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Bio-identical hormone pellets are concentrated hormones biologically identical to the hormones you make in your own body. Estrogen, progesterone and testosterone are derived from the female ovaries (primarily) and adrenal glands (secondarily) prior to menopause.

Testosterone is a hormone produced by the ovaries and adrenal glands in women. In the medical research, testosterone supplementation in women has been shown to improve fatigue, exercise intolerance, muscle tone, libido, weight, decrease depression, anxiety and mood disorders and other conditions.

Though laboratory assays can support a diagnosis of testosterone deficiency, they should not be used to exclude it as there are multiple problems in the measurement of testosterone (ex. dietary intake, sexual activity, sample storage variables, circadian variations). Greater reliance on the clinical features and consideration of symptoms is suggested as an appropriate tool in treating women with testosterone therapy. There is no generally accepted "normal" level of testosterone for women. It is reasonable to prescribe testosterone to a woman who has symptoms of low and to expect total testosterone values that are supraphysiologic after treatment.

All testosterone use in women is considered "off-label". Off label use refers to the use of any medication for something other than its FDA approval. Many medications prescribed in the US are prescribed for off-label use. The off-label use of testosterone therapy has not been evaluated by the FDA and any claims of benefit are purely educated opinions that come from consideration of various medical research studies. It is reasonable to expect a supraphysiologic testosterone laboratory value after pellet therapy is initiated.

Hormone pellet production is highly FDA regulated; however, the pellet insertion procedure is not an FDA approved procedure for hormonal replacement.

Goals for treatment with this medication will be discussed at each appointment. If goals are met, then maintenance doses will be discussed. If the treatment is not as effective as anticipated, it might be discontinued; at that time, alternative therapies will be discussed. You are welcome to seek a second opinion or a specialist consultation.

The safety of hormone therapy during pregnancy cannot be guaranteed. Notify your provider if you are pregnant, suspect that you are pregnant or are planning to become pregnant during this therapy. Continuous exposure to testosterone during pregnancy may cause adverse effects in the fetus.

SIDE EFFECTS: Side effects of subcutaneous hormone pellets will be managed clinically and individually. There have been no reported irreversible side effects of subcutaneous pellet therapy noted in the literature.

Potential side effects of pellet insertion may include, but not limited to: Surgical risks are the same as for any minor medical procedure. Bleeding, bruising, swelling, and pain; extrusion of pellets; infection or abscess formation; seroma formation; scarring at insertion site; keloid scar.

A significant hormonal transition will occur in the first 3-6 weeks after beginning your BHRT regime. Therefore, certain changes might develop that can be bothersome.

• FLUID RETENTION: Testosterone stimulates the muscle to grow and retain water, which may result in a weight change of two to five pounds. This is only temporary. This happens frequently with the first insertion, and especially during hot, humid weather conditions.
• SWELLING OF THE HANDS & FEET: This is common in hot and humid weather. It may be treated by drinking lots of water, reducing your salt intake, taking cider vinegar capsules daily, (found at most health and food stores) or by taking a mild diuretic, which the office can prescribe.
• UTERINE SPOTTING/BLEEDING: This may occur in the first few months after an insertion, especially if you have been prescribed progesterone and are not taking properly: i.e. missing doses, or not taking a high enough dose. Please notify the office if this occurs. Bleeding is not necessarily an indícation of a significant uterine problem. More than likely, the uterus may be releasing tissue that needs to be eliminated. This tissue may have already been present in your uterus prior to getting pellets and is being released in response to the increase in hormones.
• MOOD SWINGS/IRRITABILITY: These may occur if you were quite deficient in hormones. They will disappear when enough hormones are in your system.
• FACIAL BREAKOUT: Some pimples may arise if the body is very deficient in testosterone. This lasts a short period of time and can be handled with a good face cleansing routine, astringents and toner. If these solutions do not help, please call the office for suggestions and possibly prescriptions.
• HAIR THINNING: Is VERY rarely caused by the addition of hormones, including testosterone. More often a woman's hair has been thinning or dormant for a long time because of the lack of hormones. Once hormone therapy begins, the hair follicles wake up and begin to do their job- shed old hair and grow new hair. This can last several weeks and be very disconcerting, but rest assured it is normal and is a sign of healthy metabolism. Supplements and over the counter topical Rogaine helps slow down the shed stage and may be helpful. Your provider may also have other topical options available during this transition to lessen the shedding.
• HAIR GROWTH: Testosterone may stimulate some growth of hair on your chin, chest, nipples and/or lower abdomen. This tends to be hereditary. You may also have to shave your legs and arms more often. Dosage adjustment may reduce the problem but rarely will eliminate 'it.

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