Bioidentical Hormone Replacement Therapy

What is Hormone Replacement Therapy (HRT)?

It's a medical treatment used to supplement or replace hormones in the body when their levels become unbalanced or decline, often due to aging, menopause, or certain medical conditions.

Here are some common situations and conditions where HRT might be recommended:

1. Menopause: Women going through menopause often experience symptoms like hot flashes, night sweats, mood swings, and vaginal dryness. BHRT can help alleviate these symptoms by restoring hormone levels.

2. Perimenopause: This transitional period leading up to menopause can cause irregular periods, sleep disturbances, and other symptoms. BHRT can be used to manage these symptoms before full menopause is reached!

3. Postmenopause: For women who have already gone through menopause but continue to experience symptoms, or who have a higher risk of osteoporosis, BHRT may be considered to improve quality of life and prevent bone loss.

4. Andropause: Sometimes referred to as male menopause, andropause involves a gradual decline in testosterone levels in men, leading to symptoms such as fatigue, decreased libido, and mood changes. BHRT can be used to address these symptoms.

5. Thyroid Disorders: Individuals with thyroid imbalances, whether hypo- or hyperthyroidism, may benefit from hormone replacement therapy to stabilize their thyroid hormone levels.

6. Hormonal Imbalances: Conditions like polycystic ovary syndrome (PCOS) or adrenal insufficiency can cause significant hormonal imbalances, and BHRT can help provide these natural hormones back into the body!

7. Aging: Some individuals seek BHRT as part of an anti-aging strategy, aiming to maintain youthful energy levels, cognitive function, and overall well-being as they age.

8. Chronic Fatigue or Depression: Hormonal imbalances can sometimes contribute to chronic fatigue or mood disorders. BHRT might be used in conjunction with other treatments to address these issues.

What does the BHRT process look like?

You'll start your journey off with a consultation with our Wellness Director & Nurse Practitioner, Angie! We’ll have you complete a health assessment form where we can assess how you feel and what we hope hormone optimization will help with. From there, She'll draw your labs and chat with you a bit more about what BHRT and what it can do for you. We’ll get a second appointment on the books if you guys both decide what hrt method is right for you.

After the consultation comes the fun part! We'll discuss your lab results and discuss a treatment plan. We’ll also discuss any recommended supplementation to best help optimize hormone utilization in the body.

From there, you're home free to enjoy feeling and living better. We'll schedule a follow up appointment to draw labs about 4-6 weeks after to see how everything is going.

What Type of Therapies do we offer?

Typically here at sweet tox, we’ll offer all different types of therapies to meet your needs and goals. We are able to use both commercial and compound pharmacies.

Pellets
Creams/gels
Oral pills
Patches
Vaginal ring insert
Injections
Troches

What is Pelleting?

The molecular structure extracted from yams/soy will be all wrapped up into a literal pellet (about the size of a tic tac)! They’re tiny, custom-compounded therapies for symptoms that stem from hormonal imbalances. these pellets work from cardiac output, so the more you move your body, the better you’ll feel!

Think of it kind of like being implanted with a microchip. No, we’re not practicing mind control here! Just trying to help our amazing patients feel better.

Insertion Procedure (typically takes less than 10 minutes total!):

Preparation: The area where the pellets will be inserted (usually the upper buttock or hip) is cleaned and sterilized. Duh!
Local Anesthesia: A local anesthetic is applied to numb the area to minimize discomfort.
Insertion: A small incision or puncture is made in the skin, and a trocar (a special insertion device) is used to place the hormone pellets beneath the skin where your body will slowly absorb them over time to mimic normal hormone release. Typically, multiple pellets are inserted in one session.
Closure: The incision or puncture site is closed with a small bandage or steri-strips.

Post Procedure Care

Immediate Aftercare: You’ll be given instructions on how to care for the insertion site, including keeping it clean and dry. You can view these instructions below, and we’ll also give you a handout and send an email post-procedure!
Activity Restrictions: You may be advised to avoid strenuous activities or heavy lifting for a short period to ensure proper healing, so just keep that in mind and plan your workout classes accordingly!

