Why isn’t Estrogen Pellet Therapy recommended for everyone?
Almost all symptoms associated with menopause, including hot flashes and night sweats, can be treated with testosterone-only pellet therapy without the bad side effects that estrogen can cause. Because of this, I don’t recommend estrogen pellet therapy in every female. In studies, greater than 50% of the women who had estrogen pellets had experienced uterine bleeding. Past clinical studies looking at estrogen pellets reveal higher side effects: including weight gain, edema, breast pain, and increased risk for breast cancer. Estrogen in females stimulates the endometrium and potentially could cause bleeding. In a postmenopausal woman, this would cause an unnecessary evaluation by a gynecologist which typically includes a vaginal ultrasound and/or endometrial biopsy to ensure that the bleeding was not related to cancer. Most women will feel better when their estrogen levels are lower and have an optimal estrogen-to-progesterone hormone ratio.
- High estrogen levels have been associated with:
- Weight gain (belly fat)
- Heavy menstrual bleeding
- Fibroids
- Fibrocystic breasts
- Tender breasts
- Migraines
- Anxiety
- Mood swings/emotional lability
- PMS symptoms
In addition, long-term exposure to synthetic estrogens (Premarin) or higher estrogen (estradiol) is likely to increase the risk for breast cancer.
A study published by Sherwin in 1985 revealed that 89% of the participant’s menopausal symptoms, including hot flashes and night sweats, were relieved with testosterone pellets only. Testosterone pellets therapy is extremely effective and it doesn’t have the unwanted side effects like weight gain, breast tenderness/cysts formation, swelling, or uterine bleeding associated with it. It is the preferred method for hormone replacement in perimenopausal and menopausal women.
Some women may need estrogen, especially if they’ve had a hysterectomy at a young age. In addition to the testosterone pellets, a lower dosage of natural estradiol pellets are preferred and tolerated better than the higher doses that were used in past studies.
Men and women both can convert too much testosterone into estrogen by the enzyme aromatase; this sometimes can interfere with the beneficial effects of testosterone and cause unwanted side effects. Aromatase inhibitors like the natural substance DIM or the prescription anastrozole may be prescribed to prevent unwanted symptoms. Recent clinical studies have used pellet combinations of testosterone with anastrozole in breast cancer survivors and in men with higher tendencies to convert their testosterone to estrogen.
