Why do I need hormone replacement?

Women need replacement if they desire to:

• Delay the symptoms of aging

• Increase energy

• Preserve skin and muscle tone

• Look younger

• Reverse depression and anxiety

• Improve sex drive

• Decrease insomnia

• Improve physical stamina

• Thicken hair

• Strengthen the immune system

• Protect against heart disease, osteoporosis, dementia, and diabetes

• Prevent need for long term care from loss of ability to walk

• Improve general health

Pellets FAQ

What is pellet therapy?

Pellet therapy consists of inserting a prescribed number of pellets (they are a little bigger than a grain of rice) into the fatty tissue underneath your skin in the hip region. Our pellets are made of compounded estradiol and testosterone.

The pellets contain hormones, which mimic (are bio-identical to) the effects of hormones in your body, and are gradually released into your bloodstream.

The pellets are released based on your cardiac output – how much physical activity you do, how much stress you’re under, etc.

Unlike other forms of hormone replacement (creams, shots, etc), pellets do not require daily maintenance, aren’t messy, and don’t require you to remember to do something every day. No one needs the added stress!

Why haven’t I heard about hormone pellets?

• You may wonder why you haven’t heard of pellets. Pellets are not patented and have not been marketed in the United States. They are frequently used in Europe and Australia where pharmaceutical companies produce pellets. Most of the research on pellets is out of Europe and Australia. Pellets were frequently used in the United States from about 1940 through the late 70’s when oral patented estrogens were marketed to the public. In fact, some of the most exciting data on hormone implants in breast cancer patients is out of the United States. Even in the United States, there are clinics that specialize in the use of pellets for hormone therapy.

What is the cost?

• Please see our Plans & Pricing page for further information regarding pricing.

I hear so much about BioTe, what is the difference in BioTe & EvexiPEL?

• EvexiPEL was founded by Dr. Terri DeNeui a nurse practitioner who originally trained with BioTe. She branched off and developed her own empire using the BioTe processes, fine tuned the systems with the most up-to-date research, and made the pellet process even better! This is known as “The EvexiPEL method”.

• Evexias medical solutions also owns their own pharmacy in Texas, FarmaKeio which is where the pellets are made and regulated. BioTe does not have their own pharmacy.

Do you accept insurance or HSA?

• At this time, we do not accept insurance or health savings accounts. Payment can be made using cash, cashier’s check, or credit card.

Why are pellets better than patches, creams, shots, or pills?

• Pellet therapy allows a safe, economical, and more convenient way, to receive hormone replacement therapy that guarantees a therapeutic level over many months. This allows natural, bioidentical, hormone to be delivered directly into the blood stream and distributed through the body by your cardiac output. When you exercise your heart rate is faster, so you actually absorb more hormone during the time it’s needed. Due to the consistent delivery of hormone, many women feel better on pellets than other forms of estrogen or testosterone replacement.

How is the pellet dosage calculated?

• Every treatment plan and patient is unique. We utilize a state-of-the-art dosing calculator which produces dosing to recreate what the normal daily production of testosterone and estradiol by a young ovary should be. Pellet dosing is also determined by body mass, amount of exercise, and other medications the patient takes.

Where are pellets inserted?

• We place them in the upper fatty tissue of the hip slightly under the skin where they can dissolve and be picked up by capillaries.

How long will it take for the pellets to work?

• It typically takes about 3-4 weeks to get the full effect. Many patients experience symptom relief much sooner, sometimes within days. We would rather under promise and over deliver! Pellets must be re-inserted every 4 months or symptoms will return.

How long will my pellets last?

• Typically, four months. Pellets are distributed through your body by your cardiac output (stroke volume x heart rate). Pellets may last for a shorter time if you have a stressful job, exercise to extremes, or get minimal sleep. If this is the case, the dose will be titrated upward in 4 months at the time of the next pelleting.

 Do the pellets completely dissolve at the end of the 4-6 months?

• Yes. There is nothing left to be removed.

How long can I take pellets?

• As long as you wish and as long as you want to feel alive and active! Bioidentical hormone pellets are all natural and the closest thing to your body’s actual hormones. Replacing Testosterone and Estradiol actually prevents many diseases of aging which is what we are trying to achieve. As always, this is your body and your decision. We will work together to make a decision that you feel is best for your health goals.

Are there any reasons I would have to stop taking pellets?

• Testosterone may increase sex drive. This can be both good and bad depending on the woman and her personal life. This may not beneficial for women without a sexual partner or if a women feels too old for sex. These patient’s may still benefit from other forms of hormone replacement.

