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Hormone Replacement Therapy


Cathy Watkins - Nurse Practitioner and Signature Image Medical Spa Co-Owner

What is hormone replacement therapy (HRT)?

Hormone replacement therapy, or HRT, is used in women to treat a variety of perimenopausal and menopausal symptoms.  Bio-identical hormones (BHRT) are types of hormones that are derived from plant sources and are utilized and metabolized the same way as hormones produced naturally by the body.

What are some benefits of hormone therapy?

Hormone replacement can improve hot flashes, night sweats, and sleep disturbances caused by changing hormones levels of peri- and post-menopause.  It can also help with improvement of mood and energy levels as well as improve mental clarity and focus.  HRT can reduce anxiety and depression. Hormone therapy can improve vaginal dryness, sexual desire, and enjoyment.  HRT can increase lean muscle mass and make it easier to lose weight as well as maintain healthy bone density.  Overall, BHRT can improve quality of life and well-being.

Why use pellets?

The insertion of pellets is a simple and effective way of delivering a steady release of hormone therapy with consistent patient outcomes. Pellet therapy eliminates the need of daily and multiple dosing of therapy thereby ensuring 100% compliance.  The use of bio-identical pellet therapy has fewer side effects associated with blood clotting, blood pressure, lipid levels, blood glucose, and liver function.  It is a simple cost-effective delivery method requiring minimal amount of patient visits per year and recreates hormone levels better than any other delivery method.

What are the costs associated with pellet insertion?

The cost of insertion is $350.  You will probably require 3-4 insertions per year.  In addition, basic lab work will be required prior to initiating hormone therapy and periodically throughout your treatment to monitor hormone levels.  Lab work can be filed by our lab and can be run through your insurance or HSA account.  Otherwise, hormone panels are $250.  We can also complete a lab requisition so you may have blood drawn from your preferred lab facility, but we are unable to quote prices or timeliness of lab result returns.

What can I expect as far as the procedure?

You will first have a consult which includes:  a review of your medical history and current symptoms, a brief physical exam, and an assessment of lifestyle and stressors.  Blood work will be drawn with all information being put together to create an individualized treatment plan that meets your personal needs.  Sterilized pellets will be prescribed, ordered, and obtained from our reputable and certified compounding pharmacy.  You will return to the office in about 1 week for the actual insertion procedure.

The insertion involves locally anesthetizing an area of fatty tissue on your hip or abdomen.  A very small surgical incision is made, and a trocar is inserted into the fatty tissue with the hormone pellets deposited in place.  Steri-strips will be placed over the incision and may be removed in 5-7 days.

There is generally no recovery time required and you may resume normal activities although you will be advised to avoid strenuous activity for 2 days, especially activity that requires increased use of abdominal or gluteal muscles.  You may experience some local redness or discomfort at the insertion site.  If this occurs, ice or heat may be applied intermittently during the first 24-48 hour to ease discomfort.  Rarely, are antibiotics required.  You will be scheduled to return to the office in 4 weeks to draw blood and evaluate peak hormone levels and to perform a follow-up and outcome assessment.

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