When it comes to hormone replacement therapies, there are a few options available for both men and women. The therapy that has become very popular over the past decade is the use of bioidentical hormone pellets. This therapy was originally started in the 1930s, but due to lack of promotion and only recent FDA approval, this approach has not been made available in the US - though it has been widely used in Europe for decades. Pellet therapy has become the option more people are choosing due to its efficacy and convenience.
What are these pellets made from?
These pellets are made up of either estradiol or testosterone, and are compressed or sometimes fused into a small solid cylindrical shape - about the shape and size of a grain of rice - which allows for easy insertion into the body. The insertion is a short in-office procedure that involves a local anesthetic and a small incision in the upper hip area - about a half and inch long. The pellets are inserted into the fatty layer just under the skin, where they will eventually settle and slowly dissolve away over the course of 3-4 months.
Is this procedure safe?
When done by a trained medical professional, the procedure is safe and relatively pain free. After the procedure, you will just need to take it easy for a couple of days - mostly to prevent the pellets from shifting or trying to work their way out. A few days after the procedure, you can go about normal activities, and you don't need to do anything else until your next round of treatments a few months later. Compare that to creams or gels that need to be applied multiple times a day, or injections that have to be given in the clinic every couple of weeks, and you can see why it's become so popular.
Are there benefits to pellets over other options?
These hormones are bioidentical to the hormones you have in your body, and they are slowly delivered in a consistent dosage over the lifetime of the pellets - the same way your body would have delivered hormones naturally. This means you don't have the disrupting hormonal shifts associated with injections - where you get a large spike of the hormone followed by a rapid decline. And many patients begin to feel the effects of the pellets within 24-48 hours after they are implanted, which makes them a much better alternative to the creams and gels, which can take weeks or months to have any effect.
How long is the procedure?
Women receiving pellet implants, the procedure generally takes about 30 minutes. For men, it takes a little longer for the local anesthetic to sufficiently numb the area before the incision is made, so we like to plan on about an hour.
What happens after the pellets are inserted?
After the pellets have been placed, the incision is closed using SteriStrips and then covered with a waterproof dressing. The anesthetic will begin to wear off within a few hours, and you will want to be gentle around the area of the incision. To minimize bruising and swelling, it's recommended that you ice the area for about 20 minutes every few hours. For any pain or discomfort, you can take either acetaminophen or ibuprofen.
Who can receive hormone pellet therapy?
This therapy is available to both men and women who have test results indicating an imbalance or low levels of their natural hormones.
How often do I need to have pellets inserted?
These pellets are designed to slowly dissolve over a few months. A few weeks after your initial procedure, some tests will be ordered to determine how well the pellets are doing at delivering the hormone, and if there are any adjustments that need to be made, either up or down, that will take place during your next treatment. Generally, patients will need between 3 and 4 treatments over the course of a year.