Hormone Balancing

Most people have a mental picture of someone who might need hormone therapy: a cranky, red-faced, middle-aged woman. But hormone imbalance can happen to both men and women of any age, says Karen Kennedy, M.D., a gynecologist with offices in Gulf Breeze and Navarre.

The symptoms can be subtle, Kennedy says, and they aren’t limited to the mood swings and hot flashes associated with menopause. They might be physical (irregular menstrual bleeding, night sweats, insomnia, weight gain, joint pain, hair loss), or psychological (fatigue, depression, anxiety, anger, mental fog, decreased libido).

“The symptoms are due to another body system’s response to the lower hormones, such as the nervous or musculoskeletal system, because all body organs have hormone receptors,” she explains. “Many people have a wide variety of symptoms, even true medical problems, because of low hormones. Every person’s experience is different and varies in severity, and sometimes it’s surprising that low hormones are the cause.”

Everyone eventually experiences a natural decline in hormone production. In women, that decline begins in their 20s, although they usually won’t notice the effects until they’re in their 30s. In men, that pattern generally happens a decade later. Both men and women tend to experience sexual, mood, energy and bodily changes, Kennedy says.

Doctors use blood tests to diagnose hormone imbalance. Kennedy, who specializes in a type of hormone treatment often referred to as “bio-identical hormone therapy” (BHT), says many of her patients don’t realize how bad they felt until their imbalance is corrected.

BHT, which delivers hormones to the body via pellets placed under the skin, was developed as a safer alternative to traditional hormone therapy, which involves oral medications.

Like every medication or treatment, hormone therapy comes with some risk, Kennedy says. Estrogen can possibly increase the chance of blood clot, including heart attack, stroke and pulmonary embolus, and they slightly increase the risk of breast cancer. Testosterone antagonizes breast cancer, and in rare cases it can cause side effects like adverse mood changes and acne.

While both the pellets and oral medications have the same chemical structure as natural hormones, the associated risks are lessened with pellets, because the delivery system is closer to the way the body naturally works, Kennedy says. “Oral hormones have the most chance of adverse effects, and pellets have the least because they are released into the bloodstream in a way that’s physiologically similar to the way the ovaries and testes release hormones into the bloodstream.”

The pellets, which are no larger than a grain of rice, are placed in the fat layer of the buttock. A woman might require as few as two or three pellets in a single placement, Kennedy says, while a man generally requires more than one group of pellets with the one incision.

“We make a tiny incision, use an instrument to place the pellets about an inch and a half away from the incision, and then place a bandage over the incision. The process is relatively painless. The only sensation is the initial injection that numbs the skin.”

Kennedy says her patients feel the results quickly. “Sometimes people notice energy and other effects within 12 hours. Usually women feel estrogen’s effects after about three days, and women and men feel testosterone’s effects after about a week and a half.”

The pellets are pure hormone, so they disappear after a while—three and a half to four and a half months in women, and five to six months in men. A new set of pellets is placed after the effects of the prior set wear off.

People who are using the pellets to alleviate transient symptoms, like hot flashes, might choose to taper off when those symptoms subside, Kennedy says. Other people use BHT indefinitely—to build bone density, for example. In that case, the treatment has less to do with resolving symptoms than with preventing diseases linked to hormone imbalance.

“Hormones are about optimizing our health and prevention,” she explains. “They can decrease dementia and Alzheimer’s, they are heart protective, they decrease cholesterol and metabolic problems such as diabetes and hypertension, and they certainly decrease depression and many mental problems.”

Because hormones affect almost every aspect of a person’s life, Kennedy talks to her patients about BHT as part of a greater commitment to being healthier and feeling better. “I stress to people that they must also follow a healthy diet and an exercise program, and eliminate hazards from their life. We go into those details when I discuss pellet therapy.”