The Difference Between Bioidentical Hormone Replacement Therapy (BHRT) and Pellet Bioidentical Hormone Replacement Therapy

Hormones are essential chemicals in the body that regulate vital functions, from growth and metabolism to reproductive health. As we age, levels of certain hormones naturally decline, affecting energy, mood, and overall health. This decline can be more pronounced during peri and post menopause often leading to symptoms like fatigue, mood swings, and osteoporosis. Bioidentical Hormone Replacement Therapy (BHRT) and Pellet Bioidentical Hormone Replacement Therapy are treatments designed to replenish declining hormone levels, though each approach differs in formulation, origin, and impact on the body. This article explores these differences to help you make an informed choice.

Pellet Bioidentical Hormone Replacement Therapy (HRT)

Pellet bioidentical hormone replacement therapy (HRT) is a medical procedure that involves implanting small hormone pellets under the skin to help balance hormone levels as the pellets slowly release hormones into the bloodstream so a daily dose of hormones is not needed. The procedure can cause pain, bleeding, bruising, and infection. Pellet HRT can help with symptoms of hormonal imbalances, such as mood swings, low energy, trouble sleeping, decreased sex drive, fatigue, and weight gain. The pellets work for months before being replaced, every three to four months for women and every six months for men. The treatment continues indefinitely to relieve symptoms.  A doctor can customize the dosage to optimize the results. People of any gender can use pellet HRT, but it's often used to treat conditions like menopause, perimenopause, and hormone deficiencies in women. However, men use pellet therapy to treat symptoms of low testosterone as well.

Side Effect of Pellet Bioidentical Hormone Replacement Therapy

Side effects of Pellet Bioidentical Hormone Replacement Therapy can include 

  • mood swings

  • anxiety

  • acne

  • weight gain

  • hair pattern changes

  • headaches

You may need additional pellets or a dosage adjustment from your doctor. The pellets are difficult to remove because they slowly dissolve over time. The pellet may be pushed out of its insertion position, causing a bulge. Scarring may occur at the incision site or from repeated procedures.

For some people, the pellets sound appealing considering they are inserted and you don’t have to do anything for 3-6 months. However, this route of administering bioidentical hormones does not give you all the benefits of BHRT.

Each bioidentical hormone is used not only to treat specific symptoms of hormone depletion but also to combat the chronic diseases of aging such as:

  • osteoporosis

  • heart disease

  • hyperlipidemia

  • diabetes type 2

  • high blood pressure

Along with the chronic diseases come changes such as:

  • muscle loss

  • skin thinning with texture depletion

  • hair loss

  • fatigue

  • feeling cold

  • sleep disorders

That’s not even mentioning all the symptoms associated with perimenopause and post menopause.

Hormone Replacement Options

Why do we replace the hormones the way we do? Because decades of medical literature states the benefit from taking bioidentical hormones in specific forms, such as a pill or cream, because the body needs to get each hormone how it can be best utilized to restore the body and combat the effects of diminishing hormone levels with age. Let’s look at each hormone.

  • Estradiol taken orally goes through what we call in medicine the first pass effect which means it is broken down by the liver then becomes available throughout the body as it is carried by the blood. The importance of the first pass for oral estradiol is that it can clean the blood vessels giving protection from plaque build up which leads to heart disease and if plaque releases it causes a heart attack or stroke. Additional benefits of oral estradiol include helping to decrease visceral fat which in turn helps lower total cholesterol and increase HDL, the good cholesterol, as well as protecting against bone loss and memory disorders as it protects bone strength and brain blood vessels. The misconception that oral estradiol is bad comes from the Women’s Health Initiative that stated estrogen caused an increased risk of breast cancer and heart disease when taken orally, which was the synthetic estrogen and progesterone not the bioidenticals. The bioidenticals are made from plants and transformed in the lab into molecules the body recognizes and uses as it would naturally produced hormones.

  • Progesterone taken orally also goes through the first pass effect which returns a woman’s ability to sleep - a very nice first pass effect. Progesterone is also responsible for decreasing moodiness, irritability, bloating, headaches and provides protection from breast and uterine cancer. High progesterone levels in pregnancy are often responsible for making us feel great during pregnancy as PMS symptoms disappear.

  • Testosterone cream applied inside the vagina produces the greatest benefit as that’s where the highest concentration of 5 alpha reductase is located which is needed to convert the testosterone to DHT (dihydrotestosterone), which is responsible for muscle growth, libido, sexual function, and it makes testosterone apoptotic to breast cancer cells. Apoptotic means it kills the cancer cells.

A Modern Approach

Most of the benefits of bioidentical hormones are lost when not given in the manner that provides the best results just like our hormones did when we were younger. Additionally, you will not receive thyroid hormone optimization from most hormone replacement therapy specialists including pellet therapy.

Thyroid is important to regulate temperature, metabolism, and cerebral function which results in increased energy, temperature, warmth, fat breakdown with weight loss and lower cholesterol as well keeping our brains functioning. Thyroid is also important for hair growth, beautiful skin and nails. Thyroid affects every cell in the body, which means it’s critical to ensure thyroid production is optimal. Thyroid production declines as we age and although most people don’t meet the criteria for hypothyroidism and treatment with synthetic T4, all aging people will benefit from bioidentical thyroid hormone replacement.

Last but not least, another thing Raving Health does differently is interpreting lab values. Normal lab values for your age does not mean those values are optimal. Optimal lab values provide relief from symptoms and disease allowing us to age with a fabulous quality of life as we maintain our good health, feel and function better.

Optimal women’s health and wellness is our goal here at Raving Health. Let us help YOU understand and optimize your hormones. Start with a consultation today!