Bio-Identical Hormone Pellet Therapy

At DeRosa Medical, we only utilize bio-identical hormones in treating patients with hormonal deficiencies. Not only are they safer and more effective but they are the hormones which the brain fully recognizes and allow the body to restore itself to is previous young normal vital state.

Why Hormones Decline

  • Hormones decline as we age every year after the age of 30.
  • The human body was never designed to live as long as we are living today. Advances in healthcare, vaccinations, and sanitation and food preservatives have drastically increased life span. However, the glands that produce our hormones do not regenerate and continue to decline, producing fewer hormones with each passing year.
  • As we age, it becomes increasingly more important for both men and women to keep their hormones balanced to protect against fatigue, mood swings, disease, obesity and to enjoy an overall healthier sense of well being.

What does “bio-identical” mean?

“Bio-identical” hormones are compounds which are manufactured in the lab to have exactly the same chemical and molecular structure as the hormones that are produced by the human body. Though any hormone can be made to be “bio-identical”; the term is most often used to describe formulations containing estrogens, progesterone, and androgens.

By contrast, synthetic hormones are intentionally different. Drug companies cannot patent a bio-identical structure, so they most often invent synthetic hormones that are patentable (Premarin, Prempro, and Provera being the most widely used examples) or provide ‘bio-identical” hormones in a unique delivery so the delivery mechanism becomes patentable.

Why should I come to DeRosa Medical for hormone pellet therapy?

Though bio-identical hormones have been around for years (since the late 1930’s), most practitioners are unfamiliar with them.

Most practices which provide hormone therapy either only provide this therapy or are obstetrics/gynecologist. DeRosa Medical is an Internal Medicine practice that can manage your hormonal balance in conjunction with your overall healthcare and medical needs. Our providers looks at your hormonal replacement from a big picture approach and how it will affect your other medical conditions. This approach takes your whole mind, body and spirit in healing. At DeRosa Medical we can manage all aspects for your health care including hormone pellet therapy. You will not need a primary care doctor for your overall health needs, a gynecologist or urologist to do your annual reproductive well women/male exams, or other doctors just for your pellets. Our providers can help you with all of your medical needs.

If you would like DeRosa Medical to work closely with your primary care physician in regards to hormonal replacement; our providers will create a comprehensive program with open communication with your provider. We will provide them with consult and progress notes from your visits which will include the types and doses of the hormones you received.

Are bio-identical hormones better than synthetic hormones such as Premarin and Prempro?

We long ago concluded that the answer to this question is yes. But that doesn’t mean bio-identical hormones are perfect.

The great appeal of bio-identical hormones is that they are natural, and our bodies can metabolize them as it was designed to do, minimizing side effects. Synthetic hormones are quite strong; often producing intolerable side effects. Moreover, the compounded bio-identical hormones can be matched individually to each individual’s needs — something that’s just impossible with mass-produced synthetic products.

Are bio-identical hormones safer than synthetics?

European medical studies suggest that yes; bio-identical hormones are safer than synthetic versions. While this makes perfect sense, we must be cautious because they have not been well studied especially for long-term use. And in any case, we recommend that women and men never think of any drug as completely safe.

Let us note here that the WHI studies on the effectiveness and health risks of HRT were based on synthetic/equine-based hormones, and the average age of the women at enrollment was 63. These details did make a difference in their risk. Our providers will be able to discuss these studies with you in detail at your appointment.

What are the differences between pellets, transdermals (creams/gels/patches), orals and injections?

Pellet Therapy

Pellet therapy has been available in the United States since 1939. It is a sustainable delivery method for bio-identical hormone therapy and is an ideal hormone treatment that helps balance body chemistry and restores health and vitality in women and men suffering the symptoms of hormonal imbalances. The effect the pellets have is nearly identical to the way hormones are naturally produced in healthy 30-something year-old patient.

The long-lasting pellets make this hormone therapy treatment option easy and convenient. Instead of dealing with a daily hormone pill schedule, bio-identical hormone creams or shots, you meet with a DeRosa Medical provider every three to six months for an easy insertion. During the simple in-office procedure, the tiny pellets are inserted into the buttock area. The small incision site requires just a small bandage. The pellets, which contain estradiol and/or testosterone, react to the needs of your body by secreting additional hormones just as your body naturally would during periods of stress or exercise. In addition, the body does not experience extreme highs and lows because hormone delivery is constantly maintained.

Most patients notice a difference very quickly. However, it can take up to four weeks for the full affect to be felt. Results can last up to six months. DeRosa Medical will closely monitor your progress to ensure that you sustain proper hormone levels and to determine the timing for subsequent pellet insertions.

Regardless of your hormonal treatment method(s), you can rest assured that you will likely experience relief from the symptoms and chronic health issues caused by your hormonal imbalance.

Transdermal Therapy

The term “transdermal” refers to topical delivery through the skin, by the use of a gel, cream or patch.

Transdermal hormones are usually applied to the skin daily in small doses in an effort to keep a steady level of hormones in the system at all times. This approach avoids the extreme “peaks and valleys” in hormone levels sometimes associated with injectable forms. With injectables, hormone levels can reach a low-point a few days before the next shot is due, which can cause irritability, hot flashes, and low energy in some users. However, still with once daily use of gels and creams, you can experience significant peaks and valley which can cause adverse events. Transdermal application is also attractive to those individuals who are not comfortable with needles and injections.

However, there are some disadvantages to transdermal delivery. Some forms of daily transdermal application, particularly the patch, are substantially more expensive than injectable forms of hormones. Patches often cause skin irritation and/or allergic reactions to users. They can fall off with excessive sweating, and they must be fully protected with plastic when swimming. Creams and gels can be transferred by direct skin contact with a partner; special care must be taken to avoid contact with partners, children and pets.

In the United States, testosterone patches are not available for women; only estradiol patches. In Europe, a matrix delivery testosterone patch “Intrinsa” is available for women.

Oral Pills

Orally delivered hormones (pills) will pass through the liver prior to entering the blood stream. This is called “first pass” metabolism. This has been shown to increase the risk of blood clotting and increased risk of heart attack and stroke; even if the hormone is bio-identical. In addition, when the liver metabolizes hormones it increases a protein called SHBG (serum hormone binding globulin) which bind up free Testosterone and Estradiol. This essentially makes the hormones given ineffective. Estradiol and Testosterone should NEVER be administered orally.

Injectables

‘Depot’ drug formulations are created by mixing a substance with the drug that slows its release and prolongs the action of the drug. The two primarily used forms in the US are the testosterone esters testosterone cypionate (Depo-Testosterone) and testosterone enanthate (Delatestryl) which are almost interchangeable. These are only used in men as the doses would be too high for women.

The adverse side effects of injected testosterone esters are generally associated with high peak levels in the first few days after an injection followed by lows after the injection starts to wear off. Some side effects may improve by using a shorter dosing interval (weekly or every ten days instead of twice monthly with enanthate or cypionate.) 100 mg weekly gives a much lower peak level of testosterone than does 200 mg every two weeks, while still maintaining the same total dose of androgen. This benefit must be weighed against the discomfort and inconvenience of doubling the number of injections. Having “peaks and valleys” never allow the body to have sustained levels which can reset all the testosterone receptors causing the most positive effects on the body.

If you have any questions about our Men’s Health Services please contact us.

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