INTRODUCTION
Data supports that hormone replacement therapy with pellet implants are the most effective and the most bio-identical method to deliver hormones in both men and women. Implants, placed under the skin, consistently release small, physiologic doses of hormones providing optimal therapy. Testosterone pellet for treatment of hormone imbalance in women is not experimental, and has been shown to be a superior treatment for treatment of endometriosis, uterine fibroids, and PMS; improvement of insomnia, sex drive, libido, hot flashes, palpitations, headaches, irritability, depression, aches, pains, lethargy and vaginal dryness, while also improving bone density and supporting long term bone density maintenance - without increasing the risk of breast cancer.
WHAT ARE PELLETS?
Pellets are made up of either estradiol or testosterone. The hormones are pressed or fused into very small solid cylinders. These pellets are larger than a grain of rice and smaller than a ‘tic tac’. In the United States, the majority of pellets are made by compounding pharmacists and delivered in sterile glass vials. At RI BEST SELF we only purchase our pellets from a 503B compounding pharmacy, which is registered and inspected by the FDA.
WHY PELLETS?
Pellets deliver consistent, healthy levels of hormones for approximately 3-4 months in women. 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. In studies, when compared to conventional hormone replacement therapy, pellets have been shown to be superior for relief of menopausal symptoms, maintenance of bone density, restoration of sleep patterns, and improvement in sex drive, libido, sexual response and performance.
Testosterone delivered by a pellet implant, has been used to treat migraine and menstrual headaches. It also helps with vaginal dryness, incontinence, urinary urgency and frequency. Testosterone has been shown to increase energy, relieve depression, increase sense of well being, relieve anxiety and improve memory and concentration. Testosterone, delivered by pellet implant, increases lean body mass (muscle strength, bone density) and decreases fat mass. Women need adequate levels of testosterone for optimal mental and physical health. Low levels of testosterone are associated with Alzheimer’s, Parkinson’s and cardiovascular disease. Even patients who have failed other types of hormone therapy have a very high success rate with pellets. There is no other method of hormone delivery that is as convenient for the patient as the implants. There is more data in support of pellet therapy than any other method of delivery of hormones worldwide.
How and Where are Pellets Inserted
The insertion of pellets is a 5-10 minute sterile procedure, minimally invasive, relatively painless using a local anesthetic. The pellets are inserted in the upper buttocks through a small incision, which is then taped and bandaged (no sutures required). The experience of the health care professional matters a great deal, not only in placing the pellets, but also in determining the correct dosage of hormones to be used.
ARE THERE ANY SIDE EFFECTS OR COMPLICATIONS FROM THE INSERTION OF PELLETS?
Complications from the insertion of pellets include; minor bleeding or bruising, discoloration of the skin, infection and the possibility of the pellet extruding. Other than slight bruising or discoloration of the skin, these complications are very rare. In less than 10% of women testosterone may cause a slight increase in facial hair. Testosterone stimulates the bone marrow and increases the production of red blood cells. Testosterone, delivered by implants or other methods, can cause an elevation in the red blood cells. If the hemoglobin and hematocrit (blood count) become elevated, a unit of blood may be donated.
After the procedure, vigorous physical activity is avoided for 72 hours. Early physical activity is a cause of ‘extrusion’, which is a pellet working its way out.
WHAT IF MY PRIMARY CARE PHYSICIAN OR MY GYNECOLOGIST SAYS THAT THERE IS "NO DATA" TO SUPPORT THE USE OF PELLET IMPLANTS?
He or she is wrong. There is a big difference between ‘no data’ and the provider not having researched or read the data. Much of what providers know about drugs comes directly from pharmaceutical companies promoting big pharma products. Because pharmaceutical companies don’t manufacture natural hormones, most physicians do not learn about them unless they do their own personal research. Fortunately there is a growing change in how we practice medicine. This new evolution is a culmination of research efforts over years from some of the most distinguished medical and scientific research centers in the country.
DO PELLETS HAVE THE SAME DANGER OF BREAST CANCER AS OTHER FORMS OF HORMONE REPLACEMENT THERAPY?
Pellets do not carry with them the same risk of breast cancer as high doses of oral estrogens. Oral prescriptive estrogens do not maintain the correct estrogen ratio or safe hormone metabolites. Pellets do not increase the risk of breast cancer like the synthetic, chemical progestins used in the Women’s Health Initiative Trial. Data supports that balanced, bio-identical hormones are breast protective. Testosterone, delivered by pellet implantation, has been shown to decrease breast proliferation and lower the risk of breast cancer, even in patients on conventional hormone replacement therapy. Clinical studies show that bio-identical testosterone balances estrogen and is breast protective. There are currently some doctors using testosterone implants to treat patients with advanced breast cancer.
Are There Side Effects to Estrogen Delivered by Pellet Implantations?
When a patient first starts on hormone therapy there may be mild, temporary breast tenderness, which resolves 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 or can be treated short term using a mild diuretic.
HOW LONG UNTIL A PATIENT FEELS BETTER AFTER PELLETS ARE INSERTED?
Every patient is different. While some patients begin to feel better within 48-72 hours for others it may take up to 2 weeks. Patients may begin to notice that they have more energy, are sleeping better and have an overall improved sense of well-being. Muscle mass and bone density will increase while visceral fat decreases. Patients will benefit from increased strength, coordination and improved physical performance. They may notice an improvement in their skin tone and hair texture. Concentration and memory may improve as well as overall physical and sexual health.
DO PATIENTS NEED PROGESTERONE WHEN THEY USE THE PELLETS?
Yes, progesterone is prescribed for women even if she has had a hysterectomy. Progesterone is prescribed as an oral capsule. There are progesterone (not progestin) receptors in the bone, brain, heart, bladder, breast and uterus where progesterone has been shown to have beneficial effects. Natural progesterone protects against breast cancer, promotes feelings of well being, enhances the beneficial actions of estrogen, relieves menopausal symptoms, and stimulates new bone formation as well as protects against osteoporosis and cardiovascular disease. The most important use of progesterone is to prevent proliferation (stimulation) of the uterine lining caused by using estrogen alone.
HOW ARE HORMONES MONITORED DURING THERAPY?
Hormone levels will be tested and evaluated before therapy is started. This will include an in depth lab panel. Certain lab values will be reevaluated 6 weeks after your initial pellet insertion. Women must agree to routine mammograms and a pap smear as advised by their gynecologist or primary care physician.
At RI BEST SELF our belief is a well informed, educated patient realizes prevention is much more cost effective than disease. In conclusion, estrogen and testosterone therapy by implantation of pellets is a superior, safe and effective method of hormone therapy. Administration of hormones by pellet is convenient and economical. This method has consistently proven to be more effective than oral, intramuscular, and topical hormone therapy with regard to bone density, sexual function, mood and cognitive function, urinary and vaginal complaints, breast health, lipid profiles, hormone ratios and metabolites
