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Pellet Hormone Replacement Therapy: Types, Safety, and Considerations

Aging can cause your endocrine glands to secrete too many or too few hormones, resulting in hormone imbalance and triggering often severe symptoms. Many people see this as a necessary part of aging, but this doesnā€™t have to be the case. Other factors like stress, genetics, diet, and lifestyle can also add to the workload on your body and ultimately lead to hormone imbalances. There are many methods that can be used to restore the balance of hormones in your body for minimizing these unpleasant symptoms, but pellet hormone replacement therapy may be one of the most reliable. However, it is not for everyone and comes with some serious risks. How carefully you choose your hormone type and dosage can make a big difference in the safety, though.

What Is Pellet Hormone Replacement Therapy?

An image of hormone replacement therapy documents on a table with reading glasses and a blister pack of pillsYour body naturally produces hormones for many bodily functions such as growth, metabolism, and reproduction. Any deficiency or imbalance in hormones can lead to a multitude of consequences for your emotional and physical well-being. Supplements, such as natural bioidentical hormones, can help restore your bodyā€™s natural hormone levels. Pellet hormone replacement therapy is regarded as one of the most natural methods to deliver bioidentical hormones in your body.

In people whose hormone levels are low or out of balance, pellet hormone replacement therapy can help restore proper levels. During the therapy, hormone pellet implants are placed under your skin in the hip region to consistently release low, physiologic doses of the hormones to ensure optimal therapy. Hormone pellets are tiny cylindrical subcutaneous implants made of either testosterone or estradiol.

Prior to pellet hormone replacement therapy, hormone levels of the person are evaluated. This includes estradiol, FSH, free testosterone and testosterone hormones in women; and testosterone, estradiol, free estradiol, and PSA in men. After pellet insertion, the hormone levels are evaluated throughout the therapy. While some patients start feeling better within 24 to 48 hours of pellet insertion, others might take a week or two to feel the difference.

Pellet insertion is a simple and relatively painless procedure done under the use of local anesthesia. Pellets are inserted in the hip or lower abdominal wall through a small incision which is then taped closed. Here, the experience of the therapist counts in determining the correct dosage of hormones and placing the pellets. The pellets work by steadily releasing hormones over a period of time which can last from three to six months after which the pellets dissolve on their own. Excess stress, inadequate sleep, certain medication, and physical activity may increase the rate of absorption of the pellets. This may require early insertion of new pellets in some patients.

What Makes Pellet Therapy Unique?

Hormone replacement therapy can be taken in various forms including pills, skin patches, gels, cream, and nasal sprays. However, in these methods, the dosage of hormones is released in spurts. This inconsistent supplementation of hormones can aggravate the symptoms of hormonal imbalance. Pellet therapy helps restore hormone balance in your body to improve the symptoms of hormonal disruption. The unique part of pellet hormone replacement therapy is that, unlike other conventional hormone replacement therapies, the dosage of hormones is exact. This prevents any hormonal fluctuations, unwanted side effects, and ensures better control over your symptoms. Pellet therapy also does not raise the risk of blood clots. When compared to conventional hormone replacement therapy there are several advantages of pellet therapy.

Here is what makes pellet hormone replacement therapy unique:

  • Consistent Hormone Delivery - A hormone imbalance triggers a series of unpleasant symptoms in your body. In pellet hormone replacement therapy, the pellet implants placed under your skin consistently release hormones into your body. This helps in balancing hormones in your body and enables better control of unpleasant symptoms.
  • Accurate Dosage of Hormones - Pellet therapy avoids the hormonal fluctuations which are often observed in other forms of hormone therapy. Pellets contain an appropriate dosage of hormones, which prevents any hormone fluctuations in the body. Evidence shows that when compared to oral hormone pills or transdermal patches, the day to day variability of hormone levels is minimal with pellets.
  • Increased Compliance - Pellet therapy is simple and hassle-free. Pellet implants are placed under the skin through an incision, without requiring any major surgery. New pellets are inserted by appointment with your doctor every three to six months. This makes it much harder to forget a dose.
  • Lower Risk of Blood Clots - Pellets bypass the liver thus avoiding clotting factors.
  • More Effective Than Other Hormone Therapies - Pellet therapy has been successful in several patients where other hormone therapies have failed. Consistent hormone delivery, accurate dosage, and increased compliance make pellet therapy more effective than other hormone replacement methods.

What is Pellet Therapy Used For?

Hormonal imbalance gives rise to a series of side effects in your body thus triggering stress, multiple symptoms, and dysregulation of many of your bodyā€™s systems. Pellet hormone replacement therapy aims to rebalance your bodyā€™s hormone levels to reduce these problems.

