No. Testosterone is found and needed in both males and females and plays a large role in women’s health. Women make testosterone in both their ovaries and their adrenal glands.

Some studies state that women begin to decline in testosterone in their 20s, and they can see a significant reduction in testosterone production by the mid 30s. By age 40, most women have lost approximately 50% of their testosterone production.

Women over the age of 35 should consider bioidentical testosterone replacement therapy in order to protect against osteoporosis, dementia, insulin resistance, excess body fat, decreased libido, wrinkles, and stronger hair.

Because every patient’s treatment plan is highly individualized, here at The Beaumont Med Spa, we offer a variety of options when it comes to hormone replacement.

Although they may not be for everyone, pellets are one of our most preferred deliver methods for replacing sex hormones.

Pellets are small, dissolvable implants that are placed under the skin. They are naturally sourced, plant derived (typically from yam root), and very well tolerated.

Pellets are patient friendly, because there’s nothing to forget! The pellets work for months at a time through a constant, steady release of hormone, regulating blood hormone levels at a steady state. There are no erratic ups and downs in hormone levels, avoiding the fluctuations that can occur when using creams, pills or patches.

We monitor labs throughout a cycle to ensure we are correctly dosing your medications.

One of the largest reported retrospective studies to date looked at over 1 million pellet procedures over a 7 year span (from 2012-2019). The overall complication rate was <1%. The most common response reported was pellet extrusion (the pellet comes out), which was more common in men (<3%) than women (<1%). The safety of subcutaneous hormone pellet implants in men and women appears to be better than other routes of administration of bioidentical hormone replacement therapy. PMC8165877

Since pellets are bioidentical, your body recognizes them as your own. So there is no concern for any type of “allergic reaction.” The risk of infection or irritation is also rare. Scarring is minimal and the incision site is smaller than the size of a pencil eraser. Mild tenderness and bruising can occur but typically resolve within a few days.

No. Unlike oral estrogens and birth control pills, pellets avoid the “liver pass,” which means your liver is protected and clotting factors are not affected. Studies actually reveal that long term therapy is heart and brain protective.

No. HRT can actually reduce the risk of breast cancer by 23% and colon cancer by 37%. Additionally, women who are diagnosed with breast cancer, who are taking HRT at the time of diagnosis, have a reduced mortality rate of 40%. And, those with the BRCA gene who take HRT have less risk of developing breast cancer and less risk of dying from breast cancer. https://www.bmj.com/content/367/bmj.l5928/rr3#:~:text=Evidence%20suggests%20that%20there%20are,safer%20choice%20than%20synthetic%20progestins.

There is also no conclusive evidence that androgen replacement therapy for men is an independent factor for the development of prostate cancer. Overall, the current clinical data seems to suggest that androgen replacement is an appropriate therapeutic option for men with symptomatic hypogonadism provided that patients continue to receive regular prostate screenings. PMC3424887

Pellets were initially developed in Europe and have been used to treat women since the 1930s! They were used for women post hysterectomy until the development of synthetic and equine hormones in the 1940s. Over the past several years with continued research, more and more individuals, both men and women, are undergoing pellet therapy as they are convenient, well tolerated, and individualized.

The initial step in BHRT is to schedule a consultation. At this visit we will thoroughly review your personal and family medical history, discuss goals of therapy, and draw initial full panel labs. Once your labs are resulted, they will be reviewed with your history to determine your eligibility. If you are deemed a candidate for BHRT, you will then be scheduled  for an appointment for the in office procedure.

Prior to pellet insertion, you will sit down with one of our providers and thoroughly discuss your most recent labs and plan, answering all questions. Our main goal is to make sure you are well informed of the benefits, risks and expectations of treatment. Just as there are risks to an intervention, there are also risks of not. We will then get your blood pressure and full set of vitals and discuss the procedure in detail. You are then placed on your side with your legs slightly bent. The lower back/upper back/buttock is exposed, cleansed and prepped. A small injection of lidocaine is placed to the area of insertion (over about 5-10 seconds). This is typically the only discomfort of the entire procedure, as the area is then numb. Past this point you should only feel pressure, no sharp pain. The area is again cleansed and a sterile drape is placed. A very small incision is made (smaller than the charging port on your iPhone- take a look). The hormone pellets, which are bioidentical and plant based, are placed into the tissue below the skin. Men can recieve several pellets dependent on dosage, and females usually receive 1-2. Steri strips (small bandage) are placed to close the area (no stitches or suture to remove later) and a larger dressing is placed on top. TOTAL TIME OF PROCEDURE: typically less than 5 minutes.