• A small amount of women with complex symptoms of chronic fatigue or psychiatric illnesses on multiple medications may not feel improvement in symptoms as quickly as other women. Pellet dosing may take a bit longer in these women leaving them potentially frustrated and essentially give up on the treatment.

• If a patient develops breast cancer while on Estradiol pellets, those would be discontinued. 1 in 8 women will develop breast cancer whether they are on pellets or not. Pellets are the least risky BHRT in regards to the risk of developing breast cancer. Testosterone pellets are recommended to continue during breast cancer treatment as they are immuno-protective actually fighting against cancer cells.

What symptoms are treated Estradiol pellets?

• Estradiol pellets adequately treat hot flashes, a dry vagina, painful intercourse, dry skin, and thinning hair.

What symptoms are treated by testosterone pellets?

• Symptoms of low testosterone include: low libido, fatigue, weight gain, muscle mass loss, decreased stamina with exercise, brittle bones, depression/anxiety, autoimmune diseases, loss of motivation, and many others.

Can I take testosterone pellets if I am not menopausal and still having periods?

• Yes. Most patients begin treatment sometime after 40 or if their ovaries are removed. Testosterone from the ovary disappears before menopause and should be replaced when a woman starts having symptoms.

Do Testosterone or Estradiol pellets cause weight gain?

• In most cases, this is caused by temporary water retention which is often mistaken for weight gain. Testosterone increases your muscle mass and thickens your bones as well. Many women begin losing weight 9-12 months from the start of treatment.

Can I take birth control pills with testosterone pellets?

• Birth control pills dampen the effect of Testosterone. Therefore, we recommend not continuing them. We do recommend other birth control options such as getting a Mirena IUD or permanent birth control such as a tubal ligation or have your husband get a vasectomy. Women who decide to continue their pills are typically not happy with their results due to the decrease in effect.

Do testosterone pellets cause blood clots?

• No, they do not.

Do estradiol pellets cause blood clots?

• No, they do not.

Do testosterone pellets cause breast cancer?

• No. Testosterone pellets actually improve the immune system’s function which helps you to fight all types of cancers more easily than before you started.

Can I take hormones if I have had breast cancer?

• Yes & No. You CAN take bioidentical Testosterone pellets! This is the safest form for you as it actually improves your immune system fighting off abnormal cells all while giving you some relief of your menopausal symptoms. We do NOT prescribe other hormones (Estrogen, Progesterone, DHEA) to breast cancer survivors.

What other medications inactivate or interact negatively with estradiol and testosterone pellets?

• Oral contraceptives

• Progestins such as Provera

• Anti-depressants-many times covering up hormone imbalance (root cause)

• Steroids such as Prednisone or Medrol Dosepak (Methylprednisolone)

• Tamoxifen

Testosterone FAQs:

What are the benefits of TRT (testosterone replacement therapy)?

• Testosterone can balance various systems in your body and help improve your overall health along with other hormones estrogen and progesterone. It helps repair muscles and tissues, also improving your libido and enjoyment of sex life. Your energy levels and motivation will likely improve and you may notice decreased “brain fog”. Testosterone may improve your overall mood, improve sleep, increase collagen in your skin to decrease wrinkles. Most importantly, it will make you feel like you again!

Do women need testosterone?

• In short, yes! Testosterone is commonly attributed to men. Women need lower levels of testosterone than men, but they do produce testosterone in small amounts in their ovaries and adrenal glands. Those small amounts can still be critical to your overall health and well-being. Testosterone is important to your sex drive, your fertility, and the production of new red blood cells. Testosterone affects your muscle mass and how you distribute fat. In the presence of low testosterone, women can also benefit from testosterone replacement therapy!

What are the symptoms of low testosterone?

• You might have low testosterone if your sex drive is suffering or if you are experiencing vaginal dryness. Generally feeling weak and fatigued can be another symptom of low testosterone as well as weight gain and insomnia. Low testosterone can make your periods irregular and affect your fertility. BHRT with natural testosterone replacement may help you feel better.

How do you test for low testosterone levels in women?

• Your symptoms may suggest low testosterone. We will also perform a thorough medical history and exam, and a blood sample confirming low free T level.

What is classified as low Testosterone?

• When your testosterone levels fall below 300 nanograms per deciliter (ng/dL) you begin to experience the effects of low testosterone. Some women experience symptoms with higher levels. We treat for symptoms, not necessarily just the numbers.

How do you treat low testosterone levels?

• If your testosterone levels are low, our medical team may recommend a treatment protocol of the bioidentical hormone replacement of testosterone via pellet.

  • Pellets are our preferred method as they distribute evenly, are less hassle, and less messy. Testosterone pellets last three to six months at a time. You will come in for an initial consult with placement of pellet and have a follow up one month later. Pelleting occurs about every four months.