Hormone replacement therapy has been used to improve the following conditions:

  • Alzheimerā€™s disease
  • Parkinsonā€™s disease
  • Metabolic syndrome
  • Diabetes
  • Heart disease
  • PTSD
  • Thyroid
  • Hysterectomy
  • Low testosterone
  • Perimenopause
  • Postmenopause
  • Osteoporosis

Further, pellet therapy has been known to provide several benefits. Some of the positive effects of pellet hormone replacement therapy are that it:

  • helps improve mood
  • reduces anxiety
  • promotes better sleep
  • boosts energy levels
  • increases bone density and muscle mass
  • decreases fatty tissues
  • enhances strength and endurance
  • improves hair texture and skin tone
  • increases physical performance
  • improves concentration and memory
  • boosts sexual health
  • improves overall physical health

Studies show that in comparison to conventional hormone therapy, pellet hormone replacement therapy provides superior relief for the restoration of sleep patterns, reduction of menopausal symptoms, bone density maintenance, and improving libido. Further, pellets are often considered the most convenient form of hormone delivery and are known to provide high success rates where other types of hormone therapy have failed.

Do You Have A Hormone Imbalance?

An image of a female doctor holding wooden blocks with hormone balance written on themMaintaining healthy levels of hormones is crucial to ensure the optimal functioning of your body. With the natural process of aging, the level of sex hormones in your body begins to gradually reduce. This often creates hormone imbalances.

Men experience a decrease in testosterone levels in their mid-forties to fifties and sometimes as early as their thirties. However, there are men who maintain healthy testosterone levels even in their seventies. Getting your testosterone level checked can help identify any cases of hormonal deficiency.

Women may also experience a decrease in their sex hormones at as early as in the thirties. Further, perimenopause and menopause cause hormonal fluctuations in the body leading to debilitating symptoms.
Some of the common symptoms of deregulated hormones include:

  • Night sweats
  • Hot flashes
  • Low libido
  • Vaginal dryness
  • Pain during sex
  • Disturbed sleep
  • Fatigue
  • Low energy levels
  • Loss of muscle mass
  • Brain fog
  • Weight gain
  • Memory loss
  • Mood swings

Besides aging, there are various other factors that can disrupt the hormone levels in your body. Some of the factors contributing to hormone imbalance include:

  • Food sensitivity
  • Traumatic emotional events
  • Infection
  • Physical trauma
  • Aging
  • Alterations in gut health
  • Chronic sleep deprivation
  • Chronic inflammation
  • Nutritional deficiencies
  • Acute physical stress

Pellet hormone replacement therapy helps to balance the levels of the sex hormones estrogen and testosterone which are essential for the production of serotonin, a chemical and neurotransmitter that regulates mood, social behavior, sleep, sexual desire, appetite, digestion, and memory. Lack of serotonin can cause tiredness, irritation, and difficulty concentrating. In women, pellet therapy can help reduce depression, severe PMS, menstrual migraines, and sleeping disorders. The therapy can also help correct hormonal deficiencies caused by birth control pills.

Bio-Identical Hormone Preparations

Bioidentical hormones are basically a type of hormonal supplementation with the same molecular structure as that of your bodyā€™s natural hormones. Common hormones that are usually matched include testosterone, estrogen, and progesterone. Bioidentical hormones are prepared by approved drug companies. They are also custom-made by pharmacists according to the therapistā€™s specification which is referred to as compounding. Both the US Food and Drug Administration (FDA) approved and compounded bioidentical hormones are available in various doses and delivery modes including pills, gels, creams, vaginal inserts, and pellets.

The FDA has approved several preparations of bioidentical progesterone and estradiol that are molecularly identical to the structure of hormones naturally produced by the human body. These bioidentical hormones have been thoroughly tested for purity and safety to ensure each dose contains the same amount of hormones.

However, compounded bioidentical hormones are not FDA approved. Though often advertised under the name of natural products made from plants, they are processed and greatly altered in the lab. Though custom-made hormone combinations often include the same ingredients found in FDA-approved bioidentical hormones, there are custom preparations which contain additional hormone varieties that have not been tested and FDA-approved. This poses additional risk regarding the safety, purity, and potency of such products.

Bioidentical Hormones In Hormone Replacement Therapy

Bioidentical hormones are selected based on your individual hormone deficiency and the associated symptoms. Various bioidentical hormones are used during pellet hormone replacement therapy.

These should be selected with the guidance of your healthcare professional prior to undergoing any hormonal therapy whether natural or synthetic. Taking hormone supplementation without seeking the guidance of a therapist could cause irreversible damage to your body and prove dangerous. Those with adrenal fatigue also might not be able to handle the hormones in their body, making their symptoms worse if their body isnā€™t primed to take in the hormones.

