Women and Hormone Treatment – Frequently Asked Questions


Why do I Need Progersterone?

We recommend a progesterone pill for many of our female patients. Women who are menopausal, but still have a uterus are particularly recommended to receive progesterone to help protect against the development of uterine cancer. In addition, progesterone has a calming effect and helps promote a good night’s sleep.

Does Estrogen Increase My Risk for Breast Cancer?

At this time, we have no evidence that estrogen increases a woman’s risk of developing breast cancer. If estrogen does stimulate breast cell growth, it appears that testosterone counteracts that process and may be protective against breast cancer development. We do know that estrogen users who do develop breast cancer appear to have lower mortality from the disease. This may be due to earlier detection, but the research at this time is not clear. We know that the combination of oral equine estrogen and synthetic progesterone (PremPro) does increase the risk of breast cancer. Our recommendation is to stick with non-oral bio-identical estrogen and testosterone and, if recommended, progesterone.

Should I Avoid Hormone Therapy If I Have A Family History of Heart Disease?

It is unfortunate that hormone replacement therapy is regarded as bad for the heart, because this is only true in some circumstances. Generally speaking, estrogen is protective against heart disease if started at the onset of menopause. A recent study by the Mayo Clinic studied woman who had ovaries removed in their 40’s and did not receive hormone replacement. These women had a much higher incidence of heart disease, death from heart disease and neurological disease, over the following 30 years than the general population. Surprisingly, it was also found that these women had a lower chance of dying as a result of breast or uterine cancer if they developed these diseases than the control group. Your individual risk should be discussed with your health care provider.

Can I Get Pregnant When I Have a Pellet?

We do not suggest getting pellets if you are attempting to get pregnant. At this time, it is not proven whether pellets are safe in pregnancy. We ask that pellet patients who are in their childbearing years, have a birth control plan.

Will The Hormone Pellets Protect Me Against Bone Loss?

Will the hormone pellets protect me from bone loss? Yes. Estrogen therapy, especially when combined with testosterone, has been shown to maintain the mineral content and strength of bones after menopause. The consistent level of estrogen achieved by pellet therapy is especially effective in preventing bone loss.

Who Should Not Receive Hormone Replacement Therapy?

Generally speaking, women who have a personal history of breast cancer are not candidates for hormone replacement therapy. There is no evidence in literature that estrogen increases the risk of recurrence of breast cancer, but Oncologists are reluctant to approve estrogen therapy in a woman who has had breast cancer, particularly if the tumor was estrogen receptor positive. Many Oncologists, however, are comfortable with testosterone. Women who have a strong family history of blood clots should be genetically tested to see if they carry a gene that would cause their blood to clot easily. If this gene is present, then estrogen is contraindicated. If you have personally had a blood clot, you are not a candidate for estrogen therapy.

Does My Insurance Cover The Pellets?

The office visit/consult and lab work can be filed with your insurance. The pellet insertion is not covered by insurance. We do ask for payment up front prior to your pellet insertion. If you wish to request pellet insertion reimbursement from your insurance company, we can provide you with billing codes. Please note, we cannot contact your insurance company regarding pellet insertion reimbursement or coverage