At Living Wellness Medical Center, we specialize in bioidentical hormone replacement therapy. There are many methods to introduce hormones into the body, from pellets, lozenges, creams, troches, or capsules. However, in this blog post, Dr. Brouwer and Dr. Turner are discussing pellet therapy and how this method differs from the rest.
Question #1: What makes a patient a really good candidate for pellet therapy?
Dr. Brouwer: Choosing to do hormone pellets as the delivery system for hormones is just a personal choice. You can use capsules or troches, lozenges, creams; all sorts of different ways, but people that really like to do the pellets is mostly because of convenience. It’s a very convenient way to do it because you get a pellet placed once every three months instead of having to do something every day.
When it comes to testosterone replacement therapy, I think a good candidate for pellets would be men who are over the age of 40 or with low testosterone levels. Women who are post‑menopausal or even in peri‑menopause (before our ovaries stop making hormones altogether) can still use testosterone pellets effectively.
Question #2: How long do the pellets last in a male versus a female?
Dr. Brouwer: They last around three to four months for men or women. However, they can be used up faster if you’re very athletic and very active.
Question #3: What are the different types of hormones that you can get in a pellet?
Dr. Brouwer: Well, the pellets that we do here at Living Wellness Medical Center are estradiol, which is the estrogen that’s most commonly used in hormone replacement therapy, and testosterone.
Question #4: If a woman has been on hormone replacement therapy already can she transition from other methods (cream, troche, lozenge, etc.) to pellets?
Dr. Brouwer: Certainly! For estrogen or for testosterone but not for progesterone.
Because progesterone needs to be taken orally. It doesn’t go through the skin well. Pellets are considered a topical application since the hormone is picked up through the blood vessels of the skin and then distributed. Progesterone just doesn’t go through the skin very well that way.
Question #5: Can you describe the procedure of putting in the hormone pellet?
Dr. Brouwer: It’s an easy procedure done in our office and probably takes around 15 or 20 minutes to complete. The only thing we need to know before we do the procedure is if somebody is sensitive to lidocaine, as that’s the numbing agent we typically use at Living Wellness Medical Center.
We inject a little bit of lidocaine under the skin and make a tiny incision that’s about a quarter inch long. Then, we put the pellets in subcutaneously (under the fat and deep under the skin) so you won’t feel it at the surface because it’s very far down under the skin. Lastly, We put the pellets in and then tape the area shut with Steri Strips.
As far as the pain level, I think the worst part of the procedure is the numbing because lidocaine can really sting as you’re injecting it.
Question #6: Does the lidocaine feel like a little bee sting?
Dr. Brouwer: Yes it’s like a little bee sting which you could be familiar with if you’ve ever had numbing at the dentist’s office. Lidocaine is the same thing that they use, so it’s easy and simple.
For aftercare, what people need to know is that when you’re going to get your pellets done, for the next three days you’re not going to do any kind of heavy duty exercise. This is because where we place them is right in the back, above the hip, in that little fatty area, or the little muffin top area.
That area is right over your gluteus muscles which are your butt muscles, and when you’re exercising (for example: doing squats, lunges, biking, steep hiking) that’s going to irritate it a little. So for three days no heavy duty exercise and no intense yoga. That’s really the only restriction to know about.
Question #7: What about pain after the procedure? Is the hormone pellet something that will hurt later?
Dr. Brouwer: It really shouldn’t hurt. If we get the placement right, it’s going to be in tissue that’s undisturbed. Because I’m putting a foreign object into your body, of course, your body is going to have a reaction to that. Your body is going to start some healing and you’ll have a little tenderness, maybe a little tiny bit of swelling. However, the area shouldn’t be hot and it shouldn’t have any kind of redness reaction. Pain would be a bad reaction, but normally after a couple of days, even that little bit of tenderness goes away.
Actually, I did pellets for a patient, and she said how comfortable it was getting it done in our office. She mentioned that she’s had it done elsewhere and that she had pretty severe pain for four or five days afterward. But that’s just not my experience, I’ve never had that happen. The technique, placed correctly, done right you shouldn’t have pain in the next day’s other than just a little tiny bit of bruising.
Hormone Pellet Therapy Free Consult
If you are interested in hormone replacement therapy or if you have questions about the hormone pellet, we can do a free 10-minute consultation with you. To schedule a free ten-minute consultation, click here or call 480-588-6856.