Methods of Hormone Administration

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Pros And Cons of Different Methods of Hormone Therapy

Today we will take a closer look at bioidentical hormones and the pros and cons of the various methods of administering these hormones.

Hormone replacement therapy is not as easy as just taking a pill. The method in which bioidentical hormones are administered can make a huge difference in outcomes.

It is imperative that anyone interested in seeking treatment be aware of these options.

Today we will be looking at the following methods of hormone administration; oral, sublingual, intramuscular, transdermal, patches and subcutaneous. However, before we move on it is important to note that not all methods of administering hormones necessarily contain bioidentical hormones; some may be synthetic or natural. For more information about synthetic, natural and bioidentical hormones; check out our previous blog. It is also important to point out that side effects can be different depending on what type of hormone is being replaced. For the purpose of this blog we be focusing primarily on estrogen and testosterone.

Pills

When it comes to taking medications, most of us are familiar with taking pills, and hormone replacement therapy is no exception. However, oral hormones must pass through our gastrointestinal track and be metabolized by the liver. This results in harmful byproducts which can increase the risk of certain diseases such as strokes and blood clots. This process is one of the pitfalls of the Women’s Health Initiative (WHI) Study and the medication Prempro. Prempro, containing various estrogens and a progestin, was provided orally to participants. The study failed to test other methods of administration and generalized their results to all types of hormone replacement therapy. Another downfall of taking hormone replacement pills is that estrogen when taken orally often converts to estrone, which is “old lady estrogen.”

Testosterone when taken orally is more likely to be converted to estrogen, which obviously defeats the purpose of even taking testosterone in the first place. This conversion for estrogen and testosterone also occurs with sublingual tablets/drops, transdermal creams, transdermal patches and intramuscular injections. Sublingual tablets and transdermal creams need to be applied multiple times a day, in most cases. Additionally, when the hormones are released, they create a huge spike in hormone levels followed by a drastic decline. This can leave someone with up’s and down’s throughout the day.

Injections

Intramuscular injections are also prescribed, especially when it comes to testosterone and typically require someone to receive an injection one time per week. In many cases they have the same “roller coaster ride”of ups and downs. In some cases they have chemicals added to decrease these effects. Testosterone replacement for women through IM is also problematic because the testosterone increases DHT conversion which can multiply side effects such as facial hair and balding.

Patches

Another common method is transdermal patches which have become one of the more popular methods of hormone administration over the past decade. One advantage is that they bypass the effects of the liver and disperse a level of hormone that is relatively consistent throughout the day.  The downfall to the patch is….well… that it is a patch, which can be a nuisance to wear, and cause skin irritation.

Hormone PelletsPellet hormone therapy treatments involve inserting a custom hormone pellet into your body.

The final method we will be discussing today is hormone pellets. Hormone pellets are bioidentical and often administered below the hips or in the buttock region via a minor incision, which is innocuous, and does not require stitches. The fact that this method requires the use of a minor procedure can deter some individuals.

However, the benefits far outweigh any adverse effects. Bioidentical hormones, like our own hormones, are lipid soluble and are used up by the body as needed; mimicking the bodies own endogenous system. This methods also allows the hormones to be used directly negating any conversion during metabolization. Another benefit is that the patient only needs to see the doctor once every 3-4 months, which for most of us with a go-go go schedule can appreciate.

One key point to keep in mind is that we are not all the same. Okay, I know this a simplistic statement, but it is important to note as what works for one individual may not work for someone else. With that being said, this is one of the benefits of working with a doctor and a compounding pharmacy; the treatment is customized to your needs. So stay tuned next week as we look more into some of these issues and contact Vitali-T Medical Clinics to find out if bioidentical hormone replacement is right for you.

References:

Archer, David F. Estradiol gel: A new option in hormone replacement therapy. OBG Management. September 2004. Page 46-64

Barlow, et al. Long-Term Hormone Implant Therapy-Hormonal and Clinical Effects. Obstetrics & Gynecology Vol. 67, No. 3, March 1986. Page 321-325.

British Medical Journal. Volume 294, 936-937. April 1987. Effects of combined implants of oestradiol and testosterone on libido in postmenopausal women.

Buster, et al. Testosterone Patch for Low Sexual Desire in Surgically Menopausal Women: A Randomized Trial. The American College of Obstetricians and Gynecologists, Vol. 105, No. 5, Part 1, May 2005. Page 944-952.