement therapy with pellet implantation has an extremely low incidence of side effects. And high compliance rate. It has been shown to be extremely affective in the treatment of migraine headaches.

            Testosterone replacement therapy in men with subcutaneous implants (pellets) has been shown to be extremely effective, convenient and safe.

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What are pellets?

            Pellets are made up of either estradiol, prgesterone or testosterone. The hormones are pressed of fused into very small solid cylinders. These pellets are larger than a grain of rice and smaller than a “tic tac”. The majority of pellets are made by compounding pharmacists and delivered in sterile glass vials.

 

Why pellets?

            Pellets deliver consistent, healthy levels of hormones for 3-5 months in women and 4-6 months in men. They avoid the fluctuations, or ups and downs, of hormone levels seen with every other method of delivery. Estrogen delivered by subcutaneous pellets, maintains the normal ratio of estradiol to estrone. This is important for optimal health and disease prevention. Pellets do not increase the risk of blood clots like conventional or synthetic hormone replacement therapy.

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How and where are pellets inserted?

            The insertion of pellets is a simple, relatively painless procedure done under local anesthesia. The pellets are usually inserted in the lower abdominal wall or upper buttocks trough a small incision, which is the taped, closed.

 

Are there any side effects or complications from the insertion of the pellets?

            Complications from the insertion of pellets include: minor bleeding or bruising, discoloration of the skin, infection and the possible extrusion of the pellet. Other than slight bruising or discoloration of the skin, these complications are very rare. Testosterone may cause a slight increase in facial hair in some women (depending dosage), Testosterone stimulates the bone marrow and increases the production or red blood cells. A low testosterone level in older men is a cause of anemia. Testosterone, delivered by implants or other methods, can cause an elevation in the red blood cells. If the hemoglobin and the hematocrit (blood count) get too high, a unit of blood may be donated.

            After the insertion of the implants, vigorous physical activity is avoided for 72 hours in women and 5-7 days in men. Early physical activity is a cause of “extrusion”, which is a pellet working its way out. Antibiotics may be prescribed if a patient is diabetic or has had a joint replaced However, this is a “clean procedure” and antibiotics are most often not needed. The pellets do not need to be removed. They completely dissolve on their own.