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ABOUT THE AUTHOR
Dr. Nathan Bryan is an Assistant Professor of Molecular Medicine within the Brown Foundation Institute of Molecular Medicine, part of the School of Medicine at the University of Texas Health Science Center at Houston (Texas, USA). He is also on faculty within the Department of Integrative Biology and Pharmacology and Graduate School of Biomedical Sciences at the University of Texas Houston Medical School. Dr. Bryan is an active member of the Nitric Oxide Society, Society for Free Radical Biology and Medicine, and numerous other organizations.
Chapter 5
Testosterone Pellet Implantation
Stephen Center, M.D.
Medical Director, BodyLogic MD of San Diego
ABSTRACT
Evidence suggests that testosterone pellet implantation (TPI) is the best available method of testosterone delivery, yet transdermal and injectable forms of testosterone continue to be the delivery methods of choice for testosterone replacement therapy (TRT) with many practitioners. The aim of this paper is to familiarize health practitioners with TPI and to encourage its use in TRT.
INTRODUCTION
Testosterone replacement therapy (TRT) has proven to be a valuable option in bioidentical hormone replacement therapy since its inception. All physicians who prescribe testosterone are familiar with commonly used form of testosterone. Transdermal and injectable forms (cypionate, the longer acting enanthate, and others) dominate the list of therapeutic options. While some still prescribe oral testosterone, its use is more controversial due to the familiar problems with orally administered sex hormones – second pass hepatic metabolism altering what reaches the cellular receptors, among other caveats. Continuous testosterone delivered by subcutaneous implant has been safely used in women since 1938 and until recently, was the only licensed form of testosterone for women in England.
In the 1990’s and thereafter Dr. Edward Lichten, an extensively published Michigan gynecologist, bioidentical hormone specialist and a long-time member of A4M’s teaching faculty, has touted testosterone pellet implantation for men and women as a potentially better option for TRT. Among the many studies done on the benefits and safety of pellets, Dr. Lichten emphasized the benefits for diabetic patients, as testosterone pellets appear to enhance insulin sensitivity, improving diabetic control. He also showed that testosterone pellet implantation (TPI) improved circulation in these patients. Moreover his experience convinced him that pellets were superior to other forms of TRT.
Over the past 10 years or so one of the major champions of TPI therapy has been Dr. Rebecca Glaser, an Ohio surgeon. Her practice used to focus on breast cancer but evolved to pellet therapy combined with the use of other bioidentical hormones given vaginally. Dr. Glaser first
