How To Talk To Your Doctor
I receive letters almost daily from women who have taken the initiative to offer their health care providers information on bioidentical hormones. If you want to use bioidentical hormones as replacement therapy, here are the salient points to know and share with your doctor about bioidentical hormones:
- They have been prescribed by doctors for many years.
- They are readily available through formulary pharmacies.
- They are easily titrated to suit a womans individual needs.
- They are readily absorbed and utilized.
- They are safe and effective.
Many formulary pharmacists work in partnership with physicians to provide individualized hormone-replacement solutions. You may want to call a local formulary pharmacy to consult with a knowledgeable pharmacist to develop your customized plan.
Nov Hormone Pellet Therapy Versus Creams And Patches
When choosing Bio-identical hormone replacement therapy for men and women, there are multiple options available. For men, options include testosterone pellet therapy, testosterone injections, creams or gels and lozenges. We will focus on the pellet therapy and topical therapy. Women have all those options as well as oral forms. Bio-identical testosterone is not effective orally because it has to go through the liver and is broken down before reaching the bloodstream so this is not an option for men.
Going back to the beginning of hormone replacement women took their hormones orally as capsules or tablets. Then as we began to learn more about hormones when they pass through the liver after absorption it became clear that even the bio-identical estrogen estradiol could be a problem by converting to the bad estrogen estrone. So other methods of delivery have been increasing in popularity since then.
For the topical forms of therapy like creams and gels, there are more different hormones available and any dosage required is available. The dosage can be adjusted more rapidly, it is non-invasive, and it does not require as many office visits. Downsides include the possible transference of the hormone to other people and compliance.
When considering these therapies there are many factors to consider. Neither method is clearly superior to the other, so the decision comes down to personal preference and patient characteristics.
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What Are The Side Effects Of Bioidentical Hormones
When the FDA approves a drug, the drug company must report any side effects they are told about. These side effects are included in the paperwork you get when you pick your medication up at the pharmacy. Pharmacies that compound hormones do not have to report drug side effects to the FDA or provide paperwork. This contributes to the myth that compounded hormones are safer when healthcare providers don’t know all of the possible side effects of these hormones.
Side effects can occur, especially after the first dose. Your body is not used to the new level of hormones. Many side effects get better as the body adjusts to the new level of hormones. In some cases, the dose may need to be changed.
Some common side effects of bioidentical hormones include:
You may itch or get red around the area where you apply your hormones if you use a patch, cream or gel.
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Consultation And Evaluation For Hormone Pellet Therapy
Completion of the Female Hormone Pellet Therapy Consultation will involve full symptom discussion and evaluation, a pelvic ultrasound in our facility, and a panel of laboratories for baseline hormone levels plus other indicated labs. Hormone Pellets may be inserted during the second visit after a discussion of lab and ultrasound results.
Do Bioidentical Hormones Cause Weight Gain
Yes, weight gain is a side effect of bioidentical hormones.
A note from Cleveland Clinic
Bioidentical hormones are used to help people manage symptoms of menopause or other hormonal imbalances. The FDA does not approve some bioidentical hormones. All hormone replacement therapy comes with risks. Compounded bioidentical hormones may come with more risk because their effects are not well studied. Talk to your healthcare provider about the pros and cons of hormone replacement. Most importantly, know that you do not need to live with unpleasant symptoms of low hormones. Your provider can help safely manage your symptoms.
Last reviewed by a Cleveland Clinic medical professional on 04/15/2022.
References
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Just Because It Seems More Natural Become Better Informed
Given these significant differences in experiences, Dr. Jiang has serious doubts that women who opt for bioidentical custom compounds are not adequately informed about the lack of clinical evidence regarding the safety and effectiveness of these products. Nor are they sufficiently made aware that this form of hormone delivery is not subjected to the same level of regulation that is required to meet.
Pellet therapy and other compounded hormone products are regulated only be the rules governing vitamins and nutritional supplements, which means very little. They dont have to meet the same rigor as medications reviewed by the Food and Drug Administration , so theres no assurance that what is promised in the bottle is what youll get, or even that it will work as you expect. Rather, these hormonal products gain the attention of the FDA only after there is evidence of harm demonstrated in the people taking these unregulated products.
The study findings should raise red flags for any woman looking to have her doctor prescribe the compounded pelleted hormone therapy. And if you still decide to go this route, Dr. Jiang says: Women on pellet therapy need to be carefully monitored for their estrogen and testosterone levels.
You should understand that that are bioidentical and offer individualized options to women, he continues. There are FDA-approved hormone supplements available that are identical to human reproductive hormones, in a variety of dosages and delivery methods.
What Are The Benefits Of Hormone Replacement Therapy
Whatever delivery method works best for your body and lifestyle, there is no doubt that HRT restores the normal hormonal balance, alleviates the signs of menopause and improves overall health and wellbeing.