Females typically need re-pelleting every 3-4 months, while males typically need it every 4-5 months.

Pre-Procedure Do’s & Don’ts

Females: do not stop taking any form of birth control. hold any hormone replacement therapy (patches, creams, etc.) for 48 hours before initial appointment where labs are drawn.

males: hold any other hormone replacement therapy creams on morning of blood draw until your blood is drawn. if taking hrt shots, we’ll draw labs when your next shot is due or 4-5 days after your last shot.

avoid the following for 2 days before procedure: alcohol, nsaids including aspirin, vitamin e, fish oil, flaxseed oil and ginkgo biloba.

Post-Procedure Do’s & Don’ts

Your insertion site has been covered with two layers of bandages. The inner layer is a steri-strip, and the outer layer is a waterproof dressing.
Do not take tub baths or get into a hot tub or swimming pool for 3-4 days for females, and 7 days for males.

You may shower, but do not remove the bandage or steri-strips for 4 days for females, and 7 days for males.
No major exercises for the incision area. No heavy lifting using the legs for 3-4 days for females, and 7 days for males. This includes running, elliptical, squats, lunges, etc. You can do moderate upper body work and normal walking on a flat surface. The sodium bicarbonate in the anesthetic may cause the site to swell for 1-3 days.
The insertion site may be uncomfortable for up to 2 to 3 weeks. If there is itching or redness you may take Benadryl for relief. Caution: this can cause drowsiness!
You may experience bruising, swelling, and/or redness of the insertion site which may last from a few days up to 2 to 3 weeks. If the redness worsens after the first 2-3 days, please contact Sweet TOx.
You may notice some pinkish or bloody discoloration of the outer bandage. This is normal. If you experience bleeding from the incision, apply firm pressure for 5 minutes.
Please call if you have any bleeding (not oozing) not relieved with pressure, as this is NOT normal.
Please call if you have any pus coming out of the insertion site, as this is NOT normal.
We recommend putting an ice pack on the area where the pellets are located a couple of times for about 20 minutes each time over the next 4 to 5 hours. You can continue this for swelling, if needed. Be sure to place something between the ice pack and your bandages/skin. Do not place ice packs directly on bare skin!

Frequently Asked Questions/Concerns

Post-menupausal patients with an intact uterus may have vaginal bleeding after receiving estrogen pellets.
Remember to take your progesterone (a pill we'll prescribe), at the same time every day! Dose fluctuations can also cause withdrawal bleed.
We can talk through this together and come up with the best solution.
Don't fret! It's common for people to not realize that they're actually feeling better, as weird as that sounds. We'll go over your Health Assessment Form and see how you're feeling now versus when you were without pellets. Some people may need 2-3 rounds of therapy before feeling the most intense/best effects.
We can always do a boost to make sure you're experiencing optimal results!
Totally normal, but there are some questions we'll ask and things we can do to help alleviate those symptoms, including different supplements.
With changes in hormones, specifically testosterone, both of these can happen.
With acne, it's most common to experience this during the 1st round of hormone replacement, and usually improves in subsequent rounds.
Most patients will see an increase in hair growth after HRT, specifically on the scalp, legs and face for men, and fine "peach fuzz" for women.
We can prescribe a med to help combat these, too, or change your dosing for next time.
Gaining weight: Fluid retention in the muscles is possible with 1st rounds of pelleting and usually resolves itself by next round. Remember that muscle weighs more than fat, and a number going up on the scale isn't always indicative to poorer health.
Not Losing Weight: We'll evaluate your thyroid and your gut health, and see if there's something we can tweak to help move things along.
Often times outside lifestyle/stressors are contributing to this FAQ, so we'll chat about things going on in all areas of your life.
Remember that these pellets are best absorbed through cardiac output, so make sure you're getting adequate exercise.
We can also check for a certain imbalances via blood draw to see if we can even things out.