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Mammography and You

  • Ernest H. Carlton MD

We must start this discussion with a brief look at hormones and menopause.  When female patients become menopausal they are deficient in estrogen and progesterone and to a lesser degree- testosterone. Some patients move right through the menopausal years with very little or no consequences.  However, a lot of patients have varying degrees of hormone symptoms that can become debilitating.  These range from mild to severe hot flashes with night sweats resulting in little sleep, fatigue, or irritability.

They also may have vaginal dryness, decreased libido, mental fogginess or just do not feel well. This is where hormone replacement comes into action. Quite frankly most women can take a commercially prepared hormone replacement therapy and do just fine. However some just can’t quite find the right balance.

This is where Bioidentical Hormone Therapy comes into play. Most hormone replacement therapy is derived from soy or yams. However, compounding pharmacies tout the more natural release of the product if it is compounded. These types of hormones are compounded into capsules, creams and pellets. If a woman is having problems with commercially available hormone treatments she may have trouble with the capsules. The creams have a different route of absorption and may help some. I think a great route of administration is by pellets. Small pellets placed in the upper buttock just under the skin are slowly absorbed and can last from 3–5 months. Pellets are not for everybody but they have their place for women with menopausal symptoms that are not alleviated by the commercial available pills or the Bioidentical creams. Some caveats that must be looked at are:

  • All Bioidentical hormones (compounded) are not FDA approved and not covered by insurance, therefore the expense goes up.
  • Pellets have to be placed with a local numbing agent and a small incision.
  • There is no progesterone pellet available so a patient who still has a uterus must take some form of progesterone

In summary – Hormone Pellet Therapy works great for women who have menopausal symptoms not alleviated by other methods.