What causes low testosterone in women?

• Menopause is a time that brings a number of hormonal changes that may be treated with BHRT. Testosterone is one of the hormones that declines in many women as they age. However, low testosterone may occur for reasons other than menopause, such as when ovaries have been removed or in the presence of a condition known as adrenal insufficiency in which your adrenal glands do not function properly.

Is Testosterone beneficial in diabetics?

• Yes. Testosterone is very safe for diabetics. Studies actually show that Testosterone may increase insulin sensitivity which aids in stabilizing blood sugar and decrease your triglycerides. Overall, it will improve your diabetes diagnosis and help you lose excess weight that is contributing to the diagnosis.

Will I grow unwanted hair from testosterone?

• It is possible, but typically it won’t cause any more hair growth than you had in your 30s. There is also typically less hair growth with natural Testosterone compared to synthetic options which we do not use.

Will I grow a penis from using testosterone?

• No. However, you may experience slight clitoris enlargement. As women age, the clitoris among other female anatomy shrinks and becomes dry. On Testosterone, the clitoris size will be similar to how it was in your 30s.

Estrogen FAQs:

What are the benefits of ERT (Estrogen Replacement Therapy)?

• Estrogen replacement therapy benefits can help improve the uncomfortable symptoms you are experiencing, such as hot flashes, trouble sleeping, night sweats, and even excessive sweating during the day. Low estrogen levels contribute to a dry vagina leading to irritation and painful sex. You may also experience symptoms of incontinence. Low estrogen levels also contribute to brittle bones putting you at higher risk for osteoporosis. Estrogen improves balance preventing falls and fractures, prevents UTIs, decreases risk of Alzheimer’s Disease, and colon cancer. Bioidentical hormone replacement therapy can relieve all these symptoms and help you “get your life back”.

What is estrogen?

• Estrogen hormones get your body ready for pregnancy and increase your desire for sex. They also help regulate your cholesterol levels and strengthen your bones. Although estrogen is usually produced by the ovaries, your fat tissue or adrenal glands can also produce estrogen. During perimenopause or menopause, your estrogen levels drop. For some women, this can lead to such uncomfortable symptoms as depression, fatigue, hot flashes and a low sex drive. You may also experience symptoms of low estrogen at other times in your life. We may be able to treat your low estrogen with bioidentical estrogen replacement therapy.

How are low estrogen levels diagnosed?

• We'll discuss your symptoms and use a blood test to determine whether your estrogen levels are too low. When you start estrogen replacement therapy, we'll continue to monitor your levels to ensure that you are getting the right dosage and make adjustments as required.

How do you treat low estrogen levels naturally?

• If we determine that you need estrogen replacement therapy, we'll use bioidentical estrogen. This offers natural estrogen replacement with estrogen derived from plants rather than made synthetically.

Who should get estrogen replacement therapy?

• Women who suffer from a hormone imbalance may benefit from estrogen replacement therapy. After discussing your symptoms and health history and determining through a blood test that your estrogen levels are below the normal range, our medical provider will discuss if estrogen therapy is potentially right for you.

What are the effects of estrogen replacement therapy?

• As is the case with all forms of hormone replacement therapy, it may take from a few weeks to several months to recognize improvements in some of your symptoms. Improvements potentially include more energy, fewer mood swings, and an improved libido. Estrogen replacement therapy has been shown to reduce migraines and night sweats in some patients. Prior to entering menopause, taking estrogen might also make your periods more regular.

Will I need to take progesterone while I take estrogen?

Yes. If you only take estrogen and not progesterone, the estrogen alone can cause the lining of your uterus to thicken which may increase your risk of uterine cancer in women with a uterus. Taking progesterone with estrogen could reduce the risk. Also, progesterone aids in decreasing any menopausal bleeding that may occur with estrogen replacement.

Can I take estrogen if I have had a history of a blood clot or stroke?

• Yes, but only in transdermal form. This would include: pellet, patch, cream, or sublingual.

Progesterone FAQs:

What are the benefits of PRT (Progesterone Replacement Therapy)?

• Natural progesterone also known as micronized progesterone is beneficial in ALL menopausal women whether they have a uterus or not. It decreases symptoms of hot flashes, night sweats, PMS, and migraines. Women with PCOS need Progesterone as their levels are low. Natural progesterone protects against uterine, ovarian, and breast cancers, osteoporosis, fibrocystic disease, ovarian cysts, and heart disease. (NOT Progestins or Provera)

Do I really need Progesterone if I don’t have a uterus?

• Actually yes! Research shows that natural progesterone has protective affects against ovarian and breast cancers as well as heart disease. Don’t miss out on the benefits!

