Hormone Replacement Therapy – What is it?

In the field of medicine, we have made incredible technological advances, especially in terms of diagnostics and treatments. But sometimes, even with these tests and protocols, generalized symptoms can’t always be explained by any single disease. Many unexplained symptoms often represent an imbalance of one or more of our critical hormones, especially in middle age. But what exactly are hormones, why can they cause so much trouble, and how do we address them?

Hormones are chemicals excreted by the endocrine glands around the body. They carry messages that trigger certain bodily functions, including growth, metabolism, mood regulation, and sexual function. While most hormonal changes are gradual and related to age, puberty, and menopause, for example, various lifestyle and environmental factors can alter our hormonal balances and wreak havoc on our bodies. The results can be as mild as feeling sluggish or tired or severe and feature-changing or contributing to disability.

The Advent of Bioidentical Hormones

Bioidentical hormones were a step forward in the treatment of hormonal disorders. While artificially produced, they are replicas of the hormones secreted in the body. Bioidentical hormones are derived from plants, most commonly in the form of estrogen, progesterone, and testosterone. They can be premade or customized depending on a patient’s particular needs and circumstances.

What Is Hormone Replacement Therapy?

Hormone replacement therapy uses small time-released pellets inserted under the skin through an incision at the upper buttocks. The incision is small enough that no suture closure is needed – a small bandage is used to cover it. These pellets are absorbed by the body and can improve the symptoms of hormone deficiency both in men and women.

Who Can Benefit from Hormone Replacement Therapy?

Perimenopausal & Menopausal Women

Menopause is a significant event in every woman’s life and represents a permanent physiological change. We use these bioidentical estrogen pellets to level out hormonal fluctuations and address hot flashes, headaches, and mood issues commonly associated with this time in a woman’s life. Post-menopausal women can also benefit significantly from hormone replacement therapy.

Hysterectomy Patients

Hysterectomy, or the removal of a woman’s uterus, can cause significant changes in a woman’s life, both physically and emotionally. While sometimes necessary to treat various painful conditions, the potential side effects after surgery can be significant. Hormone replacement therapy has often been shown to improve symptoms and a woman’s quality of life.

Men with Low Testosterone

Hormone replacement therapies can also be effective for those experiencing low testosterone or low T. This is a common condition in middle- to later age where men lose some muscle tone, sex drive, and more. Testosterone replacement therapy can be an excellent option to restore some of those functions.

The Process

Initially, patients will be given a complete examination to identify what hormones may be causing concern. This will require a physical exam, medical history, and extensive blood work. With this knowledge, we can schedule the next visit, including inserting a customized dosage of hormonal pellets into the upper buttocks. The area is numbed, and a tiny incision is made to house the pellets. The incision is closed with a bandage and heals normally. Patients do not feel the pellets; no residual material remains once dissolved.

After the insertion of the pellets, patients should avoid significant exercise involving the lower body until the bandage is removed. Patients can shower but should not immerse themselves in a bath or pool. Patients will be given instructions and when they can resume regular activity.

Results and Reinsertion

The pellets are designed to dissolve over time, and patients should begin feeling improvement in as little as one to two months. Typically, the full improvement is felt at about the six-month mark. We expect to see the benefits of hormone replacement therapy for a while, but it does eventually wear off. As such, undergoing further reatments may be necessary periodically in the future. To extend the time between procedures, we encourage our patients to address any underlying conditions, including metabolic disorders like obesity and excess weight, which can cause hormonal fluctuations throughout the body.

If hormone therapy is discontinued, patients will most likely begin to experience the same hormone-related physical and emotional concerns they had before the procedure.

The Risks and Considerations of Hormone Replacement Therapy

As with any procedure that alters hormone levels, there are potential side effects and considerations which must be discussed during your consultation. These risks are considered when we develop the treatment plan specifically for you. There can be an increased risk of heart disease, stroke, gallbladder issues, and breast cancer. These are usually higher for people of advanced age and those in poor general health. Similarly, the dosage and length of use also increase the risk profile. We make every effort to minimize those risks through systematic and in-depth testing.

Finding Hormonal Balance

Lindsey Broadnax, PA-C at our Internal Medicine  office in Carrollwood helps both men and women find hormonal balance with a personalized, comprehensive treatment plan. The first step to improving hormonal health and rejuvenation is to Schedule an Appointment in our office.


Hormone Replacement • Internal Medicine

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