Porcaro Cosmetic Surgery
1943 SE Port St. Lucie Blvd.
Port St. Lucie, FL 34952
Phone: (772) 337-1717
Fax: (772) 337-1737
DRIVING DIRECTIONS

Info For Women

Hormone Replacement Therapy; why Pellets?

Estrogen delivered by subcutaneous pellets maintains the normal ratio of estradiol to estrone (2:1), important for optimal health and disease prevention.

Pellets do NOT increase the risk of blood clots or breast cancer like conventional synthetic HRT.

Pellets are far superior to oral hormone replacement therapy, especially with respect to bone density, insomnia, sex drive, libido, and sexual performance.

Pellets result in an extremely high level of symptomatic relief.

Pellets are the most convenient method of hormone delivery.

Problems with ORAL (conjugated; synthetic) Estrogens, i.e. Premarin, Prephase, Prempro (pills):

Horse (urine)=Equilin

Human female=Estradiol

Changes normal estrogen ratio in the body

Increases estrone;

a very strong breast stimulator (breast tenderness)

water retention;weight gain in waist & hips

increase in breast cancer.

Produce “roller coaster” effect

Reverses the normal physiologic ratio of estradiol/estrone from 2:1 to 1:2

Breast stimulators

Fluid retention and weight gain

“First pass” metabolism through the liver necessitates a much higher dose

Take “something” every day; poor compliance

Increase the chance of breast cancer after 10 yrs.

Potential and Unnecessary Effects of Oral Estrogen Therapy: Breast Tenderness, Increased risk of endometrial cancer and breast cancer, Vaginal bleeding, Headaches, Nausea and Vomiting, Fluid retention, Blood clots, Leg cramps, Gallstones

Osteoporosis- Bone Density: Pellets demonstrated 8x increase in bone density over oral estrogen and 2.5x increase over patches

1-2 % per year for oral estrogen

3.5% per year for patches

8.3% per year for Bio-Equivalent Hormone Replacement Therapy

Studd, J WW, et al (1990)
Am Journal OB/GYN 163, 1474-1479

Problems with Patches: Adhesive problems –don’t stick; allergy, change them once or twice weekly, some weight gain, but less fluid retention, estradiol levels better than pills, but not as good as pellets.

Breast Cancer Incidence with Pellets since 1992-2002 (Dr Gino Tutera)

Time on Pellet HRT	Number of Patients Total	Cases of Breast Cancer
0-2 years	352	1
3-5 years	471	0
5-25 years	153	0
	976	1

Positive Effects of Bio-Identical Testosterone:

Enhanced libido

Cardiovascular protection

Lower cholesterol

Increased energy and vitality

Feeling of overall well-being

Reducing body fat

Stronger bones and muscles

Depression relief

Cognitive clarity

The Goal for Hormone Replacement Therapy: To produce a normal, premenopausal FSH level thereby alleviating symptoms and reinstating normal female physiology.

Estradiol Pellets: The only form of HRT that produces continuous suppression of FSH over a four to six month period.

Testosterone Pellets: The only form of testosterone therapy that recreates the physiologic levels of testosterone in both men and women.

Is Bio-Equivalent Pellet Hormone Therapy right for me? John Porcaro, MD will evaluate your medical history and symptoms and order blood tests. If your blood tests show that your hormonal levels are low, Dr Porcaro will customized a treatment plan specific for your particular needs.