Why Should You Replace Your Hormones? Your Life May Depend On It

Ladies, pull up a chair—preferably one that isn’t vinyl—because if you're in the middle of a hot flash, you might stick to it. I’ve spent the last 30 years treating women who’ve been dismissed, misdiagnosed, or handed a prescription that did little more than turn them into a slightly more tired version of themselves. And after all these years women’s hormonal health, one thing has remained crystal clear: Bioidentical hormone pellets are the gold standard in hormone replacement therapy. Let me explain why—doctor-to-patient, woman-to-woman, survivor-to-survivor. “Bioidentical hormone pellets are physiologically the same as our own bodies’ hormones, and they provide the best and most consistent delivery and results.” – Angela DeRosa, DO, MBA, CPE If you’ve ever been told by your healthcare provider that your hot flashes, weight gain, brain fog, low libido, anxiety, or sleep issues are “just part of getting older,” it’s time to find a new doctor who truly understands perimenopause and menopause symptoms and how to address the root cause. Hormonal decline isn’t a character-building exercise; it’s a medical condition. And just like any medical condition, it deserves evidence-based, individualized, effective treatment. Bioidentical hormones, particularly ones in the form of pellets, are the closest thing we have to restoring your hormones to the levels Mother Nature originally designed for you. What Makes Pellets “Bioidentical”? “Bioidentical” means the hormones are identically structured to the hormones your body naturally produces. Most bioidentical hormones are plant-based, including estradiol, progesterone, and testosterone. Synthetic hormones, on the other hand, are chemically altered forms of hormones, some of which come from the urine of pregnant horses. These hormones aren’t a perfect molecular match with your natural hormone receptors, and this makes a difference to your body at a cellular level. Your body recognizes bioidentical hormones as its own. Delivered in the form of pellets, which bypass your digestive system, this form of hormones has the potential to: ● Work better ● Have fewer side effects ● Allow your body to metabolize hormones the way it’s supposed to ● Reduce cardiovascular risks ● Protect breast tissue Think of it like this: if bioidentical hormones were puzzle pieces to the cells in your body, they would provide the matching pieces for the exact fit (and therefore, potential for maximum benefits). Why Pellets? Let Me Count the Ways… You can get bioidentical hormones in many forms, including topical creams and gels; oral tablets and troches; injectables, and pellet implants. There are so many forms and dosage strengths that can be customized for your individual needs through compounded hormones. So why do I champion pellets? Why are they the gold standard in hormone replacement therapy? It’s really quite simple: the delivery system matters. A Ferrari filled with cheap gas is still a Ferrari, but it’s not going to run well. And, you're probably not going to get it up to speed with its engine purring. When prescribed correctly, think of pellets as the premium fuel of hormone therapy; the type of fuel that can rev up your menopausal body so it runs smoothly again. Let’s look at some reasons why. 1. Pellets Give You Steady, Consistent Hormones Topicals and orals can create hormonal roller coasters, leaving you feeling like you’re starring in a soap opera you didn’t audition for. Sometimes your symptoms might subside, and sometimes you might feel miserable. That’s because how well your body absorbs topical hormones through your skin, or oral hormones that have to pass through your digestive system, can fall short and even cause unpleasant side effects. Pellets on the other hand offer more of a slow-release infusion of hormones. They dissolve into your bloodstream at the perfect rate, giving you: ● Lower instance of spikes and crashes ● Less worry about forgetting to rub on your cream each day ● No worrying if your husband, kids, or dog will accidentally get a dose of estrogen because they came into contact with your skin Pellets are essentially the “set it and forget it” form of hormone therapy. 2. Pellets Are the Only Delivery Method That Truly Mimics Ovarian Function Before perimenopause and menopause, your ovaries didn’t just release hormones once a day. They released hormones steadily, continuously, in rhythm with your body’s needs. Pellets replicate that. Nothing else comes as close. 