Benefits of HRT:
- Protects against bone loss, or Osteoporosis, decreasing the risk of hip and spine fractures
- Reduces the risk of colon cancer
- Relieves hot flashes, especially at night
Risks of HRT:
Before starting a regimen of HRT, your provider will discuss all of the possible side effects and risks with you. Discuss your health and family history with your provider and be aware of the following potential issues:
- Risk of developing pulmonary embolism
- Risk of breast cancer
- Risk of uterine or endometrial cancer
- Increased risk of high blood pressure
- Risk of deep vein thrombosis
- Increased risk of gallbladder disease
To determine your very best options for HRT, discuss your hormone therapy with your doctor and review the drawbacks and benefits of each plan. The specialists at Coyle Institute have helped thousands of women reclaim their lives through safe and effective HRT programs. Call today to set up your consultation.
At Coyle Institute, We Restore Womens Lives Through Improved Pelvic Health So You Can Focus On Whats Important: Enjoying Your Life and the People You Love.
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Pellet Therapy: A More Effective Bioidentical Hormone Replacement Therapy
Many men and women are either considering bioidentical hormone replacement therapy or are actively participating in treatments using bioidentical hormones to manage aging symptoms. At Rhett Womens Center, we applaud you. The benefits associated with bioidentical hormones are both evidence-based and safe. The benefits range from improvements you see to improvements you feel . We believe that Hormone Pellet Therapy for administrating Estrogen and Testosterone is a convenient and the most effective way to replenish these hormones, which have naturally depleted as you age.
Hormone replacement using pellet implants has been used with great success in the United States, Europe, and Australia since 1938. In the last ten years, significant advancements have been made in the process of pellet implantation. BHRT Fused Pellet Implants are compounded using biologically identical hormones. The bioidentical hormone pinpoints hormone levels and the dosage needed to balance hormone deficiency. They have the same chemical structure as the hormones created naturally in the human body. The hormones tailored to each patient are pressed/fused into tiny cylinders. Pellets may be compounded for Estradiol and Testosterone.
Over 70 years of research* has illustrated that pellet implants are superior to oral and topical hormone therapy for women and men. Benefits include:
Benefits Of Injectable Testosterone
- Convenient. You can inject yourself in the comfort of your own home. Most people, even those squeamish about needles, find this is much easier than they thought it would be once they learn the proper injection method.
- Direct absorption. You will be injecting testosterone directly into the bloodstream, so you can guarantee 100% absorption of your specific dose.
- Easy to adjust and monitor. Injectable testosterone makes it very easy to control your levels. Adjustments can be made quickly and as often as needed during your treatment program.
- Alleviates symptoms quickly and effectively. This method is fast acting and you will start to feel better almost immediately. In addition, your levels should correct quickly, making this an efficient, powerful and trusted method for hormone restoration.
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No Mood Swings Or Energy Crashe
Hormone pellets release small, regular doses of your prescribed hormone into your body. The regularity of the dosage is one of the reasons why hormone pellets are so successful.
Other treatments, such as transdermal or oral hormone therapies, produce a roller coaster-like effect on the patient. When you take a hormone pill or apply a hormone gel or cream, your body receives a high level of hormones all of a sudden. Because the dosage was received all at once, youre more likely to experience a sudden drop-off.
Many people who use transdermal or oral hormones complain about the extreme mood swings and energy fluctuations they can cause. Pellet therapy neutralizes these negative side effects by keeping the hormonal release measured and consistent.
What Are The Bioidentical Hormone Side Effects
Both traditional HRT and BHRT may cause side effects. HRT may increase your risk for blood clotting, stroke, heart disease, and breast cancer. Commonly reported BHRT side effects are breakouts and water weight retention.
The good news about BHRT-specific side effects? All the above symptoms tend to go away as your body adjusts to the increased level of hormones.
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Legitimate Health Concerns Demonstrated In Women Taking Pelleted Hrt
In this study, Xuezhi Jiang, MD, PhD, and his colleagues examined the medical records of postmenopausal women who were patients at the Reading Hospital in Pennsylvania. Their goal was to compare serum levels of estradiol and total testosterone in women who had taken bioidentical pellet hormone therapy compared with women who used regular hormone therapy. The women who received hormones by solid pellet had it inserted under the skin. Dr. Jiang is an obstetrician-gynecologist and associate professor of medicine at Jefferson Medical College, in Reading, Pennsylvania.
The researchers were surprised by their findings they reported that the mean serum estradiol and total testosterone levels for women using pellet therapy were 237.7 pg/mL and 192.84 pg/mL, respectively, compared to 93.45 pg/mL and 15.59 pg/mL in women receiving traditional hormone therapy.¹ These high levels of hormones can be very concerning, Dr. Jiang tells EndocrineWeb.
Pellet therapy users also had significantly higher incidences of negative side effects, he says. Among the issues reported by the women who had pelleted hormones were: abnormal bleeding, mood swings and anxiety, breast tenderness, changes in hair patterns, acne, and weight gain.¹
Why Bioidentical Hormones Work Better
Our hormones are comprised of a solid steroid base , decorated with arms, legs, and tails pinned on here and there. These attachments are what turn hormones into specialized molecules, allowing them to plug into receptor molecules throughout the body, turning on and off much of the cellular behavior that makes us tick.
