Name of the Procedure:

Subcutaneous Hormone Pellet Implantation
Common names: Hormone pellet therapy, Estradiol pellet insertion, Testosterone pellet insertion

Summary

Subcutaneous hormone pellet implantation involves placing small pellets containing either estradiol, testosterone, or a combination of both beneath the skin to provide a steady release of hormones. This procedure helps balance hormone levels over an extended period.

Purpose

Subcutaneous hormone pellet implantation addresses hormonal imbalances such as those found in menopause, andropause, or other conditions causing low hormone levels. The goal is to alleviate symptoms like hot flashes, mood swings, decreased libido, and fatigue by providing a consistent supply of hormones.

Indications

• Symptoms of menopause (e.g., hot flashes, night sweats, mood changes)
• Symptoms of andropause in men (e.g., low libido, lethargy, muscle weakness)
• Medically determined low levels of estradiol or testosterone
• Patients seeking long-term hormone replacement therapy with a steady hormonal release

Preparation

• Patients may be advised to fast before the procedure if sedation is used.
• Some medications may need to be adjusted or paused.
• Blood tests to assess current hormone levels and ensure suitability for therapy.

Procedure Description

1. Preparation: The skin is cleaned and sterilized.
2. Anesthesia: Local anesthetic is administered to numb the target area, usually in the buttocks or lower abdomen.
3. Insertion: A small incision is made, and a specialized device is used to insert the hormone pellet(s) beneath the skin.
4. Closure: The incision is closed with sterile strips or sutures and covered with a bandage. Tools used include a scalpel, insertion device (trocar), pellet implants, and sterilization supplies.

Duration

Typically takes about 20-30 minutes.

Setting

Usually performed in an outpatient clinic or a doctor's office.

Personnel

• Primary healthcare provider (e.g., physician, nurse practitioner)
• Nurse or medical assistant

Risks and Complications

• Bruising or bleeding at the insertion site
• Infection
• Pellet extrusion (pellets coming out before fully absorbed)
• Hormonal imbalance or overdose leading to symptoms like acne, hair growth, or mood swings

Benefits

• Steady hormone levels without the need for daily medication.
• Potential relief of symptoms within days to weeks.
• Long-lasting effects, generally 3-6 months before reimplantation is needed.

Recovery

• Keep the insertion site clean and dry for a few days.
• Avoid strenuous activity or submersion in water for at least 48 hours.
• Typical recovery time is short, with most patients resuming normal activities within 1-2 days.
• Follow-up appointments may be scheduled to monitor hormone levels and assess effectiveness.

Alternatives

• Oral hormone replacement therapy (pills)
• Transdermal patches or gels
• Intramuscular hormone injections Pros and cons: Alternatives may require more frequent administration and may not provide as steady a hormone release as pellets.

Patient Experience

During the procedure, patients may feel slight pressure but should not feel pain due to local anesthesia. Post-procedural discomfort is generally mild, with possible bruising or tenderness at the insertion site. Pain management typically includes OTC pain relievers if necessary.