With those precautions in mind, the following are some of the hormones that can be used in hormone therapy:

Human Growth Hormone

Your pituitary gland, located below the hypothalamus present at the base of the brain, is responsible for the secretion of growth hormones. The hormone plays multiple crucial roles including calcium retention, stimulation of the immune system, strengthening of bones, and increasing muscle mass. Growth hormones are very important.

Deficiency of growth hormone can lead to reduced sex drive, increased body fat, reduced energy, reduced heart tissue, and bone mass loss. Estimates reveal that over ten million people worldwide suffer from this condition. There are tests to determine growth hormone deficiency.

Human growth hormone (HGH) is a replacement option for people who do not produce adequate growth hormones. Pellet therapy includes use of natural bioidentical hormones, which can help return your growth hormones to normal levels. Some of the side effects of HGH therapy include joint pain, joint swelling, increased risk of diabetes, and carpal tunnel syndrome. Prior to the therapy, it is crucial to be aware of the various aspects and related side effects.

Cortisol Hormone Therapy

Resembling the anti-stress steroid hormone cortisol, the bioidentical hormone Cortef is used to restore cortisol levels. Your adrenal glands naturally secrete cortisol for dealing with stress. As cortisol is secreted in response to stress, the hormone also contributes to insomnia, fat storage, and weight gain. Cortisol levels are high after you wake up and gradually decline, finally dropping low at bedtime to allow for sleep. Cortisol plays several important functions in the body. It helps regulate sleep, homeostasis, blood pressure, blood glucose, and central nervous system activation.

The level of cortisol rises during stress and reduces to a normal level after the stress subsides. Having a healthy level of cortisol is essential for the normal function of your body. Constant stress overburdens your adrenals, thus hampering adequate cortisol production. Imbalanced cortisol levels affect your bodyā€™s stress response system and may also lead to adrenal fatigue. Elevated cortisol levels for a longer time period can raise the risk of cardiovascular problems.

The bioidentical hormone Cortef is used to raise cortisol levels to the required standard in your body. This enables the body to overcome the negative symptoms of imbalanced cortisol levels.

Cortisol is a steroid hormone, so replacing it with Cortef can give rise to side effects. Pellet hormone replacement therapy might not be for suitable for people with adrenal fatigue. Your systems are overburdened in adrenal fatigue and not in a position to handle the side effects that might occur in hormone therapy, especially from a hormone as strong as cortisol. Many people are unable to tolerate hydrocortisone, or Cortef. A small minority actually feel worse. The weaker the adrenals and the more advanced AFS, the greater the risk. Making sure to understand your body and how it responds to the effects of hormonal supplementation could help prevent symptoms from worsening.

Testosterone Hormone Therapy

An image of a chalkboard with the word hormones on itHealthy levels of the steroid sex hormones testosterone and estrogen are essential for overall well-being. Both the hormones are present in men and women. However, women have higher estrogen levels, whereas men have higher testosterone levels. In men, testosterone levels gradually start to decline with age. Low testosterone levels in males are associated with symptoms of erectile dysfunction, reduced sex drive, muscle loss, fatigue, irritation, poor memory, increased body fat, brain fog, and depression.

Testosterone pellet therapy can help restore healthy levels of testosterone hormones in your body. The pellet implants consistently deliver a low dosage of testosterone into your body for a period of time. There are some possible side effects of testosterone pellet therapy. Some of the common side effects include fluid retention, reduced sperm count, smaller testicle size, and increased frequency of urination, sleep apnea, breast enlargement, and prostate enlargement. The therapy might also raise the risk of prostate cancer and heart attack.

Estrogen Hormone Therapy

During perimenopause and menopause in women, several hormonal changes occur within the body. The levels of sex hormones decline gradually, leading to unpleasant symptoms such as hot flashes, mood fluctuations, cognitive changes, night sweats, vaginal dryness, irregular periods, hair loss, osteoporosis, disrupted sleep, breast shrinkage, and urinary problems. In such cases, pellet therapy can help restore the lost hormones and reduce the negative symptoms. Numerous studies show a link between estrogen hormones and stress response. Estrogen is produced by the adrenal glands which are a vital part of your bodyā€™s NEM stress response system.

In menopausal women, estrogen pellets can help reduce the risk of osteoporosis by increasing mineral density, thus preventing bone fractures. Studies show that long-term estrogen pellet hormone replacement therapy can help reduce bone loss in postmenopausal women. However, according to evidence, discontinuation of hormone therapy can often cause more rapid bone loss than before.

