What are hormone pellets and when are they used?
Hormone pellets are tiny rice grain sized pellets composed of pure hormone that can be implanted under the skin. They are used to restore adequate hormone levels and balance in individuals who are experiencing the signs and symptoms of hormonal decline.
There are several methods used by physicians to deliver these hormones:
- Tablets placed under the tongue
- Patches that adhere to the skin
- Creams and gels
- Hormone pellets
Drawbacks to other hormone treatments
Patches are loaded with contaminants in the manufacture of the patch making them a very poor choice. Skin irritations and other problems are common. Creams and gels represent the best non pellet method of hormone delivery. However they will still produce somewhat of a roller coaster effect. Additionally absorption can be very variable. Many patients complain that they are messy and difficult to deal with.
Orally delivered hormones (pills) will pass through the liver prior to entering the blood stream. This is called "first-pass" metabolism. This has been shown to increase the risk of blood clotting and subsequent heart attack even if the hormone is "bioidentical". Estrogens should NEVER be administered orally.Tablets placed under the tongue will yield rapid spikes in hormone levels followed by gradual decline throughout the rest of the day. This "roller coaster" effect is not consistent with the design of the body which much prefers steady hormone levels.
Hormone pellets, planted under the skin, yield higher and steadier levels than all other methods. They represent a superior delivery method that will result in very steady hormone levels for a period of 4-6 months. Data has been collected that supports pellet implants as the most effective hormone delivery method for both men and women, as pellets release small doses which provides optimal therapy.
What is in the hormone pellets?
Pellets are composed of either estrogen or testosterone fused into tiny solid cylinders, mid-way between the size of a grain of rice and a Tic-Tac. Hormone pellets are prepared by a compound pharmacy and delivered in sterile glass jars. Progesterone is not delivered in pellet form because a progesterone pellet would be very large and, therefore, uncomfortable when placed under the skin in the hip area.
The benefit of pellets is that they deliver a consistent, healthy level of hormones for a period of months, avoiding the ups and downs of hormone levels seen with the other methods; it maintains the normal balance of estradiol to estrone (the "bad" version of estrogen that increases in post-menopausal women while estrogen simultaneously decreases). Unlike pills and synthetic hormones, bioidentical hormone pellets do not increase the risk of blood clots, which can lead to heart attack.
Studies have shown that pellets, compared with conventional HRT, deliver superior relief of menopausal symptoms, including hot flashes, disturbed sleep, poor libido and irritability.
Testosterone is also delivered by pellet implant in both women and men as a solution for poor libido, energy, weight control, strength, endurance and other symptoms. Pellet-delivered testosterone will also increase lean body mass, including bone density and muscle strength while simultaneously decreasing fat stores. Both men and women benefit from testosterone for the prevention of heart disease and chronic diseases of aging such as Parkinson's and Alzheimer's diseases, both of which are linked to low testosterone levels.
Last, pellet HRT is extremely convenient. No need to remember to take the pill, to put on the cream, to hassle with patches that never seem to fit well after showering or bathing. Surprisingly to our patients, pellets have been used since the 1930's, and there is more data supporting the use of pellet-delivered HRT than any other HRT delivery system.
How are the pellets inserted?
Pellets are inserted in the upper buttocks through a tiny incision which is then covered with a steri-strip. Local anesthesia is used prior to insertion and you'll feel almost nothing at all during the 3-minute procedure other than perhaps a little pressure when the pellets are inserted through the trocar. Other than some bruising and possibly some minor discomfort afterwards, there are very rarely any complications from this simple procedure. After insertion we suggest that you avoid strenuous physical activity for 24-48 hrs. and refrain from swimming or soaking in the bath tub for 3-5 days. You will be able to shower that evening.
If pellets have been available since the 1930's, why have I never heard of them?
Primarily because pellets aren't patented-i.e., the pharmaceutical companies do not profit from HRT via hormone pellets in the same way they profit from Estratest, Premarin, Provera or PremPro.
Isn't hormone therapy dangerous? Doesn't it cause cancer?
We believe here at SMAC, based on years of studies, that natural, bioidentical hormone therapy does not cause cancer. In fact, when you consider that the highest concentrations of estrogen in women are found when women are in their early 20's, decreasing as women age, wouldn't it seem logical that, if estrogen caused breast cancer, that women in their 20's would have most of the breast cancer diagnoses? And yet, that isn't true, is it? Remember the Women's Health Initiative trial? This is the trial that treated thousands of women with synthetic estrogen replacement made from pregnant horse urine. It was supported by Wyeth Pharmaceuticals and was discontinued early because the women were found to have increased risk for breast cancer. You must note that synthetic, chemical progestins were used, not natural bioidentical hormones. Data supports balanced, bioidentical hormones as breast-protective.
When do you remove the pellets?
The pellets last between and 4-6 months and because they are absorbed, they are not removed. The next dose is simply inserted as was the first, and so on.
Will I be monitored while using the pellets?
Absolutely. An initial blood analysis is performed to gather information about your current hormone levels, in order for the doctor to create the correct balance between the testosterone and estrogen pellets and the progesterone he will prescribe for you. Once the pellets are inserted, regular blood work will be performed to analyze your status and make sure the pellets are working as they should.