Pelleted and Bioidentical Hormone Replacement Therapy

Jun 07, 2022


Pelleted and Bioidentical Hormone Replacement Therapy

Have you ever had someone tell you that you need to get your hormones checked? In general, those are fighting words for many women and men, but many people are finding that their symptoms once attributed to “getting older” are validated and caused by hormone loss.

Common issues such as fatigue, insomnia, libido loss, weight gain, depression and anxiety can be related to loss of testosterone, estrogen, thyroid hormone or nutritional deficiencies that can lead to poor production of these essential compounds in your body.

Women and men begin to lose 1-2% of their testosterone a year starting around age 30—and events such as the birth of a child, surgeries, other illnesses like COVID—essentially any physical or emotional stress can accentuate this loss. The loss then is greater when women lose their estrogen at menopause—on average about age 51.

Many women prior to menopause—even in their 30’s or 40’s— will experience classic menopausal symptoms with their testosterone loss but fall within a “normal range” by lab values. Many providers who are not trained in hormone therapy will say that you and your labs are normal—when you know that you are not. The problem is that these lab reference ranges can be established by women drawn in their 60’s to 80’s—or as we age, a testosterone level that made us feel good at 18, is not enough to achieve the same level of function at age 50.

To function optimally—or even normally—you may take being boosted to an “A” student level rather than how you feel at a lower “D” student grade.

It all starts with a simple blood test, a panel of your blood count, your blood chemistry—liver and kidney tests, vitamin b12, vitamin d, a full thyroid panel—not just the standard tsh, estrogen, and testosterone will give many insights to a trained hormone specialist to get you feeling better again.

But beware! Not all bioidentical hormone companies, providers or therapies are alike.  BioTE is the leader in hormone education and promotion for the company and trains providers to properly interpret your lab results and gives them the connections for delivering the same hormones the same way that your body was meant to receive them. Many providers in OBGYN Affiliates have been certified through BioTE and are excellent at helping you through this process. 

What is bioidentical?

Bioidentical means that the estrogen or testosterone that you are receiving is exactly the same —not similar—to what is made in the human body. Many providers will tell you it’s estrogen—but that can be animal derived—such as Premarin—from horse urine—or the testosterone has been modified to adapt as a pill, gel or injection—none of which was native to the human body.

Things that are similar, but not the same, react differently in our bodies—and, in some cases, cause heart attack, stroke, or cancer. If you put the same thing back into your body that was meant to be there, your body is accepting of it and starts to function again. A healthy 20 year old with normal bioidentical levels does not get a heart attack, stroke or cancer.

The delivery of the hormones also makes a difference. You may have had providers suggests creams, pills or troches—which is a waxy square that dissolves underneath the tongue to be absorbed through the salivary glands.

Hormones that are taken orally, don’t absorb well, if at all. Up to 20% of people cannot absorb anything through their skin—that’s why many people don’t feel any different on these methods.

Troches may not absorb or “super absorb” giving no levels at all or abnormally high levels. A pellet delivery method is ideal because it bypasses the stomach, salivary glands or skin.

Unfortunately it involves a numbing shot and a small 3mm incision, but once deep to the skin, the body starts surrounding it with blood vessels and absorbs the hormones, just like a brand new 18 year old ovary or testicle. It lasts about 4 months or so—so no need to put on creams or gels or swallow pills every day. Because it is the same hormones, delivered in the same way, 90% of people chose to continue this therapy, whereas only 20% of people will continue with other delivery methods.

The estrogen comes up in 3 days and the testosterone increases in about 7-10 days, almost everyone feeling a difference within a month. Labs are checked to make sure that they fall closer to an optimal range—but it varies in everyone what their right levels are to promote health and wellness. It promotes targeted therapy for each patient, that’s the difference—individualizing the therapy for each patient.

Most patients return for pelleting and bioidentical hormone therapy because they feel better, but long term it decreases the risk of dementia, osteoporosis, heart disease and potentially breast cancer.

So consider a simple blood draw to analyze your symptoms and rather than fighting disease, promote health and wellness for the rest of your life.

Written By Bruce Dorr, MD, FPMRS, FACOG:

Littleton GYN & Wellness/Right Balance Hormone Health Center

Dr. Bruce Dorr is boarded in Obstetrics and Gynecology and subspecialty boarded in Female Pelvic Medicine and Reconstructive Surgery. For the last 9 years, he has directed his practice towards a functional medicine practice of hormone health and wellness. He serves on faculty for medical education for Biote, a national leader in pelleted hormone optimization and nutraceuticals.  For more information on Littleton GYN & Wellness, please visit