When we take hormonal replacement therapy that doesnt fit the original design that our cells have evolved to recognize, the end result simply may not feel or act quite right. Hence, all those side effects, ranging from annoying and uncomfortable to downright dangerous, can occur.
Bioidentical hormones, on the other hand, duplicate the structure of our hormones exactly as they are found in our bodies. This is why they work better in our bodies.
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Comparing Treatment Options: Estrogen Pellets Vs Patch
One of the greatest strengths of custom-compounded bioidentical estrogen therapy is its flexibility. Unlike conventional hormone therapy, bioidentical hormone replacement therapy allows for an individualized approach to healing, providing opportunities for precise dosing and a wide array of administration choices designed to suit your needs and preferences. To get the most out of your treatment experience, its therefore important to determine what those preferences are, taking into account your symptoms and your lifestyle.
For many, the convenience, efficacy, and safety profile of estrogen pellets and patches make both highly appealing. However, there are important differences to take into consideration. A compassionate and experienced hormone replacement therapy specialist can help you compare your optionsincluding estrogen pellets vs patchand guide you toward a treatment method that makes sense for you. But you can begin exploring the advantages and logistics of these treatment options now.
What Is The Procedure
A healthcare professional will consider factors such as hormone levels and body mass index when working out an appropriate dose of hormones to insert.
To insert hormone pellets, a healthcare professional will numb the skin and make a small incision, usually into the hip area. They will then insert one or more hormone pellets underneath the skin.
They will close the incision with Steri-Strips, a stitch, or both. A person will need to follow the healthcare professionalâs instructions after the procedure. Those with Steri-Strips may be able to remove them after 5â7 days.
The pellets provide a constant supply of hormones for about 3 months.
People wishing to use compounded bioidentical hormones may need to undergo a salivary test first to check their hormone levels. However, according to The American College of Obstetricians and Gynecologists , âsalivary testing does not currently offer an accurate or precise method of hormone testing.â
There is little scientific evidence to support the benefits of hormone pellet therapy. The FDA does not regulate compounded pellet therapy and has not approved it.
Providers of hormone pellet therapy suggest that the treatment will provide various benefits. These include:
- protecting against health conditions, such as heart disease and osteoporosis
There may also be advantages of a pellet delivery system, including:
The ACOG recommends FDA-approved hormone therapy, which includes:
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Which Bioidentical Hormones Should You Take
The molecules naturally produced in the human female body for which we most often seek replacement include:
- Estrone , estradiol , and estriol
- DHEA, an adrenal precursor to testosterone.
These truly natural hormones are available by prescription. Estradiol is available as Estrace pills, Estrace vaginal cream, or transdermals as the Vivelle Dot, and Climera. (Pharmaceutical companies have been able to patent the delivery system on these hormones, though the hormone itself is still bioidentical. Estriol is available only through formulary pharmacies. Most women do fine with just estradiol plus or minus some progesterone. And sometimes a bit of testosterone, which is available by prescription as AndroGel.
Bioidentical Hormone Replacement Therapy With Pellets
When it comes to bioidentical hormone replacement therapy pellets, the Biote Method of pellet therapy is the preferred choice among more than 4,800+ physicians. When a patient decides to start the Biote Method of pellet therapy, they may receive as few as two subcutaneous pellet insertions per yearand any needed hormone will be readily available when the body requires it..
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Hormone Pellets Vs Other Hormone Administration Methods
Hormone therapy differs not in the hormone you use but primarily in how you put it into your body.
How you take your hormones dramatically impacts the serum levels of your hormones, other sex hormones in your body, your symptoms, and much more.
Because of this, its worth exploring all of the options before you jump into hormone pellet therapy.
Hormone pellets require a procedure to be placed, which is unique among all other forms of hormone replacement therapy.
The pellet then dissolves slowly over a period of months, all the while slowly releasing a stable amount of hormone into your bloodstream.
The exact amount of hormone which is placed into each pellet can be adjusted based on the needs of the individual.
In addition, these pellets can also come formulated with multiple hormones.
Taking hormones through the skin, or via injection/pellet therapy, is preferred over oral administration.
So, pellets are favored in that way.
But how do they compare to creams/gels/shots?
In terms of efficacy, pellets are no more effective than a gel/cream or injection in theory.
Basically, as long as you dont take your hormones by mouth you should be good to go.
Are You Someone Who Likes Customization
If you dont think twice about boldly ordering exactly what you want, how you want it from Starbucks, then why not do the same with bioidentical replacement therapies?
If you love having control and getting exactly what you want and need, pellet therapy may be right for you. Why? Because BHRT pellets are compounded. This means that your unique hormone imbalance determines the blend and dose of hormones contained in the pellet.
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Are Bioidentical Hormone Pellets Safe
If youve been diagnosed with a hormone imbalance, youll want to consider how to effectively treat the condition. Your medical professional may have offered you several treatment suggestions, including bioidentical hormone pellets.
But are they safe?
As with any treatment option, you should be as informed as possible when deciding how to proceed.