What is Pellet Hormone Replacement Therapy?


A woman's palm holding about a dozen medicine pellets.
Summary
  • Pellet hormone replacement therapy is a common method for managing and reducing the severity of menopausal symptoms.
  • The procedure involves pellets that are implanted into the skin to release a continuous stream of hormones into the body over a number of months.
  • Other than relieving menopausal symptoms, pellet therapy may also improve sex drive, reduce body fat, and prevent hormone imbalance.
  • Although effective, there are risks involved in hormone replacement therapy, including an increased risk of developing life-threatening conditions like breast cancer.

Pellet hormone replacement therapy (HRT) is a method of replacing estrogen and restoring hormonal imbalances in postmenopausal women.

Although pellet HRT isn't approved by the FDA, it’s been used since the late 1930s and has since become the primary menopausal treatment in the U.S.

This article will take a closer look at pellet hormone replacement therapy to help you understand the implant procedure, as well as the advantages and risks involved.

What is Pellet Hormone Replacement Therapy?

Hormone pellet therapy is a method available to women to replace estrogen when they enter menopause.

During menopause, the body stops producing estrogen, which affects a woman’s reproductive cycle, bone health, and emotional well-being.

Hormone replacement therapy (HRT) aims to help balance estrogen levels to prevent the more serious side effects of menopause.

Who Qualifies for Pellet Hormone Replacement Therapy?

Hormone therapy is used to increase estrogen levels in the body. It’s typically used by women over 45 who start to enter menopause, but there are exceptions.

Some women younger than 45 may need more estrogen to help protect them from the long-term effects of a deficiency.

These women may need to use HRT to help their bodies produce more estrogen.

Many menopausal women experiencelong-lasting and intense menopause symptoms. To reduce their severity, doctors may recommend hormone therapy.

Who shouldn’t use pellet hormone replacement therapy?

Although HRT is generally considered safe, there are a few people that don’t qualify for treatment.

These are usually women who have other medical conditions that may interfere with the treatment or worsen existing issues.

The FDA advises against using HRT if you:

  • Have a bleeding disorder or problems with vaginal bleeding
  • Have or had certain cancers like breast cancer or uterine cancer
  • Have had a blood clot, stroke, or heart attack
  • Have been diagnosed with a liver disease
  • Have allergic reactions to hormone medicine

If you have any of the conditions mentioned above, it is advised that you look into alternative HRT options.

Are there any alternative treatment options?

If hormone replacement therapy isn’t a good fit for you, there are alternative medical treatments that may have the same results.

Clonidine

Clonidine is a prescription medication that may alleviate menopausal symptoms like hot flashes and night sweats.

This treatment doesn't contain any hormones, which means your body won’t have to adjust to it.

Taking clonidine also reduces the risk of developing severe side effects that can be caused by HRT, like developing blood clots or certain diseases.

Gabapentin

Gabapentin is a type of antiseizure medication that may help alleviate hot flashes in menopausal women.

This medication hasn’t been approved by the FDA, but it can be a useful HRT alternative for individuals who can't take estrogen.

What is the Procedure for Getting Hormone Replacement Therapy?

A healthcare professional will test your hormone levels and body mass index (BMI) before working out an appropriate dose of hormones.

Then they will make a small incision and implant a series of bioidentical or synthetic hormone pellets underneath the skin. This is usually done around the hip area.

The pellets will release a continuous supply of hormones for around three months.

Your healthcare provider may include oral and transdermal therapy (hormone patches that are applied directly to the skin) to treat more severe hormonal imbalances.

This means that you might need to take oral hormone pills or apply patches in addition to the implanted pellets.

Key Point: What is the Difference between Bioidentical and Synthetic Hormones?

Bioidentical hormones are normally made from plant sources like soybeans or wild yams. These hormones are meant to mimic the structure and composition of the ones that occur naturally in our bodies.

Synthetic hormones are made with chemical compounds like conjugated equine estrogens and progestin. These hormones are chemically altered and not the same as our naturally-occurring hormones.

The FDA has approved certain brands that use bioidentical hormones, but there is no evidence that they are safer or more beneficial than their synthetic counterparts. An exception here is progesterone (bioidentical) vs. progestin (synthetic). Progesterone appears to be safer.

How long does the treatment take to work?

It may take a few weeks before you feel the benefits of bioidentical hormone therapy. Some people even report only feeling a difference after the full three months of continuous hormone release.

If you don’t feel any difference or if menopausal symptoms persist after four to six months, it's recommended that you speak to your healthcare provider.

They may be able to recommend a different type of HRT or adjust your dose.

An Asian woman in a black shirt and black workout jacket is smiling up toward the sky.

What Are the Advantages of Pellet Hormone Replacement Therapy?

