Bioidentical Hormone Pellet Therapy
Pellet implants placed under the skin consistently release small, physiologic doses of hormones. Hormones delivered by the subcutaneous implants bypass the liver, do not affect clotting factors and do not increase the risk of thrombosis like oral methods can.
Hormone replacement using pellet implants have been used with great success in the U.S., Europe, and Australia since 1938. In fact, pellet implants were a very popular mode of hormone administration in the U.S. until the 1970s before many oral and topical commercial products were developed. Recently pellet therapy has become very popular with transgender patients.
What Are BHRT Fused Pellets Implants?
Hormone pellet implants are compounded using pure bioidentical hormones which are compressed in a sterile environment under high pressure. The hormone powder is compressed into very small cylinders.
The pellet is then inserted by a relatively simple in-office procedure done under local anaesthetic. The pellets are inserted subcutaneously (under the fatty lining of skin), either in the lower abdomen or the upper buttocks through a very small incision with a device called a trocar. The incision is then closed with surgical glue or sterile-tape strips. If inserted correctly, patients cannot feel the implants under their skin. Implants placed under the skin consistently release small, physiologic doses of bioidentical hormones, which have been shown to have many benefits.
Hormone Pellet Implants typically last between 3-6 months, depending on how rapidly the pellet dissolves and the hormones metabolized. The pellets do not need to be removed as they are completely dissolved by the body. The benefits may be felt within 48 hours by some patients, while in others it may take up to two weeks to notice a marked difference once the pellets have been inserted.
Are There Any Side-Effects of the procedure?
Complications are rare but include: minor bleeding, bruising, itching, infection, and pellet extrusion. Other than slight bruising any other complications are very rare.
Many pellet formulations include PVP (povidone). Patients may have an allergic reaction to the PVP so our pellets are PVP-Free to minimize the incidence of allergic reactions. Our pellets are made using a lipophilic matrix to maximize the integrity of the pellet. If needed an antihistamine works well for the itching.
If any infection occurs after insertion antibiotics such as Keflex are used to treat it.
Estradiol pellets are available with a doctors prescription from our pharmacy. They come in either a 3mm (thin but longer) or 4.5mm (fatter but shorter) diameter pellet size. The advantages of the 3mm pellet is that a smaller incision is required so tends to produce less scaring however having a larger surface area exposed they tend to dissolve and thus release faster giving higher peak levels but also wear off sooner – usually a month or more sooner compared to the 4.5mm pellet. The fatter 4.5mm pellet has a smaller surface area so tends to release slower thus lasting longer than a 3mm pellet but does not give as high peak levels and being fatter potentially can cause more scaring as a larger incision needs to be made. Please indicate which size is required when ordering.
How are hormones monitored during therapy?
Hormone levels should be measured every 2-3 months and once levels decline new pellets inserted. After the first year of therapy hormones tests may be followed less frequently as an appropriate dosage regime should have already been established.
Women are advised to continue their monthly self-breast exam and obtain a mammogram and/or pap smear as advised by their primary care practitioner.
Want more Information?
We recommend you discuss your options with your doctor.