Patients can begin to feel the effects of pellets in as early as a week, but most patients may not feel the effects for about 2-3 weeks. You will return for blood work at the 5 week mark to evaluate your levels post insertion. At this point, which we call the “5 week peak,” you should notice some symptom control.

The procedure is typically repeated every 4-6 months as needed, based on blood work and symptoms. Most women are redosed around 4 months, where some men may go as long as 6 months.

Majority of the time, insurance will not cover the expense of BHRT and we operate on a self pay model. We do have reimbursement forms we are happy to fill out for you if you would like to try and file with your insurance company for reimbursement. We also have financing options available.

Decisions about your treatment length will depend on your unique symptoms, how well you respond to BHRT, and any side effects of hormone replacement. Hormone therapy can be continued as long as you desire and be stopped at any time. We do encourage you that once you start a treatment with us, that we work together for at least 6 months, or two rounds of pellets, to see how your body adjusts. If treatment is discontinued, fatigue, low mood and sleep disturbances can recur as the pellets slowly dissolve.

Yes. Although most patients notice improvement in symptoms within 3 to 4 weeks, it could take up to 6 months, or at least 2 cycles, for those new to BHRT to notice significant change and full optimization.

A patient’s age, weight, activity level, metabolism, and male/female can affect dosing and length of benefit from treatment. Pellets can be used long term and they can be discontinued at any time.

Discontinuation will lead to your hormones resting back at a pre-procedure range; they will not slow the natural production of your endogenous hormone levels. 

Yes. Again, hormone replacement is very individualized and at times we may have to trial alternate methods to see what works best for your body.

For example, some patients may begin on an injection or troche form of testosterone when starting, but then transition to pellet therapy once a dose and range has been calculated.

Cardiovascular Benefits

"The reduction in incidence of clinical ischemic events has been substantial ranging from 30% to 90%. HRT alters the biology of the vessel wall, causes vasodilation and provides anti-inflammatory benefits, reducing heart attacks." New England Journal of Medicine 2000; 343(8):572-574.

"HRT also causes sustained Increases of nitric oxide levels and reductions in norepinephrine, plasma renin activity and endothelin. These endothelial changes have been associated with vasodilation, reduced olood pressure, increased blood flow and improved cardiac performance." J Gen Intern Med 2004; 19 (7): 791-804.

Alzheimer's Prevention

"Our findings, along with other recent work, suggest that HRT may be effective for the primary prevention of Alzheimer's Disease-if not for its treatment". JAMA 2002; 288:2123-2129.

"Human neuroimaging studies provide evidence that estrogen containing hormone therapy influences the pattern of brain activation during memory processing...Findings from a number of case-controlled studies and 2 prospective investigations suggest about a 30% reduction of Alzheimer's Disease, added in women who report ever having received hormone therapy compared to nonusers.

Resnick S., JAMA 2002; 288: 2170 (editorial)

"As in the previous studies, the adjusted risk of incident AD among lifetime HRT users was reduced to little more than half that among nonusers."

JAMA 2002; 288: 2123-29

Increased Bone Density / Diabetes Prevention

"Hormone replacement has beneficial effects other than cancer and cardiovascular disease, such as a 35% decrease in hip fractures, 35% decrease in new onset diabetes and a 60% decrease in recurrent urinary tract infections." J Gen Internal Medicine 2004:19(7): 791-804

Mortality

"Pooled data from 30 trials, with 26,708 postmenopausal women followed for a mean duration of 4.5 years, indicate that hormone replacement does not increase total mortality."

