Bioidentical Hormone Replacement Therapy

Bioidentical hormone replacement therapy with pellets is a natural alternative to synthetic hormone replacement therapies. With bioidentical hormones, the structure of the hormone – testosterone, estrogen, or both – is matched to the individual patient’s needs. Bioidentical hormones are natural, plant-based substances that metabolize in our bodies the way nature intended.

Synthetic hormones are mass-produced and artificially formulated in a lab. Artificial hormones are intentionally manufactured to be slightly different than natural human hormones, so the manufacturer can patent the formulation.

Consequently, synthetic hormones may not provide a good fit or optimum outcome for the human body like bioidentical hormones do.

Composed of either estradiol or testosterone, bioidentical hormone pellets are larger than a grain of rice and smaller than a Tic Tac. We source our pellets from FarmaKeio, a leading compounding pharmacy in the U.S. that presses the hormones into the tiny, solid cylinders.

During the sterile procedure, the practitioner applies a local anesthetic, makes a small incision, then inserts the pellets into fatty tissue under the skin – typically in the blank or upper buttocks. The incision is then closed without any need for stitches.

The pellets release testosterone or estrogen into the bloodstream based on cardiac output, in other words, due to increased physical activity or emotional stress (good or bad). This steady stream of hormones helps keep symptoms such as mood and energy fluctuations at bay.

Subcutaneous (under the skin) pellets have been used to treat hormone imbalance since the 1930s, and research consistently shows bioidentical hormone replacement therapy with pellet implants is the superior method to deliver hormones in both men and women.

Even if the patient doesn’t have symptoms, imbalanced hormones may be threatening their health.

It’s important to note that many patients with low testosterone or estrogen don’t experience the common symptoms related to hormone imbalance. They may believe they don’t need bioidentical hormone replacement therapy, since they generally feel well, and their energy levels are up. Unfortunately, this may be a dangerous assumption.

While bioidentical hormone replacement therapy via pellets effectively treats symptoms related to imbalanced testosterone and estrogen levels, research also suggests that hormone optimization may play a key role in preventing diseases such as osteoporosis, cardiovascular disease, Alzheimer’s disease, certain cancers, and others.

As we age, testosterone, estrogen, and progesterone naturally decline over time. Around age 35, men experience a gradual reduction in testosterone, typically 2 to 10 percent per year. For women, pre-menopause may start as early as in the 30s. In fact, often hormone imbalance kicks in long before hot flashes do – by 10 to 15 years!

Patients need to listen to their bodies. Is the body saying, “I feel a bit off?” In other words, do they feel like many men and women in their 30s, 50s, and beyond who…

• Lack motivation and feel more tired than usual.
• Gain weight for no reason – especially belly fat!
• Wonder why their sexual desire and libido have tapered off.
• Experience mood swings more frequently.
• Feel anxious and depressed.
• Struggle with brain fog and insomnia.

If these symptoms sound familiar, the patient may be an excellent candidate for subcutaneous hormone pellet implants. So, how can patients find out for sure? They can speak with us, who specializes in subcutaneous bioidentical hormone replacement therapy.

Getting to the root of the problem

Unfortunately, most traditional medical practices don’t take the time to find out WHY patients don’t feel like themselves anymore. Instead, they keep writing prescriptions for antidepressants, anti-anxiety medication, sleeping pills, and other drugs that simply mask symptoms.

We get to the root of the problem to uncover WHY our patients do not feel well. While hormone imbalance often plays a role, BHRT alone isn’t always the answer. Depending on the patient, he or she may need an integrated treatment plan that includes pellet therapy, resolving leaky gut issues, detoxification (physical, environmental, and mental toxicity), nutrient supplementation, and more.

For men who feel their get up and go, got up and went, or who are struggling to maintain their youthful vigor and appearance, testosterone imbalance may be to blame.

Testosterone imbalance in men may lead to:

• Fatigue, lethargy, and lack of motivation
• Mood swings, anxiety, and depression
• Decline in general well-being, feeling burned out
• Inability to focus and remember things
• Insomnia
• Stubborn weight gain, belly fat and food cravings
• Frequent illnesses
• Hair loss
• Saggy, dry, aging skin
• Aches, joint pain and longer recovery time from injuries
• Loss of libido and inability to achieve or maintain an erection

Men with Androgen Deficiency are at increased risk for Alzheimer’s disease, cardiovascular disease, prostate cancer, and diabetes.

As women age, hormone imbalance can wreak havoc on both physical and emotional well-being.

Imbalanced estrogen, testosterone and progesterone may lead to:

• Fatigue, lethargy, and lack of motivation
• Inability to focus and remember things
• Mood swings, anxiety, and depression
• Insomnia and night sweats
• Stubborn weight gain, belly fat, and food cravings
• Frequent illnesses
• Muscle loss and weakness
• Hair loss
• Saggy, dry, aging skin
• Aches, join pain, and longer recovery time from injuries
• Loss of libido, difficulty achieving arousal and orgasm
• Painful intercourse
• Frequent urinary tract infections (UTI)
• Hot flashes, vaginal dryness, and night sweats
• Infrequent menstrual cycles – or lack of menstrual cycles – prior to menopause

Research consistently shows pellet implants offer the most effective method to deliver hormones in both men and women. Implanted in the fatty tissue under the skin, pellets release a constant stream of hormones into the body, 24/7/365, most closely mimicking the way the body naturally releases hormones.

