Hormonal imbalances in women are not uncommon, however many do not realize that the day to day feelings of tiredness, weight imbalance, and overall changes in their complexion may be due to an internal shift. With hormone therapy, and the guidance of an Urbane expert, you can improve your overall health, function, and complexion vibrancy with hormone replacement therapy. With a customized dosage, hormone therapy is a natural way to deliver treatment by consistently releasing hormones over an extended period of time.
Alleviate symptoms of decreased hormone production in the body
Give protective benefits originally provided by naturally occurring hormones
Re-establish hormone balance
Increase energy levels, enhances weight-loss, stabilizes mood, boosts libido, and improves sleep
Schedule a consultation with your healthcare provider to discuss if HRT is right for you.
Inform your healthcare provider of any medical conditions, allergies, or medications you are currently taking.
Follow any instructions provided by your healthcare provider for preparing for hormone level testing.
Avoid smoking and consuming alcohol for at least 24 hours before HRT treatment.
Inform your healthcare provider if you are pregnant or breastfeeding.
Discuss any potential risks or side effects of HRT with your healthcare provider.
Inform your healthcare provider of any history of blood clots, heart disease, or stroke.
Follow any additional pre-care instructions provided by your healthcare provider.
It's important to note that individual instructions may vary depending on your specific medical history and the type of HRT being administered. Always consult with your healthcare provider for personalized pre-care instructions.
The first four weeks following pellet insertion your body will be adjusting to new hormone levels. Because of this transition you may or may not experience some of the following changes. As your hormone levels adjust these symptoms should minimize and ultimately disappear.
MOOD SWINGS/IRRITABILITY – This is especially true if you were deficient in hormones prior to therapy. Your body will adjust once your hormone levels are stable.
SWELLING (usually hands and feet) – Sometimes swelling can occur following pellet insertion. This is usually in hot and/or humid weather and can be alleviated in most cases by increasing water intake.
HAIR GROWTH/LOSS – This is usually related to Testosterone levels. Testosterone can stimulate hair growth and can sometimes be seen on the chin, chest, nipples, and/or lower abdomen. Females that convert testosterone may experience hair loss, although this is rare. Adjustments in dosage can eliminate this problem.
FLUID RETENTION – Testosterone stimulates muscle growth and water retention which can cause weight gain. This is usually temporary.
UTERINE SPOTTING/BLEEDING – This is usually related to progesterone levels and may occur in the first few months after an insertion. Correct dosing should eliminate this problem.
FACIAL BREAKOUT – If testosterone levels were significantly deficient, the changes in levels can sometimes cause pimples. This is usually temporary and can be taken care of with a good cleansing protocol.
POST-INSERTION INSTRUCTIONS FOR WOMEN
It is recommended to put an ice pack on the insertion site 2-3 times following the procedure for about 20 minutes each time.
Your insertion site is covered with a bandage. Please leave the outer pressure bandage on for 3-4 hours. There is a waterproof foam bandage or steri-strips that should not be removed for at least 2 days following the procedure.
Do NOT take tub baths or get into a hot tub for 2 days. Do NOT scrub the site for at least one week.
NO heavy lifting, exercise that causes impact or vigorous exercise for 4-5 days.
The sodium bicarbonate in the anesthetic may cause swelling for 1-3 days.
The site may be uncomfortable for up to 2-3 weeks. You may have bruising, swelling, and/or redness of the insertion site which may last from a few days to 3 weeks.
You may experience some light bleeding from the incision. This is normal and can be relieved by firm pressure for 5 minutes. If you continue to have bleeding and/or pus coming from the insertion site, and is not relieved by pressure, please call the physician’s office.
Follow up with your practitioner as directed.
WHAT ARE PELLETS?
The most common pellets are made up of either estradiol or testosterone. The hormones, estradiol or testosterone, are pressed or fused into very small solid cylinders. These pellets are larger than a grain of rice and smaller than a ‘Tic Tac’. In the United States, pellets are made by a licensed compounding pharmacist and delivered in sterile glass vials.
HOW DO I KNOW IF I AM A CANDIDATE FOR PELLETS?
Some of the symptoms you might experience include excessive weight gain, low libido or sex drive, mood swings, insomnia or trouble sleeping, depression, and or irritability. If you are experiencing any of these symptoms, you could be a candidate for BHRT pellet therapy.
WHY ARE PELLETS OPTIMAL FOR HORMONE REPLACEMENT?
