Policy

Estradiol and/or Testosterone Acknowledgement Insertion knowledge;

General: Bioidentical hormone pellets are comprised of naturally derived concentrated hormones. These hormones are designed to be biologically identical to the hormones a woman makes in her own body prior to menopause, including estrogen and testosterone which are made in the ovaries and adrenal glands. Bioidentical hormones have the same effects on the bod as one's own estrogen and testosterone did when the woman was younger, without the monthly fluctuations (ups and downs) of menstrual cycles.

Bio-identical hormone pellets are made from yam or soy and are FDA monitored but not approved for female hormonal replacement. The pellet method of hormone replacement has been used in Europe and Canada for many years and by select 0B/GYNs in the United States. You will have similar risks as you had prior to menopause, from the effects of estrogen and androgens, given as pellets.

Birth Control: Patients who are pre-menopausal are advised to continue reliable birth control while participating in pellet hormone replacement therapy. Testosterone is listed as a category X (will cause birth defects) and cannot be given to pregnant women.

Benefits and Risks:
I have been told I may have testosterone inserted under my skin to achieve a steady delivery of natural hormone into my blood stream. The potential benefits of testosterone include decreased hot flashes and sleep disruption, increased libido and sexual function, increased well-being and motivation, increased energy, decreased depression and anxiety, decreased mood swings, and improved memory and cognition, Testosterone may decrease the frequency of headaches including migraine headaches, Testosterone may also decrease the incidence of breast and colon cancer, be cardioprotective, may increase bone density, and my decrease the risk for Alzheimer's disease. I have been told that I may have estradiol pellet(s) inserted under my skin to achieve a steady state of estradiol in my body. The potential benefits of estradiol include alleviation hot flashes, vaginal dryness, sleep disruption, decreased mood swings and irritability, decreased depression and anxiety, improved memory and cognition, increased bone mass, cardio protection, protection against Alzheimer's disease and colon cancer.

The above potential benefits come with some risk. In cases of excessive consumption of synthetic testosterone by women (generally orally or by injection), adverse conditions included heart problems, liver problems and elevated cholesterol. Pellet therapy is non-oral, uses natural testosterone and is not associated with such problems.

In a rare number of patients, the body will convert testosterone to DHT, which can cause acne, hair loss and increased facial hair. The estradiol dosage that I may receive can aggravate fibroids or polyps, if they exist, and cause bleeding.

Side effects of complications are substantially less when compared with synthetic hormones but may include: lack of effect (from lack of absorption); breast tenderness and swelling especially in the first three weeks (estrogen pellets only); water retention (estrogen only); increased growth of estrogen dependent tumors including endometrial cancer, breast cancer and liver tumors, and clitoral enlargement -which is reversible.

Insertion of pellets may cause bleeding, bruising, infection, or pain at the insertion site. Pellets may also be extruded.

Charges: I understand there is a charge which varies depending on the number of pellets I may receive. The precise amount is to be determined your medical provider. I understand payment is due in full at the time of service.

I have read and understand the above. I have been encouraged and 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 the risks and benefits of this treatment have been explained to me and I have been informed that I may experience complications, including one or more of those listed above. I accept these risks and benefits and I consent to the insertion of hormone pellets under my skin.