Convenience is also a big factor. With pellets, patients undergo the procedure two or three times a year and get on with their lives. Other modalities, like pills and messy creams, need to be used daily. Patches work a bit better, but the absorption of skin-based delivery methods is variable. Plus, we often lose sensitivity over time, which means patients will regularly need to find a new spot to apply the cream or adhere the patch.

On average, pellet implants last 5 to 6 months in men (two visits per year) and 4 to 5 months in women (three visits per year). Since patients receive a topical anesthetic during the procedure, most can expect to experience little to no discomfort during or after the procedure.

Although most people experience substantial benefits after the first round of therapy, many patients experience a more pronounced benefit after the second round of pellet implants. Therefore, we advise patients to have the procedure performed at least two times before expecting optimum results.

Remember, people don’t get out of balance overnight, so it often takes a few months to get back on tract.

We do ask that patients take it easy and avoid strenuous exercise for a few days following the procedure – 72 hours for women and 5 to 7 days for men. This helps ensure the incision heals and can prevent extrusion of the pellet from under the skin.

Most female patients begin to “feel better” within 48 to 72 hours, though it may take a week or two for some women to notice a difference. Men can expect to experience the benefits of their pellet implants within 1 to 2 weeks. To achieve optimal health, living a healthy lifestyle – balanced diet and regular exercise – goes hand-in-hand with hormone balance.

We treat patients of all ages. The length of your treatment plan and therapy is directly related to how long you want to look and feel your best.

During the patient’s initial consultation, the practitioner will discuss his or her health and wellness goals and conduct a thorough medical exam and tests to determine the root cause of the patient’s health problems.

If hormone levels are imbalanced or other health issues are identified, the practitioner will create an integrated treatment plan.

Research repeatedly links hormone imbalance to an increased risk for cancer, osteoporosis, stroke, thyroid disorders, diabetes, heart disease and other age-related disease processes.

During pre-menopause, menopause, and andropause (the male version of hormone depletion), declining health is considered the norm. But feeling poorly doesn’t need to be the norm, thanks to bioidentical hormone replacement therapy and other treatments we may recommend.

Estrogen loss puts women at risk for premature ovary failure, osteoporosis, heart disease, colon cancer, Alzheimer’s disease, tooth loss, impaired vision, Parkinson’s disease, and diabetes. These risks increase the longer a woman suffers from estrogen deficiency.

However, women also need testosterone! Imbalanced testosterone levels in women may compromise mental clarity, libido, and muscle tone and mass. The brain needs testosterone in balance with estrogen – and a healthy gut – to produce serotonin, which supports emotional balance.

Bioidentical hormone replacement therapy is NOT a magic bullet for losing weight, however when hormones are optimized, weight loss efforts typically begin to pay off. Patients still need to eat a balanced diet and exercise, and increased energy levels will help in that area!What bioidentical hormone replacement therapy may do is increase energy, improve quality of sleep, increase muscle mass and fat burning, and decrease cortisol.

Hormone imbalance and “Low T” are by far the most common causes of sexual dysfunction in men and women. By balancing hormone levels with pellet therapy, most patients have experienced a return of or significant improvement to their sexual libido and function.

Testosterone contributes to healthy skin by aiding oil production, which allows skin to hold onto moisture. Skin can become dry, crêpey, and dull when testosterone is low.

In addition, testosterone is a natural blood vessel dilator, which facilitates blood flow to the skin. These two factors – moisture and blood flow – contribute to the dewy, rosy, vibrant complexion associated with youth.

For women, estrogen and collagen go hand-in-hand. Collagen naturally plumps the skin, so when estrogen declines, wrinkles and saggy skin result. Prevention is key, so optimizing hormones as early as possible is essential to maintaining healthy, younger-looking skin.

Testosterone and estrogen can be supplemented in the form of pellets, but other hormones may be out of whack, too. Many of our patients also benefit from progesterone and thyroid optimization.

Depending on the patient’s individual needs, he or she may benefit from an appropriate detox program, probiotics, nutritional support in the form of supplements or IV therapy, weight loss programs, and other treatments.

Complications from the insertion of pellets may include: minor bleeding or bruising; discoloration of the skin; infection; and possible extrusion of the pellet. Other than slight bruising and skin discoloration, these complications are very rare.

The most common side effects are increased hair growth and possible skin breakouts with the first round of therapy, because the body is getting used to increased oil production in the skin. We may recommend patients change their skin care regimen from heavy anti-aging products to lighter, oil-free skin care lines. Side effects may be avoided with decreasing doses on subsequent rounds of therapy.

There are currently no known health conditions that exclude a person from undergoing bioidentical hormone replacement therapy with pellet implants. The majority of people with hormone imbalance are great candidates for the therapy.

However, we take an individualized approach based on the patient’s medical history. We modify our approach to bioidentical hormone replacement therapy for patients who are estrogen-positive breast cancer survivors and prostate cancer survivors.