Bioidentical Hormone Replacement Therapy For Men

Testosterone Replacement Therapy (TRT) is a well-established science and there are hundreds of studies documenting the safety and effectiveness of TRT. Some of the largest studies simply observe that men who are low in testosterone have about a 50% increased death rate over the subsequent decade when compared to men with normal testosterone levels.

Heart disease is the number one killer in men. Testosterone helps prevent heart disease by improving the cholesterol profile, discouraging blood clots, and by keeping blood vessels open and elastic. Testosterone can be given to men with advanced heart disease and is shown to improve their functional ability to stress the heart.

Sarcopenia is the age-related loss of muscle mass, strength, and function. Muscle is replaced by fat and fibrous tissue. Hormone decline, particularly androgens like testosterone, is one of the biggest reasons for sarcopenia in men and women. Maintaining muscle mass means less frailty, more energy, and more stamina.

Testosterone indirectly prevents diabetes by preventing sarcopenia. But, TRT also has a direct effect on helping insulin work better. Several studies show men who replace testosterone need about 50% as much insulin. Adding TRT to an exercise program results in much better blood sugar control than exercise alone. TRT should be considered in all patients with type 2 diabetes or metabolic syndrome X.

Osteoporosis or “brittle bones” is not as common in men as women, since men build stronger bones in the first place because of testosterone. However, the mortality and disability caused by osteoporosis in men are worse than in women! Again, TRT has a direct stimulating effect on bone — testosterone will build bone!

Dementia and depression are much higher in men with low testosterone levels. Testosterone has both protective and growth-stimulating effects on nerve tissue in the brain and is shown to have a regulating effect on the plaque that accumulates in the brain with Alzheimer’s Dementia. TRT improves cognition and mood, especially abstract and spatial skills such as reading a map, coordination, and balance, and motor control.

The myth of testosterone causing prostate cancer has been thoroughly debunked. In fact, at the time of diagnosis, men with prostate cancer tend to have a lower testosterone level than average. Men with low testosterone also tend to have more aggressive forms of prostate cancer. TRT does not increase the risk of cancer, and recent studies show it is even safe to use TRT after treatment of prostate cancer.

This all sounds great, but what are the risks of TRT? The main risk is if a man already has existing prostate cancer, then TRT will stimulate cancer. We monitor this through routine blood testing and it is very rarely an issue. TRT will also cause an increase in the production of red blood cells, which alone does not cause blood clotting like other syndromes of increased bone marrow cells, so this is not a big issue.

When replacing testosterone, we only use bioidentical hormones that are derived from natural plant-based sources. This means the molecular structure of the hormone supplement is exactly the same as the hormones produced by your body. Thus, your body recognizes these hormones as if it produced them itself. The best delivery method for TRT is the placement of small, time-release pellets placed easily under the skin of the hip/buttock which lasts 4-6 months. This method allows for steady testosterone levels, which can self adjust to your needs in times of stress or exercise. Furthermore, you don’t have to remember to rub on messy creams daily (which can rub off on others), have uncomfortable weekly injections (which cause wild fluctuations in your testosterone levels resulting in a roller coaster of mood and energy), or swallow a daily pill (which can be poorly absorbed and is metabolized by the liver, placing you at possible risk for adverse effects). This is why bioidentical hormone pellets are the preferred method of treatment at Action Health Centers.

Improved mood, energy, sleep, sex drive, and general outlook will usually start within a few weeks of TRT. It may take a few months to fully appreciate the improved stamina, muscle-building, fat-burning, and erectile function effects of TRT. TRT prevents disease and helps maintain quality of life, and like other age-management strategies, it is changing the paradigm of normal aging!

Studies have shown optimized hormones significantly reduce the risk of serious health problems such as osteoporosis, Alzheimer’s disease, heart disease, and diabetes. Pellet therapy uses hormones that replicate the body’s normal hormonal levels. Oral and transdermal forms of hormone therapy can produce turbulent hormone levels, resulting in mood and energy fluctuations. The BHRT uses pellet therapy that provides sustained hormone levels throughout the day for up to three to five months without any “roller coaster” effects.

To create hormone pellets, a compounding pharmacist fuses estrogen or testosterone into small cylinders. These pellets, some of which are smaller than a grain of rice, are placed in the fatty tissue beneath the skin and mimic the actions of healthy ovaries and testicles in regards to hormone release into the bloodstream. The hormone pellet implantation is a quick and easy procedure easily performed in the office.

Pellet dosing is customized for each individual’s needs. Pellets have the capability to deliver bio-identical hormones directly into the bloodstream 24 hours a day, 7 days a week for up to five months. Other methods of hormone therapy cannot provide a steady delivery of hormones 24/7.

The bioidentical hormone pellets that we use at Utah Stem Cells are derived from natural plant-based sources. This means the molecular structure of the hormone supplement is exactly the same as the hormones produced by your body. Thus, your body recognizes these hormones as if it produced them itself, and do not carry the inherent risks that possibly could be present with synthetic hormones.

The desired physiologic effects attained with pellet insertions are far superior to oral, gel, and intramuscular modes of delivery.

The pellets are able to supply a smooth and steady supply of the desired hormone and avoid the erratic absorption and wild fluctuations of circulating levels in your bloodstream that accompany the aforementioned methods. Your body also recognizes the location of this “depot” of hormones that are slowly released and can self adjust to draw more of the hormones during times of stress or exercise when needed.

With the painless placement of the pellets in the upper buttocks region, you avoid having to remember to rub on messy creams, swallow pills, or take weekly painful injections. Once the pellets are placed you can forget about them, and they last for about 3 months for women and 6 months for men.

The cost of our BHRT pellets is significantly less expensive than the other possible delivery methods described above.

The appropriate dose of hormone pellets will be individually selected for you to take several different factors into consideration. These include your age, body type, pre-treatment hormone levels, and the degree/types of symptoms present.

The bioidentical hormone pellets are inserted with very little discomfort under the skin in the upper buttocks region just below the pants line. We use a local anesthetic (usually lidocaine) to numb the skin and surrounding tissue, and then a needle is inserted. The very small hormone pellets (about the size of a grain of rice or Tic Tac) are then placed in the hollow needle and slid into the proper place under the skin, in the fatty tissue. You will barely feel the local anesthetic as it numbs the skin and tissue. Most people describe it as hurting less than a flu shot or drawing blood from a vein for routine labs. You will usually feel no pain at all after the skin and tissue has been numbed, and while placing the pellets through the hollow needle. For a couple of days after the procedure, the only discomfort you will experience is similar to that of a mild bruise. You will be able to resume all of your normal activities immediately
following the procedure. We only ask that you avoid any strenuous
activities that specifically target the buttocks muscles for a few days.

We would then have you return to the clinic in 5 weeks for a re-evaluation with the labs repeated. We would review your new hormone levels to see if they are now in the target range and correlate this with the degree of improvement in your symptoms. This helps us determine your correct hormone dosage and adjustments can be made.