Family Doctors of DuPage, S. C.

HORMONE PELLET IMPLANTS

Hormone pellet implants have been around for over 60 years. They are the ultimate in bioidentical hormones. There are many articles in mainstream peer-reviewed medical journals proving the safety and efficacy of estradiol and testosterone implants. Unfortunately, they have never really caught on, in spite of the fact that they represent, so far, the most physiologic, most natural form of hormone replacement yet devised. The reason this is the case is that they have never been taught to medical students or residents, and these hormones cannot be patented. And since they can’t be patented, they would not be a profitable item for a drug company to try and market.

The advantage of pellets over pills, patches, creams, gels, and injections is that they are more convenient (they are inserted only 2-3 times a year)*, and they provide a much more even level of hormone in the blood. And in contrast to oral pills, they avoid the “first pass effect” of having to go through the liver, and getting metabolized to a great degree before they really get into your bloodstream to have their desired effect. In addition, when testosterone is delivered via a patch or gel, it often is converted into estrogen by an enzyme in the skin called aromatase.

Major side effects of pellet implants are essentially none. Minor side effects are also uncommon. An example would be tender breasts if more estrogen was given than was actually required. Testosterone given to women by pellets to raise libido and strengthen the bones, never causes unwanted hair growth, or lowering of the voice. The most common undesirable event that occurs in patients receiving sub dermal implants is temporary minor discomfort at the pellet site lasting maybe 5-10 days.

In the doctor's office, using a local anesthetic, they are painlessly
inserted under the skin of the hip, through a tiny incision, using a small
insertion device. Then, a small piece of tape is used to close the
incision. The whole procedure takes only a few minutes, and the amount of
discomfort one feels is actually less than getting a blood test.

If pellet therapy is being considered, it is essential that certain lab tests be performed both before and after pellet insertion, to ensure that proper doses are being given. Insurance usually covers the associated office visits, lab tests, and insertion fee. The patient is responsible for the cost of the pellets themselves, since most insurance plans do not reimburse for them.

* If a woman still has her uterus, then she will need to take oral progesterone on a regular basis.

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BIOIDENTICAL HORMONES - REPLACEMENT  
What does “bioidentical” mean?

Bioidentical means “exactly the same”. In other words, if you did a chemical analysis of two substances that were bioidentical, they would be the same substances, interchangeable. It would be like buying Tide detergent in Chicago, or buying Tide detergent in Los Angeles. It’s the same stuff.

Bioidentical is an important quality in hormone replacement. If you are low in estradiol (the most important of the three human estrogens), you want to replace it with estradiol. Not estropipate, ethinyl estradiol, equiline (horse estrogen), or other estradiol look-alike. And if you’re low on testosterone, you want to replace it with testosterone, not a synthetic anabolic steroid that is simply somewhat similar to the real thing.

Bioidentical also means that the risk of side effects is much lower, because you are simply raising levels of hormones you already have had for decades into a healthier more optimal range.

Bioidentical hormones (estrogen, progesterone, and testosterone) have been around for a long time, and there is simply no valid reason to use patented synthetic drugs to replace them. They are clearly safer than the synthetics, especially when delivered through the skin or under the skin..

 
   

 

William Epperly, MD, FAAFP, CCN

 


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