No. Testosterone is found and needed in both males and females and plays a large role in women’s health. Women make testosterone in both their ovaries and their adrenal glands.

Some studies state that women begin to decline in testosterone in their 20s, and they can see a significant reduction in testosterone production by the mid 30s. By age 40, most women have lost approximately 50% of their testosterone production.

Women over the age of 35 should consider bioidentical testosterone replacement therapy in order to protect against osteoporosis, dementia, insulin resistance, excess body fat, decreased libido, wrinkles, and stronger hair.

Pellets are small, dissolvable implants that are placed under the skin. They are naturally sourced, plant derived (typically from yam root). They are well tolerated, and treatment is individualized. And with an implanted hormone pellet, there’s nothing to forget! The pellets work for months at a time through a constant, steady release of hormone, regulating blood hormone levels at a steady state. There are no erratic ups and downs in hormone levels, avoiding the fluctuations that can occur when using creams, pills or patches.

One of the largest reported retrospective studies to date looked at over 1 million pellet procedures over a 7 year span (from 2012-2019). The overall complication rate was <1%. The most common response reported was pellet extrusion (the pellet comes out), which was more common in men (<3%) than women (<1%). The safety of subcutaneous hormone pellet implants in men and women appears to be better than other routes of administration of bioidentical hormone replacement therapy. PMC8165877

Since pellets are bioidentical, your body recognizes them as your own. So there is no concern for any type of “allergic reaction.” The risk of infection or irritation is also rare. Scarring is minimal and the incision site is smaller than the size of a pencil eraser. Mild tenderness and bruising can occur but typically resolve within a few days.

No. Unlike oral estrogens and birth control pills, pellets avoid the “liver pass,” which means your liver is protected and clotting factors are not affected. Studies actually reveal that long term therapy is heart and brain protective.

No. HRT can actually reduce the risk of breast cancer by 23% and colon cancer by 37%. Additionally, women who are diagnosed with breast cancer, who are taking HRT at the time of diagnosis, have a reduced mortality rate of 40%. And, those with the BRCA gene who take HRT have less risk of developing breast cancer and less risk of dying from breast cancer. https://www.bmj.com/content/367/bmj.l5928/rr3#:~:text=Evidence%20suggests%20that%20there%20are,safer%20choice%20than%20synthetic%20progestins.

There is also no conclusive evidence that androgen replacement therapy for men is an independent factor for the development of prostate cancer. Overall, the current clinical data seems to suggest that androgen replacement is an appropriate therapeutic option for men with symptomatic hypogonadism provided that patients continue to receive regular prostate screenings. PMC3424887

Pellets were initially developed in Europe and have been used to treat women since the 1930s! They were used for women post hysterectomy until the development of synthetic and equine hormones in the 1940s. Over the past several years with continued research, more and more individuals, both men and women, are undergoing pellet therapy as they are convenient, well tolerated, and individualized.

The initial step in BHRT is to schedule a consultation. At this visit we will thoroughly review your personal and family medical history, discuss goals of therapy, and draw initial full panel labs. Once your labs are resulted, they will be reviewed with your history to determine your eligibility. If you are deemed a candidate for BHRT, you will then be scheduled  for an appointment for the in office procedure.

Prior to pellet insertion, you will sit down with one of our providers and thoroughly discuss your most recent labs and plan, answering all questions. Our main goal is to make sure you are well informed of the benefits, risks and expectations of treatment. Just as there are risks to an intervention, there are also risks of not. We will then get your blood pressure and full set of vitals and discuss the procedure in detail. You are then placed on your side with your legs slightly bent. The lower back/upper back/buttock is exposed, cleansed and prepped. A small injection of lidocaine is placed to the area of insertion (over about 5-10 seconds). This is typically the only discomfort of the entire procedure, as the area is then numb. Past this point you should only feel pressure, no sharp pain. The area is again cleansed and a sterile drape is placed. A very small incision is made (smaller than the charging port on your iPhone- take a look). The hormone pellets, which are bioidentical and plant based, are placed into the tissue below the skin. Men can recieve several pellets dependent on dosage, and females usually receive 1-2. Steri strips (small bandage) are placed to close the area (no stitches or suture to remove later) and a larger dressing is placed on top. TOTAL TIME OF PROCEDURE: typically less than 5 minutes.

Patients can begin to feel the effects of pellets in as early as a week, but most patients may not feel the effects for about 2-3 weeks. You will return for blood work at the 5 week mark to evaluate your levels post insertion. At this point, which we call the “5 week peak,” you should notice some symptom control.

The procedure is typically repeated every 4-6 months as needed, based on blood work and symptoms. Most women are redosed around 4 months, where some men may go as long as 6 months.

Majority of the time, insurance will not cover the expense of BHRT and we operate on a self pay model. We do have reimbursement forms we are happy to fill out for you if you would like to try and file with your insurance company for reimbursement. We also have financing options available.

Decisions about your treatment length will depend on your unique symptoms, how well you respond to BHRT, and any side effects of hormone replacement. Hormone therapy can be continued as long as you desire and be stopped at any time. We do encourage you that once you start a treatment with us, that we work together for at least 6 months, or two rounds of pellets, to see how your body adjusts. If treatment is discontinued, fatigue, low mood and sleep disturbances can recur as the pellets slowly dissolve.

Yes. Although most patients notice improvement in symptoms within 3 to 4 weeks, it could take up to 6 months, or at least 2 cycles, for those new to BHRT to notice significant change and full optimization. A patient’s age, weight, activity level, metabolism, and male/female can affect dosing and length of benefit from treatment. Pellets can be used long term and they can be discontinued at any time. Discontinuation will lead to your hormones resting back at a pre-procedure range; they will not slow the natural production of your endogenous hormone levels.