What is the function of progesterone?

• Progesterone has a number of functions in a woman's body, including helping to strengthen bones and reducing the likelihood of osteoporosis.

Is progesterone replacement therapy only for women in menopause?

• BHRT is most commonly prescribed to women who have gone through menopause since progesterone levels often drop significantly post-menopause. However, hormonal imbalances can affect women at other times in their lives. In the decade or more leading up to menopause, which is called perimenopause, women's hormones may also be out of balance. Progesterone can help regulate heavy or irregular periods during perimenopause as well as symptoms of PMS. At Reviving Wellness, we will design a treatment plan for you that could include hormone replacement therapy at any stage of your life.

What are the symptoms of low progesterone?

• Low progesterone symptoms are similar to those related to other types of hormonal imbalances as well as other conditions. They include depression, moodiness, an irregular period, urinary tract infections and painful sex as a result of vaginal dryness. The variability of these symptoms is why it is important to confirm a progesterone imbalance exists by taking a simple blood test. Then our medical team can prescribe the appropriate treatment plan for you.

Why should I AVOID taking progestins or Provera?

• These medications are synthetic, not natural. According to research, these medications have a higher risk of blood clots, strokes, and heart attacks. These medications are also correlated with a higher risk of dementia and Alzheimer’s Disease as well as breast cancer.

Will I gain weight on Progesterone?

• Not necessarily. In most cases, this “weight gain” is caused by temporary bloat/water retention which is often mistaken for true weight gain. In certain patients, we may prescribe a diuretic for a month to help with this.

Does oral Progesterone poison the liver?

• No, it does not

Thyroid FAQs:

What are low thyroid treatment benefits?

• Many women simply do not produce enough thyroid hormone, therefore replacing thyroid helps. As your thyroid hormone levels balance, you will likely notice an increase in your energy levels as well as experience better sleep and mood. You may even lose some unwanted weight, could experience improvement in sex drive and possibly even have decreased pain in your muscles and joints.

What is the thyroid gland?

• Your thyroid is a small gland shaped like a butterfly that is found at the front of your neck and that helps all of your organs function. If your thyroid gland is not producing enough hormones or is producing too many hormones, it can affect many different parts of your body and cause a number of symptoms.

What is hypothyroidism (low thyroid)?

• If your body is not producing enough of the thyroid hormone, this is known as hypothyroidism. It is most commonly caused by a condition known as Hashimoto's disease, in which your immune system attacks the thyroid gland. The damage that results is what causes the gland to underproduce.

What are hypothyroid (low thyroid) symptoms?

• If you have low thyroid, you might feel tired and lack stamina. Weight gain and constipation can also be symptoms of hypothyroidism. An intolerance to cold, numbness in your hands and feet, muscle aches, poor concentration, poor short-term memory, dry skin, hair loss and depression or mood swings are also symptoms. If you have started missing periods or your periods are irregular, this could be a symptom as well.

What is hyperthyroidism (high thyroid)?

• When you have hyperthyroidism, your body is producing too much thyroid. This can cause your metabolism, your heart rate and other bodily functions to increase. Hyperthyroidism is usually caused by Graves' disease, an immune system disorder.

What are hyperthyroid (high thyroid) symptoms?

• Hyperthyroidism symptoms may appear so gradually that it can be some time before you start to notice them. You may start losing weight even though you have not changed your diet, or you might even be eating more than usual. A rapid heartbeat, anxiety, irritability, and insomnia are also symptoms. You might often feel sweaty and overheated, and your fingers and hands may shake. Some people have eye changes, such as bulging or irritation. Hyperthyroidism can also cause weak muscles and brittle bones.

How are thyroid problems diagnosed?

• The first sign of thyroid issues might be certain symptoms, such as fatigue, cold intolerance, or unexplained weight gain or loss. However, like the symptoms associated with other hormone-related imbalances, symptoms of hyperthyroidism and hypothyroidism can indicate other conditions. At Reviving Wellness, in addition to assessing your symptoms, we will test your blood to determine whether you have thyroid problems.

How are thyroid problems treated?

• Our approach to treating hypothyroidism or hyperthyroidism varies according to its cause and your general health, but most cases can be treated with medication. Lifestyle changes can also help to keep your thyroid in balance.

What if my thyroid levels are “normal”, but I’m still having low thyroid symptoms?

• At Reviving Wellness, we dial in on your symptoms. We assess an entire hormone blood work panel as symptoms can be caused from multiple imbalances. In regards to thyroid, we don’t just treat the TSH level like many other providers. We monitor all of your thyroid levels and replace both your T3 and your T4 levels utilizing natural thyroid hormone.

Most Common Side Effects: