General: Hormone Therapy including creams injections, and pellets are naturally derived concentrated hormones, which are biologically and synthetically similar to an individual’s naturally occurring hormones. These have been successfully used since the 1930s and provide a longer acting alternative to other hormone combinations such as tablets, patches, or injections.
Benefits: Potential benefits can include decreased frequency and severity of menopausal symptoms, such as hot flashes, night sweats, headaches, mood swings, anxiety, increase in muscle mass, and decrease in subcutaneous fat.
Side Effects: Hormone related side effects and risks are generally applicable to the use of hormones, regardless of the mode of delivery. These may include irregular bleeding, breast tenderness, swelling, increase in hair growth, water retention, increased growth of estrogen dependent tumors, blood clots, liver tumors, and acne. Procedure related complications may include infection, bleeding, bruising, swelling, pain, extrusion, or scarring. Surgical risks are the same as for any minor medical procedure and include those described above.
Contraindications: Potential contraindications include pregnancy, undiagnosed abnormal vaginal bleeding, active thromboembolic disorder, myocardial infarction, breast or endometrial cancer, or liver disease. Each woman will be evaluated to determine appropriateness for hormone therapy prior to beginning therapy. As with all hormone replacement therapy strategies, patients who are not sterilized and not menopausal are strongly advised to continue reliable birth control while participating in pellet hormonal replacement therapy. Testosterone is category X (will cause birth defects) and cannot be given to pregnant women.
Minimizing risk: An important part of minimizing potential complications is understanding risk. This will be done by getting baseline labs and doing a simple physical exam. All patients should be including mammogram, gynecologic exam and pap if indicated in their examinations with their primary care doctor. Pathway Wellness medical will order regular blood work to analyze CBC, metabolic panel, and hormone levels. These will be repeated at a minimum annually. As you continue to use hormone therapy it will be important to keep all of your providers aware of any changes that may affect your response to hormones. This may include a new diagnosis, or a change in your medications, or even plans for surgery. If your plans for fertility change, you will likely need to stop hormone replacement therapy. Additionally, studies have shown that when women are physically active, eat a healthy diet, and maintain normal weight, they can minimize their risks further.
CONSENT FOR TREATMENT: I have read and understand the above. I have had the opportunity to ask any questions regarding pellet therapy. All of my questions have been answered to my satisfaction. I further acknowledge that there may be risks of hormone therapy that we do not know at this time. I understand the risks and benefits of this treatment. I have been informed that I may experience complications from infection, extrusions, or that I may note no effect or otherwise be dissatisfied with my treatment. I agree to report to my provider any adverse reaction or problems that may be related to my therapy, so any issues can be addressed in a timely manner and minimize any potential complications or adverse reactions.