Some of the side effects of hormone replacement therapy include headache, breast tenderness, nausea, bloating, and leg cramps. In natural bioidentical hormone therapy, estrogen, when used along with progesterone, can cause certain health risks. Studies have linked hormone therapy in women with increased risk of breast cancer, so it is important to do your research and discuss with your doctor what options might be safe for you.

The symptoms and risks related to hormone therapy largely vary from person to person. Therefore, a thorough evaluation is required to understand whether or not the side effects and risks are worth bearing for reducing the symptoms of menopause or other hormone imbalance.

Precautions for For Pellet Hormone Replacement

There are various types of hormone replacement therapies including skin creams and gels, skin patches, nasal sprays, vaginal ring, pills, and pellet. Each of them comes with their own set of side effects and pellet hormone replacement therapy is no exception. Therefore, it is important to take precautions prior to undergoing therapy.

Before undergoing pellet therapy, be sure to plan for the following:

  • Check for FDA approval. Customized and compounded bioidentical hormones used in pellet hormone replacement therapy are often advertised to be a natural and safer alternative to conventional hormone therapy. However, large-scale studies do not support this. Further, compounded products lack FDA approval, thus posing risk regarding their safety and purity. They do not comply with safety measures. For example, many include the addition of the extra hormone progestin, which increases cancer risks.
  • Look out for the presence of additional hormones. Though custom hormone combinations make use of FDA approved ingredients, such as plant-derived micronized progesterone, they also include additional hormone varieties such as DHEA and estriol which are not FDA approved products. Further, compounded bioidentical hormone pose the risk of infection and bleeding, have a higher risk of overdose, and lack information on the rates of release.
  • After insertion, be ready to avoid water and exertion. Insertion of pellets can cause bruising, minor bleeding, local nerve irritation, lumping, infection, and discoloration. In pellet hormone replacement therapy, extended exposure to water or moisture is to be avoided (swimming, bathtubs, hot tubs). Vigorous physical activity is to be avoided for around a week after pellet insertion. Diabetics and people with recent joint replacement can be given antibiotics to avoid any infection from the incision.
  • Take time to research the side effects. Research shows that hormone therapy can increase the risk of blood clots, stroke, cardiovascular disease, and gallbladder disease. Hormone therapy in older women for an extended period can raise the risk of breast cancer and heart disease. Many claim that bioidentical hormones are safer than regular hormone therapy. However, large scale research suggests that bioidentical hormones do carry certain risks and side effects.Hormone supplementation has a powerful and often irreversible effect on the body. Therefore, prior to undergoing the therapy, it is highly recommended that you spend time analyzing the side effects and risks involved. Further, the unpleasant symptoms of pellet therapy vary from person to person. While some might find pellet therapy as an effective solution to balance hormone levels, for others the therapy might cause unpleasant symptoms. Before hormone therapy produces a significant impact on your health, make sure to evaluate if the risks are really worth reducing the unpleasant symptoms of hormone imbalance.

Hormone Imbalances Due to Stress

Many hormone imbalances are caused by aging, but these conditions can often be worsened by stress. Hormone imbalances that are caused by stress bear special mention because the factors that cause them can be ongoing and create a cycle of symptoms that supplementation alone does not solve. Many of these imbalances start with the adrenal glands, which are the main organs responsible for responding to stress.

The adrenal glands secrete numerous important hormones. Excess stress can overburden your adrenal glands, decreasing the secretion of crucial hormones, including cortisol. This leads to deficiency or imbalance of hormones in your body. Hormone imbalance can lead to various health issues including thyroid problems, hair loss, mood swings, memory degradation, infertility, and adrenal fatigue. Stress is a major contributing factor to hormone imbalance in your body. Therefore, managing stress can significantly help in preventing adrenal exhaustion and maintaining healthy levels of hormones in your body.

NEM Hormone CircuitThe adrenals are not alone in managing stress. The NeuroEndoMetabolic (NEM) Stress Response is your bodyā€™s natural stress-fighting system. It is an intricate network of various organs and six circuits including the Hormone circuit. During stressful situations, the NEM signals your adrenals through the Hypothalamus-Pituitary-Adrenal (HPA) axis to secrete the anti-stress hormone cortisol to deal with the stress. However, constant stress can leave your body overburdened. Your adrenals become fatigued and unable to secrete adequate cortisol. This, in turn, reduces your bodyā€™s natural stress-fighting ability, which can lead to adrenal fatigue. Disrupted cortisol produces symptoms including decreased muscle mass, disturbed sleep, increased wound healing time, and high blood pressure. It also leads to extreme fatigue along with symptoms of brain fog, low concentration levels, low energy levels, difficulty in waking up, insomnia, constipation, stubborn weight gain, or craving for salty and fatty foods, which could be indicative of Adrenal Fatigue Syndrome (AFS).

