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| Pellets |
The size of pellets.
Compared with Tic Tac. |
What are Pellets?
Pellets are made up of either estradiol or testosterone compressed into very small solid cylinders. Testopel® is an FDA approved pellet. Other doses may need to be compounded by a trained pharmacist.
How and where do you insert the pellets?
The insertion of pellets is a simple office procedure done under local anesthesia. The pellets are usually inserted through a small incision in the lower abdominal wall or hip. There may be slight discomfort or minor bruising. Experience of the health
care practitioner is important.
What happens to the pellets?
Pellets completely dissolve over time. They do not need to be removed.
Why Pellets?
Pellets provide consistent, physiologic levels of hormones. Pellets avoid the fluctuations of hormone levels seen with every other method of delivery. Pellets do not increase the risk of breast cancer like high doses of oral estrogen or the synthetic progestins. Data supports that balanced hormones are breast protective. Even in patients who have failed other types of hormone therapy, pellets are successful.
What can I expect from hormone therapy with pellets?
- More energy
- Better sleep
- Relief of migraine or menstrual headaches
- Feeling happy, a sense of well being
- Relief from depression and anxiety
- Increased muscle mass and bone density
- Decreased soft fatty tissue
- Increased co-ordination and strength
- Increased physical performance
- Improved skin tone and hair texture
- Increased concentration and memory
- Improved overall physical & mental health
- Increased libido and sexual satisfaction
- No increased risk of strokes or blood clots
When will I feel a difference?
Most people feel a difference within 24-48 hours, while others take up to 10-14 days.
Why haven’t I heard of pellets?
Pellets are not patented or marketed in the United States. They are frequently used in Europe and Australia, where most of the data is from. Pellets were used in the United States from 1938 until the 1970’s, when patented estrogens were marketed
to the public. Even in the United States, there are clinics that specialize in pellets.
My doctor says ‘There is no data to support the use of pellets’.
Your doctor is wrong. There is a difference between ‘no data’ and ‘not having read’ the data.
Are pellets a good way to deliver testosterone?
There is no better, safer or more convenient way to deliver testosterone in men and women than with pellets. In men, the pellets deliver healthy levels of testosterone while maintaining normal levels of estrogen. Men should be tested as soon as
symptoms develop which is usually between 45 and 55 years of age. Some men need to be tested and treated even earlier. It is never too late to improve your health with hormone therapy.
Testosterone is needed for optimal health in women. Testosterone delivered by pellets does not increase the risk of breast cancer or liver failure like oral, synthetic methyl- testosterone.
Will I need to have testing done?
Yes, hormone levels will be drawn andevaluated before therapy is started. These may include FSH, estradiol, free and
total testosterone in women. Men need a PSA, estradiol, testosterone, bood count and possibly liver enzymes if on statins or other drugs that affect the liver. Levels will also be re-evaluated during hormone therapy.
How much do pellets cost?
The insertion of pellets costs $250. The patient will also need to pay for the pellet prescription which is $15-$30 for women and $100-$200 for men depending on the dose of hormone and the number of pellets inserted. Men need a much larger dose
of testosterone than women. Most prescription cards cover the cost of Testopel® for men and the patient pays a co-pay to the pharmacy. It works out to be $2-$3 a day for therapy.
How often do pellets need to be inserted?
Pellets need to be inserted 3 to 4 times a year for women and 2 to 3 times for men..
Do insurance companies cover the cost of pellets?
This varies by insurance company. Most physicians require payment for theirservices. You may want to contact your insurance company to see if they will reimburse your cost. Disease prevention is cost effective. The FDA testosterone pellet Testopel® may be covered by a prescription card.
Do pellets have the same increased risk of breast cancer as conventional synthetic hormone therapy?
- NO, pellets do not have the same risk of breast cancer as high doses of oral estrogens like Premarin®, that do not maintain the correct estrogen ratio
- Nor, do they increase the risk of breast cancer like the synthetic, chemical progestins used in the ‘WHI’ trial
- Testosterone delivered by pellets does not increase the risk of breast cancer like oral, synthetic methyl- testosterone
- Testosterone hormone implants have been used to treat breast cancer (endometriosis, uterine fibroids)
- Data supports that balanced hormones are breast protective
Are there any side effects?
- When a patient first starts hormone therapy, there may be mild temporary breast tenderness which gets better on its own
- The hormone receptors may be very sensitive and take time to adjust
- There may be a temporary water weight gain
- Overall the body will ‘tone up’ as bone density and muscle mass increase and the soft fatty tissue decreases
- As with other types of HRT, women with an intact uterus may experience bleeding
How long after the pellets are inserted will I notice a difference?
Some people feel better within 24-48 hours while others may take a week to 10 days to notice a difference.
How long will the pellet last?
Pellets, in women, usually last between 3 and 5 months. In men, the pellets usually last between 5 and 6 months.
What happens to the pellets?
The pellets do not need to be removed. They completely dissolve over time
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