3. Pellets Bypass the Liver (Your Liver Says “Thank You!”) Oral hormones have to go through the liver, which can increase inflammation and impact clotting factors, especially if you are a smoker. Pellets go straight into your bloodstream, skipping the liver processing. 4. No Mess, No Fuss, No “Oops, I Forgot” We’re all busy. As women, we often juggle careers, kids, marriages, divorces, pets, aging parents, and (my personal favorite) uneducated doctors who still think women don’t need testosterone. Pellets help take daily compliance off your plate. Once inserted during a quick, easy, in-office procedure (you’ve undoubtedly had pap smears that were more unpleasant!), pellets offer your body a steady dose of hormones for the next 3 to 5 months. 5. The Results Are Often Much Better Than Other Forms of Hormones I’ve seen thousands of women get their lives back (and then some) with the right combination and doses of hormone pellets, including: ● Boosted libido ● Improved sleep ● Less anxiety ● More energy ● Disappearing hot flashes ● Weight loss ● More even moods ● Less brain fog ● Happier relationships In most cases, when women’s hormones are optimized and stable, everything else follows suit. Pellet Myths I Hear All the Time You’ve probably heard them too, so let’s bust a few myths while we’re here, shall we? “Pellets are dangerous.” This is simply not true. What is dangerous is walking around chronically hormone-depleted for decades. That’s what accelerates aging, increases disease risk (including cardiovascular, bone, and brain ), and drains your quality of life. “Pellets make you grow a beard.” While increased facial hair growth may be a potential side effect of increasing your testosterone levels, experienced pellet providers (key piece of the puzzle) know how to adjust your hormone doses to minimize that. As I’ve said before, if someone offered you a million dollar home for free, but you were responsible for mowing the lawn every week, would you say: “No thanks! I don’t need the house of my dreams. It’s not worth the maintenance!” If you have to wax your mustache for a couple months while your body gets used to feeling wonderful from the inside out, I’d say it’s a fair trade off. And, most likely, the extra hair growth will regulate itself, too— IF you even experience it at all. “I heard pellets aren’t FDA-approved.” Compounded hormone pellets are made with FDA-approved ingredients, and are highly regulated and held to their own set of standards within the compounding industry. It’s also a little-known fact that hormone pellet therapy has been in use since the 1930s. It’s not something new that hasn’t been scientifically and clinically studied. In fact, pellets and their positive effects on overall health, have been studied significantly in the last several decades. Why I’ve Dedicated My Career to Helping Women through Menopause For decades, mainstream medicine has misunderstood women’s hormones, under-treated women’s symptoms, and over-prescribed antidepressants, sleeping pills, and anti-anxiety meds instead of addressing the root cause—hormonal decline. I was tired of watching women suffer. I was tired of seeing women brushed off (myself included). And frankly, I’m still tired of the inaccurate information being fed to women. So I wrote my book, started teaching physicians, and dedicated my career to getting bioidentical hormone replacement therapy into the hands of women who deserve better. If You’re Struggling, Please Know This: You Are Not Crazy You’re not imagining your symptoms. You’re not “just stressed.” You’re not “just aging.” Your hormones matter. Your health matters. YOU matter. Pellet therapy isn’t just about optimizing hormones—it’s about giving women their lives back. After 30 years and thousands of patients, I can confidently say: Bioidentical hormone pellets are truly the gold standard in hormone therapy; the most transformative method of BHRT. Your ovaries may be retired…but with pellet therapy, your vitality doesn’t have to be. As someone who has treated more than 20 thousand patients in the last 30 years, and written about BHRT, you might find my book, A Woman’s Hormonal Health Survival Guide: How to Prevent Your Doctor from Slowly Killing You , a helpful tool in your perimenopause journey and beyond. Read more about hormone delivery methods, including pellets in Chapter 8: Giving Back What Mother Nature Intended Us to Have: Treatment Options Explore the differences of synthetic vs. bioidentical hormones in Chapter 2: Challenges, Myths and Misconceptions About HRT