The Hormone circuit of the NEM includes the ovaries/testis, thyroid, and adrenal glands. It is responsible for regulating stress hormones (including cortisol), body temperature, and thyroid hormones. Any imbalance in this circuit can lead to weight gain, thyroid problems, fatigue, hair loss, reduced libido, miscarriage, and infertility. Imbalances in cortisol cause hormone imbalances leading to a dysfunctional Hormone circuit. This affects your bodyā€™s NEM stress response system.

Hormonal replacement therapy can help restore the normal level of hormones in your body. There are various types of hormone therapies among which pellet hormone replacement therapy is considered to be one of the most natural. However, if you do have adrenal fatigue, hormone replacement may not be a good idea for your body right now.

Hormone Replacement Should Be A Last Resort

Your bodyā€™s stress response system and hormones are deeply connected. Healthy levels of hormones in your body keep the Hormone circuit in balance, which is essential for the effective functioning of the NEM system. Any imbalance in the hormone levels directly affects your bodyā€™s stress response system.

Various factors such as age, stress, nutritional deficiency, medication, trauma, and prolonged stress can cause imbalanced hormones. Knowing the underlying causes of hormone imbalance can help in effectively dealing with the problem. In several cases, altering eating habits and lifestyle can help in normalizing your hormone balance without the need for hormone replacement therapy.

Each of the various approaches to increasing hormone levels in your body comes with its own set of risks. Pellet hormone replacement therapy is considered one of the most natural methods of delivering bioidentical hormones into your body.

However, hormone therapy in any form should be the last resort. When hormone supplements are introduced into your body, the natural feedback loops which enable your body to self regulate get disrupted. Further, in clinical trials, the results are uncertain. Carefully measuring your hormone levels beforehand, starting at a low dose, setting a clear timeframe for planned hormone use, and having an exit strategy can help minimize issues with tolerance, resistance, and dependency on supplementation.

Fortunately, your body is capable of self-regulating in most situations. You can in many cases avoid needing any form of hormone replacement therapy, natural or synthetic, by allowing your body to heal itself naturally. In people with adrenal fatigue, hormone replacement therapy can be avoided by optimizing the function of the adrenal glands. There are also natural solutions to replace hormones without the use of supplementation or hormone replacement.

Exposure to moderate sunlight, maintaining a nutritious diet, getting restorative sleep, minimizing stress, and getting regular exercise can help in balancing your hormone levels. All these methods can help boost your adrenal health, maintain a healthy level of hormones, and help alleviate AFS symptoms. However, implementing these solutions in your everyday busy schedule can prove quite tricky, so it can be wise to seek out support professionals, groups, and plan to start slowly.

Conclusion

An image of an older woman sitting on the couch holding her forheadWith aging, the level of certain key hormones such as estrogen, progesterone, and testosterone gradually decreases. Further, many other factors can cause hormonal imbalances in your body. When the level of hormones goes out of balance, it directly affects the stress response. Pellet hormone replacement therapy can help restore your bodyā€™s hormone balance and minimize the side effects. It is regarded as the most natural method to deliver bioidentical hormones to your body. During the therapy, pellet implants are placed under the skin. The implanted pellet under the skin delivers a consistent healthy level of hormones into your body for three to six months based on the dosage. Consistent release of hormones, accurate dosage, hassle-free hormone administration, and effectiveness makes pellet therapy unique when compared to other hormone therapies.

Hormone therapy whether natural or synthetic comes with a set of risks and side effects, including cancer, which are often irreversible and can last for a lifetime. Each person responds differently to the therapy and its associated side effects. Therefore, prior to undergoing any hormone replacement, it is crucial to carefully investigate the facts and evaluate if the therapy is worth its side effects.

There exist numerous natural and effective solutions that can help restore a healthy level of hormones in your body. Plus natural solutions are effective and safe without any damaging side effects. Understanding your body and implementing natural methods is the key to maintaining a healthy balance of hormones for optimal health and wellbeing.

 
© Copyright 2020 Michael Lam, M.D. All Rights Reserved.


Dr. Lam's Key Question

No, it is probably not a good idea. Adrenal fatigue is caused due to imbalanced cortisol levels. Pellet hormone replacement therapy is used to restore your bodyā€™s normal hormone levels. However, the therapy has its own share of side effects. Adrenal fatigue suffers have a weak body and are not in a position to handle the side effects of this therapy.

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