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Health with Hormones

By Meagan Russell
In Center Block
Jan 1st, 2022


Article By Meredith McKinnie

Bioidentical hormone replacement therapy is an individualized approach to treat hormonal imbalances in men and women. “Bioidentical” means plant-based, identical to what one’s body would normally produce. As many patients are in search of a more natural form of treatment, the pellet form of hormone replacement is ideal. The implanted pellet is similar in size to a grain of white rice and can be inserted right under the skin, the subcutaneous area. The pellet slowly dissolves over a 3-6-month period, depending on various factors such as the type of patient or individual body chemistry. The steady state of absorption into the body results in less risk factors and often fewer side effects than traditional hormone therapy dependent upon pills, patches, or creams. 

The pellet treatment is completely individualized to each patient based on preliminary lab work and patient symptoms. After a simple blood draw, they check a patient’s existing hormone levels and make sure the patient is up-to-date on overall wellness. For females over 40, providers make sure a current mammogram has been performed. For males, providers check for prostate specific antigens. Six to eight weeks after the initial treatment, follow-up lab work is performed to address any necessary dosage adjustments. As long as a patient is feeling well and hormone levels are optimized, lab work only must be performed every 6-12 months based on the provider’s discretion. The implantation procedure is simple, with little to no pain to the patient. Many pellet recipients only report slight discomfort with the injection of the numbing medication (lidocaine), a slight sting with the initial prick. The incision is small, only three millimeters and doesn’t require a stitch, typically in the fat pads of the upper buttocks. Once the pellet is placed under the skin, the area is covered with a waterproof bandage. Typically, females must leave on the dressing for three days; men might have to leave on the dressing for up to five days due to a larger dose of required testosterone. The injection site may feel like a slight bruise for a few days, though many patients report not feeling anything post-procedure. Patients are immediately allowed to return to work, though they should refrain from any strenuous exercise until the dressing can be removed. 

After implantation, the hormones take about a week to absorb into the bloodstream, and feelings of well-being continually increase for 4-6 weeks. Hormone replacement therapy helps to optimize existing hormone levels and can begin alleviating associated symptoms within a week. For example, testosterone is often considered a male hormone, but it is extremely important for women as well and is not just related to sexual function. Increased testosterone can help improve sleep, energy throughout the day, concentration, skin texture, lean muscle mass, metabolism, and female libido. When testosterone drops, females often experience increased anxiety, feelings of depression, concentration issues, and brain fog. Perimenopause can begin in a woman’s 30s causing hot flashes and aforementioned low-testosterone symptoms. As a result, many women begin taking testosterone alone to stabilize levels and reduce symptoms. During menopause, combination treatments of estrogen and testosterone work well together, with increased levels also reducing existing symptoms. Pellet hormone therapy is best for optimizing an individual’s hormone levels.

Patients for bioidentical hormone replacement therapy vary in age and gender. Due to medical issues, some women require a complete hysterectomy in their 20s. Ovaries help protect a woman’s heart, bones, and mind. If those hormones are not replaced in someone very young, quality of life is drastically reduced and life expectancy even goes down. For patients with a history of breast cancer, traditional estrogen supplements pose a significant risk to overall health. For too long, hormone therapy providers didn’t have much to offer them. Prior breast cancer patients had to suffer through hot flashes, mood swings, and vaginal atrophy. Now with testosterone therapy via pellet implantation, those patients have options. Crystal Sanches, a Nurse Practitioner at Louisiana Center for Women’s Health has been consulting with oncologists after patients’ breast cancer treatments to offer testosterone therapy. Sanches says, “It’s great having oncologists on our side. It’s such an improvement for breast cancer patients who traditionally would have no hormone treatment options.” 

Many patients go directly to bioidentical hormone replacement therapy before trying other methods. While there are certain risk factors with any kind of hormone treatment, pellets offer less risk due to their individualization by patient. With oral estrogen, some risk factors include stroke, blood clot, and heart attack. Any patients with a personal or family history of any of the aforementioned risk factors should consider the pellets. The most risk of side effects come with oral hormone replacement. Transdermal patches and creams reduce the risk of side effects, but bioidentical hormone replacement poses the overall lowest risk. 

If one is unsure if they are a candidate for hormone replacement therapy, consider existing symptoms. Do you feel tired all the time, even after adequate sleep? Do you get more tired throughout the day, perhaps experience the afternoon slump? Do you aggravate easily or have increased anxiety or feelings of depression? Do you suffer from brain fog or reduced concentration? Have you noticed aching in your bones or joints? These are all signs of hormonal fluctuation. Women in their mid-30s and beyond should start thinking about their hormone levels. While some women have been put on antidepressants to address common hormonal imbalance symptoms, treatment therapy allows some of them to reduce their antidepressant dosage or come off the medicine altogether. 

Crystal Sanches claims, “If I can take people off medicine, that’s really my goal.” Sanches, age 43, has been using bioidentical hormone replacement therapy for the last three years. She never imagined her symptoms could be due to low testosterone. She was just living life – married, with two children and a full-time job. She assumed being tired was just part of it. After checking her hormone levels, she noticed her testosterone was really low. Almost immediately after the pellet implantation, Sanches noticed the small improvements. She started sleeping through the night for the first time in years. She felt better throughout the day and had more patience with her children. 

Dr. Laurie LeBleu, an OB-GYN at The Woman’s Clinic, has been on bioidentical hormone replacement therapy for the last 11 weeks. After noticing low testosterone levels, Dr. LeBleu decided to try the pellets and is extremely happy with the results. After battling with fatigue, sleep issues, and irritability, Dr. LeBleu noticed a difference two weeks after the initial pellet implantation and felt like a completely different person after four weeks. The Woman’s Clinic has been offering Biote hormone therapy for three months, and patients are also incredibly excited about the results. The high-quality Biote pellets are available in the Woman’s Clinic office. After initial lab work, the hormone therapy consultation and implantation can be performed during the patient’s next visit. Like herself, Dr. Le Bleu’s patients report “more energy, better sleep patterns, and they just feel good.” 

Nurse Practitioner Elizabeth Hoskins at Professional Laser Center prescribed bioidentical hormone replacement therapy to one of her patients who had been using creams to address hormonal imbalances. After a combination therapy of estrogen and testosterone, the patient reported feeling better, with more effect from the pellets than the creams. Hoskins notes that only 10% of creams are actually absorbed by the body. Likewise, transdermal patches can come off the skin easily. The continuous release of the pellets allows for optimal absorption. 

Hormonal imbalance disrupts living. Collectively, those minor symptoms can cause significant decreases in quality of life. Reaching out to your local OB-GYN or Nurse Practitioner for more information on hormone treatment therapy can make all the difference. 

This article is only meant to inform, please consult with your physician before making any medical decisions.