“I want my drive back!” How many times have patients (especially women) sat in my office and said these exact words? We have an assumption that youth and vitality are simply a state of mind. And that losing that vitality over time must only be because (insert excuse here)… Work is exhausting, the kids are demanding, or worse yet, the marriage has gone stale… But what if the actual reason was less mental and more PHYSICAL? And that the rest of these very valid excuses were more of a SYMPTOM of a slow decline in natural hormone levels over time?
- Fatigue
- Loss of libido
- Loss of muscle mass and corresponding weight gain, to name a few.
Is this process “natural?” Sure. But do we HAVE TO live this way? No!
Lots of things can cause hormone levels to drop including age, illness, injury, lifestyle choices and childbearing.
In our “one size fits all” world, we like to think that hormone changes only happen to the older population. And as a result, we have associated older numbers on our driver’s license with an attitude of “Well, this is how it should be for my age.” But the 40’s, 50’s and even 60’s of our parent’s generation are not the same as today. Advances in science have helped us safely identify and treat hormone changes and bring back that vitality of younger years. Not only that, but with more advances in data and research on hormone replacement therapy, medical providers are now able to dose more safely than ever. This gives optimal results to the patient’s quality of life and minimizes risks that may have been seen in the past.
- Hormone replacement therapy can happen in several forms:
- Bioidential hormone “pellets”
- Testosterone injections
- Topical hormone creams and oral tablets or “troches.”
All these forms can be effective for replacing hormones, but each has their “pros” and “cons” to consider.
Oral tablets / capsules / troches –
Historically, oral HRT is the most common and inexpensive way to replace hormones. The benefit is that you simply take the hormones daily (usually in the evening) and then see your provider every 90 days for refills and follow up.
There are several problems with the oral route, the primary one being that you are reliant on your digestive tract being able to uptake the medications at a therapeutic level without having issues such as digestive upset, food interactions, or sometimes the body not being able to absorb enough of the medications to reach a consistent therapeutic range.
Daily compliance can also be an issue for some people, as is having to manage prescription pickups, and the inevitable forgotten or lost pill container while traveling. These interruptions can cause hormone fluctuations and side effects.
Testosterone Injections –
For men, testosterone injections have been the longest standing method for delivering additional testosterone to the body. The patient is given injection instructions along with a vial of testosterone in oil, and they self-inject twice a week into muscle. These injections have a benefit if raising testosterone levels rapidly and giving rapid hormonal changes within 24 hours of injection. The benefit of this method is a low-cost way of rapidly delivering testosterone. There can be several drawbacks to injectable testosterone. The first – of course – is the ongoing injections that are self-administered. Over time, injection fatigue can happen, resulting in non-compliance. Bruising, pain, and injection site soreness can also be an issue. Overdosing with injectable testosterone is common, so frequent lab draws are needed to ensure safety. Some men may develop elevated red blood cell levels as a result of excessive testosterone, so many times blood donation will be required to offload the excess cells.
Creams –
Hormone replacement in the form of creams has been presented to both men and women as an option for hormone replacement. The benefit of topical creams is the ease of applying a thin layer to the skin and have the hormones absorb slowly over time. Creams also give a benefit of being able to be “bioidentical,” or made from plant sources that mimic human hormones much more closely. The problem being found with creams is that unless the user is very careful, creams tend to not absorb properly and can also migrate from the application site onto other people and objects in the environment.
Bioidenital Hormone Pellets –
In recent years, pelleting has become the more popular trend in hormone replacement for both men and women. Time releasing pellets the size of thin ticktacks are painlessly inserted under the skin in the upper buttock. These pellets slowly dissolve over time, releasing a steady level of hormones over a 4-6 month timeline. Because there is relatively little maintenance needed on the patient’s part, pellets are increasingly growing as the more popular choice for hormone replacement.
No matter what method you and your provider decide on to replace hormones, having your hormone levels checked via lab work is the very first step. Check with your provider and see what your levels are. By supplementing hormones, levels can be returned to healthy levels, providing relief from hot flashes, low libido, fatigue and other reversable symptoms.