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Pros, Cons, and Risks of HRT Pellets

Evidence-based Reviewed Article

Both women and men may experience changes in their hormone levels. This could occur for many reasons. In women, aging and going through menopause are the most common reasons. HRT pellets may help both men and women dealing with hormone issues.

Signs and Causes of Hormone Imbalances

An image of two healthcare professionals inserting a small whit thing into a metal tubeYour body goes through many changes as you get older. This is normal. One of these changes is a change in hormone levels. And it usually magnifies around the time women, for example, start on their menopausal journey. In most cases, this starts around the age of 45. Hormones are created by glands and other tissues that make up your endocrine system. They play a key role in many body processes, such as:

  • Sexual function
  • Reproduction
  • Circadian rhythm
  • Growth
  • Mood
  • Maintaining internal homeostasis, i.e., balance

Hormone Imbalance Causes

Many things can contribute to a hormone imbalance in your body. They include:

  • Aging
  • Hormone medications like birth control pills
  • Certain medications
  • Tumors
  • Stress
  • Cancer
  • Cancer treatments
  • Injuries
  • Trauma
  • Hyperthyroidism or hypothyroidism
  • Health conditions like Cushing’s syndrome or Addison's disease

Hormone Imbalance Symptoms

Both men and women may have similar symptoms of hormone imbalance. They also have some different symptoms, however.

Common hormone imbalance symptoms include:

  • Weight gain
  • Fatigue
  • Painful, stiff, or swollen joints
  • Increased thirst
  • Increased hunger
  • Urinating frequently
  • Anxiety and/or irritability
  • Depression
  • Hair loss
  • Dry skin

Women may also experience:

  • Increased hair growth on the chin or face
  • Acne
  • Vaginal dryness
  • Issues with their periods
  • Night sweats
  • Hyperpigmentation in certain areas like the neck and groin

Men may experience:

  • An increase in breast tissue
  • Tender breasts
  • Loss of muscle or bone mass
  • Problems in concentration
  • Erectile dysfunction

HRT Pellets (Hormone Replacement Therapy Pellets)

HRT pellets are a form of hormone replacement therapy that involves placing pellets under the skin. The hormones used in HRT pellets, called bioidentical hormones, are commonly sourced from plants. "Bioidentical" refers to their structure, as they have the same chemical structure as hormones naturally produced in the body.1

HRT pellets often contain a variety of hormones. In this instance, we refer to them as compounded bioidentical pellets. These pellets are individually crafted, considering a person’s specific hormone issues. Thus, these HRT pellets may contain estrogen, dehydroepiandrosterone (DHEA), and testosterone.

The HRT pellets may also contain other hormones like melatonin or thyroid, depending on the person’s hormone replacement needs. Also, because of the issues addressed by these HRT pellets and their specific composition, you may find that your skin looks smoother, your cognitive function improves, and you feel younger and healthier.

The Role of Key HRT Hormones

Estrogen

Estrogen is probably the most essential sex female hormone due to its role in female reproduction.2 Its beneficial influence on a woman’s menstrual cycle is also common knowledge. Due to its neuroprotective properties, this hormone can also promote brain health and help reduce the risk of dementia. Estrogen also plays a role in keeping skin supple and strong. The aging process, accompanied by a decline in estrogen levels, tends to make the skin thinner and dehydrated, resulting in skin dryness and wrinkles.

DHEA

DHEA, produced in the brain, gonads, and adrenal cortex, can act in the same way as estrogen, neurosteroids, and androgens. As a result, DHEA is involved in many functions in the human body.3 DHEA may:

  • An image of the representation of DHEA chemical compositionSupport adrenal health
  • Slow down the aging process
  • Improve cognitive function
  • Improve mood
  • Provide energy
  • Promote immune health
  • Build up muscle and bone strength

Testosterone

Also called the male hormone, testosterone keeps the body in a state of homeostasis for both men and women. This is especially important regarding bone health, the risk of heart disease, and sexual health.4 Testosterone may also improve skin elasticity and play a role in weight loss.

Importance of The Hormone Circuit

The Hormone circuit consists of the adrenal, thyroid, and sex glands. Dysfunction in any of these components affects the others as well.

Stress, for example, sees a drastic increase in cortisol production in the adrenal glands. This increase results from activating the NeuroEndoMetabolic (NEM) stress response apparatus when the Hypothalamic-Pituitary-Adrenal (HPA) axis sends out chemical messengers, i.e., neurotransmitters. While the production of certain hormones, such as cortisol, increases during this period, the production of other hormones decreases or stops. The usual hormone balance returns once the stressor goes away.

Under certain circumstances, the hormone balance does not return. This may result from stress, the aging process with a corresponding decline in the production of sex hormones, or any of the other reasons already mentioned. This imbalance may cause more stress on your body, further contributing to the adrenals producing more cortisol. This could result in health issues relating to adrenal fatigue as well as the numerous health issues that result from hormone imbalance.

Benefits of HRT Pellets

HRT pellets may offer many benefits as opposed to regular HRT. These include the following:

  • Relief of menopausal symptoms
  • Improved mood
  • Increased energy levels
  • Increased libido
  • Protects against health issues like heart disease and bone density problems
  • Reduction in body fat
  • May reduce the risk of certain types of cancer
  • Helps restore hormone levels
  • Avoids damage to the gut and liver because the hormones are directly absorbed into the bloodstream
  • Performed in an easy in-office procedure conducted two to four times a year
  • A reliable method of ensuring a scheduled, metered-out dosing of hormones

Side Effects of HRT Pellets

It takes about three weeks for people to start seeing an improvement in their symptoms after they start using HRT pellets. After the pellet is spent, you need to have it replaced. This usually occurs every three to four months.

The average time for HRT pellets is three years, depending on the person. Many men can safely continue this treatment for longer. However, the length of treatment with HRT pellets typically depends on the individual. The pellets are specially made according to an individual’s hormone requirements.

The most common side effects associated with using HRT pellets include the following:

  • Acne/frequent breakouts
  • Breast tenderness
  • Mood swings
  • Tiredness
  • Blurred vision
  • Bone density changes
  • Appetite issues
  • Menstruation issues
  • Nausea
  • Vomiting
  • Bloating
  • Stomach cramps
  • Libido issues

Most of the side effects take place after the first pellet. In most cases, the body adjusts after a while. Please talk to your healthcare provider if you do not see any positive changes within the first three weeks after insertion.

Individuals experiencing adrenal fatigue should exercise caution with hormone pellets, as there's a risk of overdosing. The body may not tolerate high hormone levels over an extended period. Once implanted, pellets are difficult to remove, making it challenging to adjust dosages. Therefore, it is advisable to explore other forms of hormone replacement therapy (HRT) that allow for daily adjustments to more accurately determine the appropriate stable dosage before considering pellet therapy.

HRT Pellets: The Takeaway

HRT pellets may prove a safer form of hormone replacement therapy than that which is conventionally used. This is because the plant hormones used correspond with those naturally made in the human body. You should always talk to a doctor if you are concerned you have a hormone imbalance and research the side effects and risks of any hormones you choose to take. If you'd like help determining if HRT is right for you, call our office at +1 (626) 571-1234.

© Copyright 2024 Michael Lam, M.D. All Rights Reserved.
References

Files, Julia A., et al. “Bioidentical Hormone Therapy.” Mayo Clinic Proceedings, vol. 86, no. 7, 2011, pp. 673-680,  https://doi.org/10.4065/mcp.2010.0714.

Farkas, Szidónia, et al. “Estradiol and Estrogen-Like Alternative Therapies in Use: The Importance of the Selective and Non-Classical Actions.” Biomedicines, vol. 10, no. 4, 6 Apr. 2022, https://doi.org/10.3390/biomedicines10040861.

Tang, Justine, et al. “The Utilization of Dehydroepiandrosterone as a Sexual Hormone Precursor in Premenopausal and Postmenopausal Women: An Overview.” Pharmaceuticals (Basel, Switzerland), vol. 15, no. 1, 29 Dec. 2021, https://doi.org/10.3390/ph15010046.

Polackwich, As, et al. “Benefits and Consequences of Testosterone Replacement Therapy: A Review.” European Endocrinology, vol. 9, no. 1, 2013, pp. 59-64, https://doi.org/10.17925/EE.2013.09.01.59.

Dr. Lam’s Key Question

HRT pellets may help a flagging libido because they can help restore your body’s hormonal balance. Do make sure to talk to your healthcare provider about the pros and cons of this form of therapy.

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