The biggest advantage of HRT is that it provides relief from menopausal symptoms. This also means that HRT is likely to:

  • Improve energy and mood
  • Reduce the risk of developing certain types of cancer
  • Improve low sex drive
  • Reduce body fat
  • Restore the body’s normal hormone levels
  • Protect against health conditions like osteoporosis and heart disease

Pellet hormones are also directly absorbed into the bloodstream, which helps avoid damage to the liver or gastrointestinal system.

Are There Any Side-Effects of Pellet Hormone Replacement Therapy?

Side effects commonly occur after the first dose, while your body is still adjusting to the new level of hormones.

Many side effects resolve without additional treatment as you get used to the hormone levels.

If they persist, it’s recommended that you speak to your healt care provider. They will likely change your dose to make the side effects more manageable.

Common side effects

These side effects usually occur while your body adjusts to the hormonal change. They may include:

  • Weight gain
  • Tiredness
  • Acne or more frequent breakouts
  • Headaches
  • Blurred vision
  • Increased facial hair
  • Breast tenderness
  • Spotting, cramping, or bloating
  • Mood swings
  • Changes in bone density
  • Loss of appetite

Hormone replacement therapy may also increase the chance of developing certain diseases.

What are the Safety Concerns Involved in Pellet Hormone Replacement Therapy?

There are a few risks involved in bioidentical hormone replacement therapy that can impact your overall health.

The biggest concern is that many of these treatments aren’t FDA-approved since they haven’t found enough evidence that pellet HRT is safe and effective.

This also means that no official pharmaceutical body regulates the quality of the medication. There is also no standardization in how these pellets are manufactured or regulations on how much of a specific hormone they can contain.

Long-term use of HRT may also increase the risk of developing the following conditions:

  • Breast cancer
  • Blood clots and stroke
  • Coronary heart disease
  • Pulmonary embolism

How Can You Reduce the Risk Factors of Hormone Therapy?

After you’ve undergone HRT, it's advised that you speak to your doctor about managing possible side effects. They may recommend some of the following: Choose the right aftercare products

One of the most effective ways to alleviate the negative side effects of getting HRT pellets implanted is by having the right products on hand after the procedure.

These may include:

  • Anti-inflammatories that can reduce redness, itchiness, and pain around the incision site.
  • Medication that can reduce swelling and bruising.
  • Paracetamol or aspirin that can relieve headaches and other bodily pain.

Make follow-up appointments

Visit your doctor frequently after your procedure. This can help them to monitor your symptoms and any side effects you may be experiencing.

They will be able to recommend additional treatments or medication to help your body adjust to the HRT.

Regular follow-up appointments can also help minimize the risk of developing some of the more severe side effects — like breast cancer or heart disease — since your doctor will be monitoring you constantly.

These appointments also help to ensure that you’re getting the most out of your hormone treatment.

If you discover that the compounded bioidentical hormones aren’t working for you early on, you can discuss an adjusted dose with your doctor.

Make healthy lifestyle choices

Incorporating healthy habits into your daily routine can help the body manage and adjust to HRT.

If you’re unable to use HRT, these lifestyle changes may also work as an alternative treatment.

These habits include:

  • Getting physical exercise
  • Following a nutritious diet
  • Maintaining a healthy weight
  • Managing stress
  • Managing other health concerns like high cholesterol, blood pressure, and hypertension

It's also recommended that you avoid smoking and use of alcohol as much as possible.

A fit-looking woman with cropped grey hair and a blue workout outfit is sitting outside on a set of stairs. She is holding an apple and smiling to someone or something off the camera.

Hormone Replacement Therapy Frequently Asked Questions

In this section, we’ll take a look at a few frequently asked questions about HRT.

Does HRT affect sex drive?

HRT is used to alleviate menopausal symptoms that may include a lower-than-normal sex drive in women.

Research has shown that HRT can significantly enhance a woman’s sex drive after treatment.

Does HRT cause memory loss?

There is currently no evidence that supports the idea that HRT causes memory loss or that it increases your risk of developing Alzheimer’s or dementia.

What is the best natural alternative to HRT?

Some herbal remedies may alleviate menopausal symptoms and be effective in replacing lost estrogen hormones.

These include:

  • Evening primrose oil
  • Black cohosh
  • Angelica
  • Ginseng
  • St. John's wort

Research is still being done on the best dose and lasting health benefits of these remedies.

If you’re considering a natural HRT treatment, it’s always recommended that you speak to your doctor first.

Are You Interested in Pellet Hormone Replacement Therapy?

Pellet hormone replacement therapy is a well-known method for managing and providing relief from menopausal symptoms.

If you are interested in pellet therapy or any other hormone replacement treatments, head over to LifeMD to make a telehealth appointment with a board-certified doctor or nurse practitioner.

Dr. Danielle Weiss

Dr. Weiss earned her MD from NYU School of Medicine, completed her residency at Scripps Mercy San Diego, and an endocrinology fellowship at Stanford University. She’s Board Certified in both Internal Medicine and Endocrinology, Diabetes, and Metabolism.

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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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