Hormone Pellets for Menopause: Pros and Cons
Pros of Hormone Pellets
Bioidentical hormone pellet therapy may offer some benefits to those who use them. These benefits may include:
- Consistent hormone release: Hormones are consistently released into the bloodstream, and their effects can last three to six months.
- Convenience: For people who prefer not to take a daily pill, hormone pellets offer a convenient alternative, as a healthcare provider implants them under the skin.
- May provide symptom relief: Hormone pellets may help alleviate menopause symptoms, including hot flashes, night sweats, and other symptoms.
- Can be personalized: Unlike prescription medications with fixed ingredient amounts, compounding pharmacies can mix, alter, or combine ingredients to create a product that suits the individual’s needs.
Cons of Hormone Pellets
- Not FDA-Approved: Hormone pellets are compounded, which means they are prepared by a pharmacist in a compounding pharmacy by mixing or altering ingredients. However, compounded drugs are not subject to the same strict regulatory guidelines as FDA-approved prescription drugs, which means the FDA has not verified or vetted their use before they go to market. As a result, there is an additional risk that products may vary in quality or pose safety concerns.
- Requires Minor Surgery: Hormone pellets must be implanted under the skin by a healthcare provider, where they will slowly release hormones over time until they dissolve. During the procedure, a local anesthetic is used to numb the area, and then a small incision is made and the tiny pellets are placed into fatty tissue under the skin. The area is then covered with a dressing and compression for several minutes. After the procedure, the individual must follow aftercare instructions for applying ice and changing the dressing for a few days. The procedure is relatively minor, but it will be required every few months for continued treatment.
- Potential for Side Effects and Risks: Compounded products, such as hormone pellets, are at risk for variations in quality and strength. This can result in unknowingly getting too much or too little of the hormones included. Due to these potential risks, the American College of Obstetricians and Gynecologists (ACOG) recommends FDA-approved hormone treatment over compounded hormones.
Who Should Not Use Them?
You should not take hormone pellets or any type of hormonal replacement therapy if you have or have had any of the following conditions:
- Breast cancer
- Endometrial cancer
- Stroke
- Heart attack
- Blood clots
- Liver disease
- Pregnancy or possible pregnancy
Alternative Therapies
There are various alternatives to hormone pellets, including both hormonal and nonhormonal treatments.
- For those seeking an FDA-approved alternative to hormone pellets, there are several options, including estrogen pills, patches, gels, and sprays, as well as vaginal estrogen products, which are suitable for people whose primary symptom is vaginal dryness.
- If you still have a uterus, you will also need progestin therapy, which helps lower the risk of uterine cancer that can occur when taking estrogen alone. The combination of estrogen and progestin is called combined hormone therapy.
- For those who cannot take hormones, there are other options to consider under the guidance of your healthcare provider, such as:
- OTC vaginal moisturizers for vaginal dryness
- Antidepressants for hot flashes
- Selective estrogen receptor modulators (SERMs) for hot flashes or pain during intercourse
- Vezolinetant, a hormone-free treatment that helps with hot flashes and became FDA-approved in 2023
Summary
Hormone pellets for menopause are made by compounding pharmacies and may help alleviate symptoms such as hot flashes and night sweats. However, there are negative side effects of hormone pellets to consider, such as the fact that they are not FDA-approved and require a minor procedure for insertion. Consult a healthcare provider to determine your best treatment options.