J Gen Intern Med 2004; 19 (7): 791-804

Central Obesity/BMI Reduction

"In women with diabetes mellitus, HRT reduces central adiposity and improves glycemic control and physical functioning." J Gen Intern Med 2004; 19 (7): 791-804

*Hormone replacement therapy in postmenopausal women and testosterone replacement in older men appear to reduce the degree of central obesity." Obesity Revien 2004 Nov; 5(4): 197-216

"Age-adjusted comparisons indicated intermittent and continuous hormone users had significantly lower mean BMIs at baseline than women who never used hormone replacement therapy." JAMA 1996; 275(1): 46-49

Benefit of Estrogen Replacement.

Cognitive Support

"Multiple medical studies have demonstrated estrogen's protective effects against Alzheimer's, memory loss, loss of cognition. Estrogen decreases colorectal cancer, cataracts, macular degeneration, prevents tooth loss and gingivitis, and prevents urogenital atrophy, painful intercourse and stress incontinence." Biomedica Jan 2000; Vol. 3(1):6-9

Cardiovascular Protection

"Estrogen therapy alters the biology of the inner vessels (of the heart). Hormone replacement therapy protects through vasodilation, anti-inflammatory and anti-proliferative effects, providing significant coronary artery benefits." NEJM 2000; 343: 572-574

"Current estrogen use is associated with a reduction in the incidence of coronary heart disease as well as in mortality from cardiovascular disease." NEJM 1991; 325: 756-62

"In addition to potentially beneficial vascular effects of ERT, well established lipid alterations with oral ERT include favorable reductions in low-density lipoprotein (LDL) cholesterol and lipoprotein(a) and increases in high-density lipoprotein (HDL) cholesterol," AHA Scientific Statement. Circulation 2001; 104: 499-503

"There is an impressive, large collection of biological data and observational studies indicating that postmenopausal HRT protects against heart disease and stroke. There is good reason to believe that the full impact of estrogen's beneficial actions on cardiovascular tissue requires the presence of healthy endothelium (normal blood vessels). It is most appropriate to prescribe hormones to post-menopausal women to protect against cardiovascular disease. Vascular biologists are convinced of estrogen's essential role in protecting against cardiovascular disease. Estrogen's role is protecting against the development of atherosclerosis." Circulation 2001; 104:499-503

Increased Bone Density

"In older women, a dosage of 0.25 mg/d of 17-beta-estradiol increased bone density of the hip, spine, and total body, and reduced bone turnover, with minimal side effects." JAMA

2003; 290 (8): 1042-1048

All-Cause Mortality

A recent study done by doctors at Yale evaluated the result of this widespread reduction in HRT use in women aged 50-59 post hysterectomy. According to their calculations, estrogen avoidance may have led to as many as 90,000 preventable deaths and breast cancer in these women. According to the authors: "Estrogen therapy in younger postmenopausal women is associated with a decisive reduction in all-cause mortality." Philip M. Sarrel, Valentine Y. Njike, Valentina Vinante, and David L. Katz. The Mortality Toll of Estrogen Avoidance: An Analysis of Excess Deaths Among Hysterectomized Women Aged 50 to 59 Years. American Journal of Public Health: September 2013, Vol. 103, No. 9, PP. 1583-1588

Testosterone Replacement in Females - Benefits

Sexual Health / Bone Density / Cardiovascular

"A persistent view of testosterone as the male hormone deprives many clinically androgen deficient women of effective treatment." J Reprod Med 2001; 46: 281-90

"Restoring a physiological level of testosterone to women after hysterectomy not only can improve quality of life in terms of sexual libido, sexual pleasure, and sense of wellbeing but also can build bones - and may be a key to protecting cardiovascular health." J Women's Realri 1998; 7: 825-29

"Testosterone increases bone density in women. Testosterone protects against heart di in women." Journal of Reproductive Medicine 1999; 44(12): 1012-20

"Testosterone replacement in women significantly decreases carotid atherosclerosis and cardiovascular disease." American Journal of Epidemiology 2002;155: 437-445

“Our results suggest that in the physiological range, DHEAs and androgens in women are correlated with lower risk of carotid artery disease." J Clin Endocrin Metabol 1999; 84: 2008-2012

“We found the lowest odds of carotid atherosclerosis for women with the highest total testosterone concentrations". Amer J Epidem 2002; 155 (5): 437-45

“Androgens offer positive effects on bones." J Reprod Med 2001; 46: 281-290