Bioidentical Hormone Pellet Therapy
Research supports bioidentical hormone replacement therapy with pellet implants as an effective bio-identical method for delivering hormones in both men and women. 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 with a better understanding of the benefits of fused pellet implants for hormone replacement this mode of hormone administration has grown again in popularity in the U.S.
What Are BHRT Fused Pellets Implants?
Hormone pellet implants are compounded using pure bioidentical hormones (most often Estradiol) 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 3-5 months, depending on how rapidly the hormones are 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?
Generally, there are minimal side-effects associated with the pellet implant 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.
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.
Estradiol Pellets for Women
Estradiol pellets were approved by the TGA and commercially available in Australia until only recently when the company producing them decided to stop. It was considered an effective means for supplementing bioidentical estradiol.
Our laboratory produces 50mg and 100mg estradiol pellets. Pellets are 4.5mm ( in diameter) which is the same size as the Organon brand which was previously available in Australia. We specialise in sterile compounding required to make these pellets.
It is very important that while using estrogen pellets you must also use progesterone to counterbalance the estrogens and achieve the required hormone balance. Progesterone is not available in pellet form as the doses required are much greater than estrogen and the pellet required for progesterone would be the size of a golf ball equivalent to 40 or so standard pellets. We recommend using a progesterone cream for this.