Bio-identical Hormone Replacement Therapy

What is Bio-identical Hormone Replacement therapy or BHRT?

Hormones - such as estrogen and testosterone - play an essential role in keeping our bodies functioning optimally. But as men and women age, hormone production decreases, leading to symptoms and health issues we normally associate with growing older such as fatigue, low sex drive, hot flashes, brain fog, difficulty staying asleep, reduced bone density, and belly fat.

The good news is that Bioidentical Hormone Replacement Therapy (BHRT) can give you renewed vitality and overall wellness by optimizing your hormone levels. Identical on a molecular level to the hormones that naturally occur in the body, BHRT can be a safe and powerful tool in treating menopausal and andropausal symptoms and preventing disease.

Depending on their symptoms and priorities, women may require supplementation with some or all of the following hormones: estradiol, progesterone, testosterone and DHEA. Men may require testosterone and DHEA. With over 13 years experience in prescribing hormones, Dr. Krupa is well-versed in various delivery options of bio-identical hormone replacement including transdermal creams, oral hormones, patches, injectables, and pellets. Each individual patient’s risk factors, lifestyle and preferences may dictate the most appropriate protocol for them. If a patient chooses to explore hormone replacement, Dr. Krupa takes extensive time explaining hormone function, including the risks, benefits and misconceptions of hormone replacement.

TESTOSTERONE REPLACEMENT THERAPY (For men and women)

Starting around a man’s mid-30s, total testosterone generally declines at a rate of approximately 10 percent each decade. And as many as 20-30% of men over the age of 45 years have symptoms of low testosterone. It is common for men to experience symptoms of low testosterone as they age.

Testosterone plays a role in many biological processes in the body. Low testosterone levels can have a detrimental impact, and may be associated with increased risk of cardiovascular disease, insulin resistance and diabetes, decreased lean muscle mass, lower bone density, a sharper decline in sexual function (erections) and libido, decreased desire to engage in life, and depressed moods.

Men with low testosterone may experience the following symptoms:

Fatigue, lack of energy
Decreasing or no libido (i.e. sex drive)
Difficulty initiating or maintaining an erection
No morning erection
Decrease in muscle mass
Change in fat distribution (especially around the middle)
Weight gain unrelated to diet

Poor memory
Decrease in motivation or drive
Difficulty concentrating or brain fog
Feeling “past your prime”
Depression or anxiety
Lack of self-esteem
Gynecomastia (enlargement of men’s breasts)

Testosterone replacement is not just for men, but for women as well

Many women as early as their 40s can experience symptoms of low testosterone. It is commonly seen in menopausal women. Women with low testosterone can experience many of the symptoms men with low testosterone do including:

Fatigue, lack of energy
Decreasing or no libido (i.e. sex drive)
Decrease in muscle mass
Change in fat distribution (especially around the middle)
Depression or anxiety

Weight gain unrelated to diet
Sleep disturbances
Poor memory, difficulty concentrating or brain fog
Decrease in motivation or drive

HORMONE PELLET THERAPY

NO MESSY CREAMS, NO PAINFUL INJECTIONS, JUST STEADY DELIVERY

Dr. Krupa helps patients explore all options to determine if pellet therapy is the right approach. BHRT via pellet implantation might be a great option, in particular, for women or men who have struggled to optimize levels with cream or injections, for men who no longer wants to inject themselves weekly, and for anyone who has experienced unpleasant side effects from other forms of hormone replacement therapy or just wants the convenience.

Dr. Krupa is one of the select few doctors who offer bioidentical hormones via pellet implantation, and has extensive training and experience in all safe methods of BHRT delivery. Before treatment, he takes the time to evaluate the risks and benefits of hormone replacement with each and every patient, explaining safe and less-than-safe methods of delivery. Done correctly, hormone replacement can prevent osteoporosis, decrease risk of dementia, protect your cardiovascular system, increase energy and drive for life, stop hot flashes, improve low moods, increase sex drive and improve your quality of life.

What are BHRT fused hormone pellet implants and how are they implanted?

Fused hormone pellet implants are compounded using biologically identical hormones (most often Estradiol or Testosterone). The hormones are pressed / fused into very small cylinders, and are implanted into the fatty tissue just under the skin of your hip through a very small incision done under local anesthesia. The incision is then closed with sterile-tape strips. It is a simple painless procedure. You are in and out of the office in under 30 minutes. If inserted correctly, patients cannot feel the implants under their skin. Implants placed under the skin consistently release small, physiologic doses of hormones, which have been shown to have many benefits.

How long have hormone pellets been used?

Hormone replacement using pellet implants has been used with great success in the U.S., Europe, and Australia since 1938. In fact, pellet implants were a very popular mode of hormone administration in the U.S. until the 1970s, when many oral and topical commercial products were developed. While the demand for pellets diminished in the U.S., pellet implants continued to be a very popular mode of hormone administration throughout Europe and Australia. In the last 10 years, due to advances made in processes and a better understanding of the benefits of fused pellet implants for hormone replacement, this mode of hormone administration has grown in popularity in the U.S.

How long will the pellets last?

Fused Pellet Implants typically last between 3-6 months, depending on how rapidly the hormones are metabolized. Some patients begin to feel symptom relief within a few days, while others may take up to two weeks to notice a marked difference. The pellets do not need to be removed. They are completely dissolved by the body.

Are there side effects?

Generally, there are minimal side-effects associated with the pellet implant procedure. Complications include: minor bleeding, bruising, infection, and pellet extrusion. Other than slight bruising, the other complications are very rare. Hormone side-effects vary and will be discussed by your physician.

How do I know what hormones I need? And how much?

This will be discussed during your appointment. Based on existing hormone levels and health history, Dr. Krupa will select a specific dosage. Once pellets have been inserted, hormone levels will be reevaluated prior to the insertion of the next round of pellets.