What are Pellets?
Pellets or implants are made up of bio-identical hormones (i.e. testosterone or estradiol that are the exact chemical formula, and identical molecular structure, to what your body produces) and are derived from natural plants that are pressed into very small solid cylinders. These 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 since “big pharmaceutical companies” can’t profit from the production of unpatentable, natural substances.
Why Pellets?
Pellets deliver consistent, healthy levels of hormones for approximately 4 months in women and 5 months in men. The pellets dissolve completely on their own during this time. They avoid the fluctuations or ups and downs of hormone levels (roller coaster effect) seen with EVERY other method of delivery. This is important for optimal health and disease prevention. In studies comparing pellets to conventional hormone replacement therapy, pellets have been shown to be superior for the 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. Testosterone also helps with vaginal dryness, incontinence, urinary urgency, and frequency. In both men and women, testosterone has been shown to increase energy, relieve depression, increase the 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. Men and women need adequate levels of testosterone for optimal mental and physical health and for the prevention of chronic illnesses like Alzheimer’s and Parkinson’s disease, which are associated with low testosterone levels. Even patients that have not had success with other types of hormone therapy have a high success rate with pellets. There is no other “method of delivery” that is as convenient, effective, and safe for the patient as implants. Implants have been used in both men and women since the late 1930s. There is significant data that supports the use of testosterone implants in both men and women.
How long until a patient feels better after pellets are inserted?
Some patients begin to “feel better” within 24-48 hours, while others may take 10-14 days to notice a difference. Diet and lifestyle (exercise), along with hormone balance are critical for optimal health. Stress is a major contributor to hormone imbalance and illness. Side effects and adverse drug events from prescription medications may interfere with the beneficial effects of the pellets.
How long do pellets last?
The pellets usually last between 3-5 months in women and 4-6 months in men. The pellets do not need to be removed. They completely dissolve on their own . . . And remember, not all pellets are created equal. We have dedicated significant resources and research to finding a compounding pharmacy that produces the best pellets in the country.
Do female patients need progesterone when they use the pellets?
Women who are treated with testosterone implants alone (no estrogen therapy) do not require progesterone therapy. However, if estradiol or other estrogen therapy is prescribed to a woman who still has her uterus, progesterone is also needed. The main indication for progesterone is to prevent the proliferation (stimulation) of the uterine lining caused by estrogen. Progesterone therapy is NOT required if estrogen therapy is not prescribed. However, there may be other health benefits from the hormone, progesterone. It may be used in addition to other hormones to help women who have difficulty with sleep, hot flashes, tension, or anxiety. Testosterone and progesterone have beneficial effects on the brain and nervous system. Progesterone implants have been used since the 1940s.
How are hormones monitored during therapy? Hormone levels will be drawn and evaluated before therapy is started. Every patient will have individualized dosing that is calculated from these lab values, height, and weight.
Women are advised to continue their monthly self-breast exams and obtain a mammogram and/or a pap smear as advised.
Is there a role for testosterone implants (pellets) in premenopausal females
Testosterone pellets may be used in premenopausal females (women who have not stopped menstruating). Testosterone has been shown to relieve migraine and menstrual headaches, help with symptoms of PMS (premenstrual syndrome), relieve anxiety and depression, increase energy, help with sleep, and improve sex drive and libido.
If a premenopausal female has a testosterone pellet inserted, birth control is recommended.
Can a patient be allergic to implants?
Very rarely, a patient will develop a local zone of redness (3-8 cm) with itching at the site of the pellet. If needed, 25-50 mg of Benadryl works well for the itching.
Insurance does not cover Pellet Hormone Replacement Therapy.
It is considered an elective procedure. You will be responsible for payment at the time of the procedure.
Complete Healthcare for Women - Obstetrics and Gynecology
Richard Lorenzo, D.O.
Kortney Jones ARNP
