Hormone Pellet Therapy Side Effects Explained

brandon llewellyn | 22 August, 2022

            Hormone Pellet Therapy Side Effects Explained

Hormone pellet therapy is a safe, simple, and inexpensive method of replacing or regulating hormones in both males and females. Males may be treated with hormone pellets for steady, regulating augmentation of testosterone levels.

Females past the age of menopause may be given hormone pellet therapy with analogs of estrogen and progesterone to relieve disagreeable symptoms without increased cancer risk. Transgender people may receive hormone pellet therapy as part of their transition.

Like every other therapy, hormone pellet therapy requires balancing benefits with risks. The side effects of hormone pellet therapy are rare, but not unknown.

How Do Hormone Pellets Work?

A hormone pellet is an implant that a health professional inserts beneath the skin with a device called a trocar. Most commonly, the pellets are manufactured in small batches by compounding pharmacists using bioidentical hormones extracted from plants. However, there are also hormone pellets that contain synthetic testosterone which has to be processed by the liver before it becomes biologically active.

How Effective Are Hormone Pellets?

Hormone pellets are therapeutically distinctive from other forms of hormone replacement and augmentation.

  • Unlike hormone replacement in the form of gels and creams, hormone pellets are fully absorbed. Gels and creams interact with sweat. They can be rubbed off by friction with clothing.
  • Unlike hormone replacement by injection, hormone pellets deliver continuous hormone replacement. Hormones are continuously metabolized by liver enzymes, but they are also continuously released by the pellets for several months.
  • And unlike orally administered hormone replacement, hormone pellets do not have to pass through the digestive tract and hepatic portal vein into the liver before they are absorbed by the body. They are not affected by irregularities of digestion and absorption.

Although there are synthetic forms of testosterone such as Testopel that are also given in the form of injected pellets, most hormone pellet therapy involves bioidentical hormones. There are several advantages of bioidentical hormones over synthetic hormones:

Bioidentical hormones such as estradiol, estriol, and progesterone possess the same chemical structure as the hormones that naturally occur in the human body. Synthetic hormones, for example, Premarin and Provera, have to be activated by the liver into a form to which target tissues can respond.Oral hormone replacement therapy is sent directly to the liver and can compete for enzymes the body needs for general health. These enzymes may be in short supply when the liver is diseased.

Also, because bioidentical hormone pellets are made in small batches by compounding pharmacies, it is easy to adjust dosages. Synthetic hormones are mass-produced by pharmaceutical companies in a small number of dosages.

What Are the Side Effects of Hormone Pellets?

In treating hormone deficiency in women, it is important to keep in mind that there are a few instances in which synthetic hormone replacement therapy is objectively better.

For instance, estrogen replacement therapy needs to be balanced by progesterone replacement therapy to mitigate a small increase in the risk of uterine cancer when estrogen replacement is used as monotherapy.

So, why not just get the compounding pharmacy to make pellets that contain both bioidentical estrogen and bioidentical progesterone?

The problem is that hormone pellets release hormones continuously.

While women are still menstruating, their estrogen levels peak just before periods and their progesterone levels peak just before ovulation. They don't have the same estrogen and progesterone levels all the time.

TheWomen's Health Initiative ran a clinical trial involving 16,608 women who received either synthetic estrogen plus synthetic progestin or a placebo for five years. They stopped the study when they observed that continuous progestin therapy (with the synthetic form of progesterone) increased the risk of breast cancer, heart attacks, and strokes.

Women who have passed menopause can still benefit from progesterone replacement, but it needs to be cyclical not continuous. The best way to give cyclical progesterone replacement is with a skin cream, not with a pellet or an injection or a pill. And it turns out that synthetic progestin is better absorbed through the skin than bioidentical progesterone.


What Are the Benefits of Hormone Pellets?

The relationship of estrogen deficiency in women to Alzheimer's, heart disease, colon cancer, gall-bladder disease, diabetes, and osteoporosis is well-established. The previously mentioned Women's Health Initiative Study found that hormone replacement therapy reduced the risk of diabetes by 14 to 19 percent and the risk of urinary incontinence by as much as 50 percent. And almost any woman who has gone through menopause will attest that estrogen deficiency is associated with mood changes, dry skin, vaginal dryness, hot flashes, night sweats, chills, and weight gain.

While women seek estrogen and progesterone replacement therapy for relief of a wide range of symptoms, men usually seek testosterone replacement therapy for a single concern, such as infertility, sexual dysfunction, or general physical condition. Hormone pellet therapy is the treatment of choice for women who would benefit from continuous bioidentical estrogen replacement therapy and for men who would benefit from long-term testosterone replacement therapy.

First-time patients may need brief counseling before insertion of the pellets. They need to know that the trocar makes a small (3.2 mm) incision through the skin and the fascia,so small that it does not need stitches.

However, patients need to be counseled to keep the incision bandaged as directed for 2 to 3 days. Since the fascia is affected by muscle movement, they need to understand that exercise or other strenuous activity until the wound begins to heal.

And patients need to be reminded that follow-up visits and lab work are essential for verifying that they are receiving the right amount of hormone replacement therapy.

Trocar Supplies offersdisposable medical tray kits and trocar wrap kits for inserting extended-release hormone pellets. Our products are designed to minimize the risk of herniation and infection, and to leave patients with the least possible discomfort after the insertion procedure.

Do you have questions? Call us at(937) 478-0469 orcontact us online.