Pellets deliver consistent, healthy levels of hormones for 3-6 months, depending on the dosage. They avoid the fluctuations, or ups and downs, of hormone levels seen with every other method of delivery. It is the fluctuations in hormones that causes many of the unwanted side effects and symptoms a patient experiences. Pellets do not increase the risk of blood clots like conventional or synthetic hormone replacement therapy. In studies, when compared to conventional hormone replacement therapy, pellets have been shown to be superior for relief of menopausal symptoms, maintenance of bone density, restoration of sleep patterns, improved libido, sexual response and performance. Even patients who have failed other types of hormone therapy have a very high success rate with pellets. In addition, there is no other method of hormone delivery that is as convenient for the patient as pellets.
HOW AND WHERE DO YOU INSERT PELLETS?
The insertion of pellets is a simple, relatively painless procedure done under local anesthesia. The pellets are usually inserted in the hip through a small incision which is taped closed. Experience of the health care professional counts; not only in placing the pellets but in determining the correct dosage of hormones to be used.
WHAT ARE POTENTIAL COMPLICATIONS FROM INSERTING HORMONE PELLETS? Complications from the insertion of pellets include minor bleeding, bruising, discoloration of the skin, infection, and possible extrusion of the pellet. Other than slight bruising or discoloration of the skin these complications are very rare. Extended exposure to moisture (swimming, hot tubs, bathtubs) is avoided for 4 to 5 days, and vigorous physical activity is avoided for 48 hours in women and up to 5 to 7 days in men.
WHAT CAN I EXPECT AFTER PELLET INSERTION?
After pellets are inserted, patients may notice that they have more energy, sleep better and feel happier. Muscle mass and bone density will increase while fatty tissue decreases. Patients may notice increased strength, coordination and physical performance. They may see an improvement in skin tone and hair texture. Concentration and memory may improve as will overall physical and sexual health.
DO PELLETS HAVE THE SAME DANGER OF BREAST CANCER AS OTHER FORMS OF
Pellets do not have the same risk of breast cancer as high doses of oral estrogens, like Premarin, that do not maintain the correct estrogen ratio or hormone metabolites. Nor, do they increase the risk of breast cancer like the synthetic, chemical progestins used in the Women’s Health Initiative Trial. In fact, data supports that balanced hormones are breast protective.
WHAT ARE THE MOST COMMON SIDE EFFECTS WHEN THE PELLETS ARE FIRST INSERTED?
When a patient first starts hormone therapy, there may be mild, temporary breast tenderness, which gets better on its own. Hormone receptors may be very sensitive and take time to adjust. There may be a temporary water weight gain which will also resolve on its own. The body will tone up, as bone density and muscle mass increase and fatty tissue decreases. Patients may experience a mild form of “puberty” as their hormonal levels come up into normal ranges.
HOW SOON WILL I FEEL THE EFFECTS OF THE PELLETS?
Some patients begin to “feel better” within 24-48 hours while others may take a week or two to notice a difference.
HOW LONG DO THE PELLETS LAST?
The pellets usually last between 3 and 5 months in women and 5-6 months in men. High levels of stress, physical activity, some medications and lack of sleep may increase the rate at which the pellets absorb and may require that pellets be inserted sooner in some patients.
DO THE PELLETS NEED TO BE REMOVED?
The pellets do not need to be removed. They completely dissolve on their own.
DO MEN NEED HORMONE REPLACEMENT?
Testosterone levels begin to decline in men beginning in their 30’s. Most men maintain adequate levels of testosterone into their mid-40’s to mid-50’s, some into their late 70’s early 80’s. Men should be tested when they begin to show signs of testosterone deficiency. Even men in their 30’s can be testosterone deficient and show signs of bone loss. Most men need to be tested around 50 years of age. It is never too late to benefit from hormone therapy.
DO PATIENTS NEED PROGESTERONE WHEN THEY USE THE PELLETS?
Any time estradiol is prescribed, progesterone is also prescribed. There are progesterone (not progestin) receptors in the bone, brain, heart, breast and uterus. Progesterone can be used as a topical cream, a vaginal cream, oral capsule, or sublingual drops or capsules. If a patient is pre-menopausal, she uses the progesterone the last two weeks of the menstrual cycle.
HOW ARE THE HORMONES MONITORED DURING THERAPY?
Hormone levels will be drawn and evaluated before therapy is started. This will include an FSH, estradiol, testosterone and free testosterone for women. Men need a PSA, estradiol, free estradiol and testosterone prior to therapy. Levels will be reevaluated during hormone therapy at 4-6 weeks and again in 3-5 months. After the first years of therapy hormone levels are followed less frequently. The PSA in men is followed every 6-12 months.
WHAT IS THE COST FOR PELLETS?
The cost will vary depending on the dose of the hormones. Men typically need a much larger dose of testosterone than women so the cost is higher. Please ask your clinic for pricing.
HOW DO I GET STARTED?
Once your initial consultation is complete, the provider will review your symptoms and blood labs to determine if you are a candidate for pellet therapy. The initial insertion appointment can be scheduled at that time.