Male Hormone Deficiency

Adam Male Hormone Need Questionnaire

Natural Hormones vs. Synthetic

Signs of Hormone Imbalance

Bioidentical hormones are a popular choice because the have a lower side effect profile than synthetic hormones and initial data seems to indicate they are safer as well.  The question then is how to deliver them to the body.  Compounding pharmacies now provide us with multiple delivery choices. 

  • Pellets
  • Sub lingual drops
  • Sub lingual troches
  • transdermal creams
  • Injections
  • Oral capsules

Each system has its advantages and disadvantages.

Pellets - Hormone pellets are implanted under the skin of the buttock or lower abdomen.  Pellets offer some unique advantages, especially for women.  The big advantage pellets offer is slow release that is somewhat tied to activity.  The more muscle movement the higher the blood flow and circulation around the pellets.  This causes more hormone to be released when you are active and less when sleeping or sedentary.  This slow release reduces side effects and allows much higher doses of testosterone (the sex drive hormone) in women without causing the side effects of the same dose delivered by any other means.  The most complained about side effects of testosterone in women are hair growth and acne.  These side effects are very rare, when testosterone is delivered by pellets. 

When it comes to improving libido no other delivery method works nearly as well as pellets.  The other benefits of testosterone are more energy, improved cognitive function and drive.  Hormone pellets last between 3 to 6 months with a gradual fall off in hormone levels as time goes on.  Pellets inserted using a small trochar under local anesthesia.  The entire procedure takes less than 15 minutes.

The disadvantage of pellets is the therapy lasts 3 to 6 months.  This is only a problem if the dose causes problems.  The most common problem occurs in women that have their uterus and are getting estrogen pellets.  If the estrogen is not balanced with progesterone this can cause break through bleeding.  Hormone pellets can be used with other delivery forms and most frequently combined with either transdermal or sublingual progesterone.

A typical hormone treatment for women would include a small amount of estrogen and larger dose of testosterone with progesterone added by other means.  Testosterone pellets alone can also be used in women with estrogen and progesterone delivered by creams or troches.  The primary advantage here is the estrogen dose can be reduced quickly if break through bleeding occurs in women that have their uterus.