A Word About The Process We Use

The process for any hormone balancing/replacement begins with an office visit with lab tests. Some lab tests may have been done previously by your primary care provider – please bring them to this visit for review. At this visit, we will go over your medical history, your symptoms, and review what’s been tried so far to relieve your symptoms. A physical exam will be done – simple vs complex, depending upon what you need. It is important to have normal wellness tests done yearly, e.g. Pap smears, PSA tests, mammograms. This visit as well as the lab tests are typically covered by most insurances, although they may go toward your yearly deductible.

A number of different options for hormone replacement will be discussed, covering effectiveness, length of results, and costs. This discussion will cover oral, topical (applied to the skin), and subcutaneous (under the skin) methods of replacement, and you will be encouraged to decide what seems best for you. Time will be allocated for your questions to be answered. If you are undecided, printed materials and resources may be given to assist you.

If you choose bioidentical hormone replacement therapy with pellets, another appointment will be made for you to have those inserted. At that appointment, your results will be reviewed and consent forms will be signed. Again you will be given the opportunity to ask questions.

Then the skin on your upper buttock will be cleansed, a local anesthetic will be administered, and a small (5mm) incision will be made for the insertion of the hormone pellets. Women usually get 2-4 small pellets, men get 9-12 large pellets. After the insertion, the skin is closed with a steri strip and covered with a compression dressing (BIG bandaid). You will be offered an ice pack. That’s it! We may prescribe certain medications to avoid common occurrences after hormone administration, depending upon your circumstances and history.

You should begin to feel some effect after the first insertion anywhere from 3-10 days. Subsequent insertions are less dramatic because you will know when your levels are dropping and come in earlier than for the typical first time.

We will ask you to return in about a month for blood tests to correlate your symptom improvement with the hormone levels, and also to monitor 2 other tests for men. If all goes well and the doses remain the same over time, we can defer some of these tests. Women will need pellets every 3-4 months, and men every 6 months on average. You can quit at any time if your circumstances change.