If you read my blogs or have heard me speak, you know that I’m passionate about helping women get the hormones their bodies need to thrive at every age. I’m especially concerned about women getting the testosterone they need as part of their hormone therapy during perimenopause, menopause, and well into their later years of life, because providers often overlook that hormone. In fact, when I teach medical providers about hormone therapy so they can best serve their male and female patients, I always talk about the importance of testosterone for BOTH men and women. In addition to being a testosterone advocate for women, I’m also a proponent for thyroid health. More often than not, well-meaning, but undereducated providers misunderstand the importance of thyroid hormones during perimenopause and menopause. As is often the case with tests that attempt to assess fluctuating estrogen, progesterone, and testosterone levels, thyroid tests often appear to be in the “normal” range for many women. I’ll explain why in a minute. First, let’s look at some surprising statistics: One in eight women experiences a thyroid disorder in her lifetime. Women are five to eight times more likely than men to have thyroid problems. Nearly 60 percent of people with thyroid issues have no idea there's a problem. Undiagnosed thyroid disease may put women at risk for serious conditions, including cardiovascular diseases and osteoporosis. You have to wonder, why are so many women suffering from thyroid disorders instead of getting the help they need? It could be largely a result of inadequate testing. Standard blood tests often miss the REAL thyroid information. Why Should You Think About Your Thyroid in Perimenopause and Menopause? Thyroid hormones play an important role in regulating the female reproductive system. During perimenopause, fluctuating estrogen levels directly impact how your thyroid hormones function. It’s a complex, intricate connection between the thyroid and your hormones. And, to make things even more confusing, symptoms of a thyroid disorder mimic and overlap some of the same symptoms of perimenopause, like hot flashes, anxiety, heart palpitations, and weight gain. Typically, when a woman in her 40s or 50s conveys these symptoms to her provider, she gets “standard” testing for hormone levels and TSH (thyroid stimulating hormone). But, this is a limited approach, and doesn’t portray the complete picture of your thyroid function. To fully understand whether or not your thyroid is underactive (hypothyroidism) or overactive (hyperthyroidism), you need to have a more comprehensive thyroid test – one that evaluates T3, T4, and reverse T3. All the T’s of Your Thyroid When it comes to evaluating your thyroid, there are a lot of T’s involved! Let’s break them down: TSH is the thyroid stimulating hormone released from the pituitary gland in your brain T4 is thyroxine, an inactive precursor and the main hormone produced in your thyroid gland. It gets converted to T3. T3 is triiodothyronine, the active hormone Reverse T3 (rT3) is an inactive form of the thyroid hormone, after T4 is converted – a “byproduct” so to speak Your body produces most of your T3 from your T4. T4 needs to be converted to T3 to perform optimally, and how well your body converts T4 into T3 is often a factor in thyroid disorders. T3 affects your heart rate, digestion, and metabolism. With all these variable T’s in production and conversion, there are three ways your thyroid can run amok and cause symptoms like fatigue, weight gain/weight loss, hair loss, muscle aches, anxiety, and sleep problems. Here’s what typically goes undetected: Your thyroid doesn't produce enough T4 Inactive T4 has trouble converting to active T3 Active T3 can't get into the receptors because it's blocked by reverse T3 Request a More Complete Thyroid Picture Most standard blood tests for thyroid only indicate TSH levels. Reverse T3 can be tested, but your provider needs to request that specific bloodwork. It helps if you have a practitioner who truly understands the thyroid connection to other hormones, including testosterone, estrogen, and progesterone. “Unless all of the levels are tested, you can’t properly diagnose thyroid disorders, and hypothyroidism is the one most often missed. Luckily, hypothyroidism is usually not difficult to treat.” – Angela DeRosa, DO, MBA, CPE As someone who has treated more than 20 thousand patients in the last 30 years, and written about thyroid and hormone therapies, you might find my book, A Woman’s Hormonal Health Survival Guide: How to Prevent Your Doctor from Slowly Killing You , a helpful tool in your perimenopause journey and beyond. You can read more about thyroid disorders in Chapter 3.