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Method and Choices
Pellet Therapy: Pellets contain a natural plant source of estrogen and testosterone. The estrogen or testosterone utilized in the pellets is compounded by hand and formed into a pellet shape. The pellets-which are smaller than a grain of rice-are then placed in the fatty tissue underneath the skin and act as if an ovary or testicle is present. The implantation procedure is easily performed in the office. Dr. Rhoe recommends this method for those individuals who want a delivery system that is the most physiological approach and decreases the “roller-coaster” effect seen is some other methods. She has received specialized training and certification in this procedure as well.
Transdermal: Just like the subcutaneous route this vehicle will bypass the liver. However, you must do this at the same time of day every day and make sure you wash the site before applying. You apply the HRT lotion to the inner arms or upper inner thighs. You need to rotate sites so that there will be no saturation in the receptor site you are using. Unfortunately, it may take several weeks to months to titrate to adequate levels.
Sublingual: This vehicle will bypass the liver; however, several patients say this is bitter tasting, and patient compliance isn’t always the best with this choice.
Subcutaneous: Pellet Therapy is the most physiological way for the hormones to react in the body. It acts most consistently like the testicles and ovaries. The body draws what it needs as it needs it. Many patients choose this vehicle, and many doctors only do this type of hormone replacement therapy. You go to the doctor once every 3 to 4 months for women and every 4 to 6 months for men for your implantation. You are sore for about 3 to 4 days and may have some slight bruising. The procedure itself is not painful at all. You feel about 3 seconds of a stick and burning.
Oral: Although this is the easiest form for the administration of hormones, it is also one of the least optimal forms given the limitations for maximizing delivery.
There are other ways as well, but the above are the most well known, the others are:
Injectable, Vaginal, and Rectal