Hi. Today, we’re going to talk about the different ways, your options, so to speak, for taking testosterone and estrogen, and we’re going to limit ourselves to the two main hormones, because they’re related to each other. Testosterone is one step away from estrogen. … by the enzyme aromatase. Aromatase lives in the fat cells. I don’t think I knew in medical school how closely linked those two hormones are, but they’re just one step apart from each other.
Testosterone and estrogen should never be taken by mouth, which are in the form of pills and/or troches. Troches, if you’ve never heard of troches before, it’s like a lozenge, and it goes next to your cheek. The theory is, is that it is absorbed through the lining of your cheek straight into the body’s bloodstream. The problem is, is that there’s no way to have a lozenge in your mouth and some of it doesn’t get mixed with your spit and get swallowed into your stomach. Once the hormone goes into your stomach, that blood supply picks up whatever you’ve eaten and takes it straight to the liver for processing, so the testosterone and estrogen are hitting the liver before they hit the rest of the body, so some of that will be metabolized, and then some of it will go into the bloodstream as testosterone and estrogen. It’s too hard on the liver. It increases your total body inflammation. It increases your risk for blood clots, and it increases your cancer risk, so that’s not a route that I use to help people with the testosterone and estrogen level.
First, we will talk about the hormone estrogen. The human body makes three types of estrogen, estrone, estradiol, estriol. Estrone is more cancer-promoting, so we never replace that one anymore. It used to be, probably 20, 30 years ago, they did replace estrone in a format called triest, the thought being if the human body made it, then we probably needed it for some reason. With more medical research, now we know that it just promotes cancer, and there’s really no reason to replace that one, so we do not actively replace it any more. Estradiol is the strongest of the estrogens, so it’s the workhorse. Estriol is a weak estrogen, but it helps with bone density.
As far as options for taking testosterone or estrogen, and this goes for men and women, I am going to start with a common option, lotions and creams. With men, I typically write for testosterone with chrysin in a lotion. Chrysin blocks that enzyme to convert the testosterone to estrogen. Men need some estrogen but not too much, and we keep an eye on that. We measure it, and we make sure that they’re not getting too much. The chrysin is in there to prevent that conversion, so they get some but not too much. It absorbs through the skin nicely. I have men that are on testosterone lotion. They love it. They’re lotion kind of guys, and it works just fine.
The downside is that it’s a daily hassle. You put it on in the morning after you get out of the shower, so it’s just like one more step in your daily routine. Most of us, our lives are so complicated, we’re trying to simplify instead of adding on more steps. The other problem is transferring. Because it’s on the skin, you can transfer the hormone to other people. That’s why we want to do it in the morning, because intimate activities are typically going to be at nighttime instead of in the morning, and your skin is more open after it’s just gotten out of the shower. Then, you put clothes on. It’ll take an hour to two hours to truly soak into the skin, but if you hug anybody, you can transfer that hormone to somebody else, so your spouse, your children, your grandchildren, your coworkers, friends, and even your dog. That’s kind of a downside with the lotion, but it does work nicely, and I have clients who do just fine on it.
Women, if we’re doing a lotion, typically, they need biest, which is going to be the estradiol with the estriol. We’ve taken out the estrone, so it’s no longer triest, and it’s biest with estradiol and estriol. The next way to take testosterone would be an injection into the muscle, which is called an intramuscular injection. Usually that’s the thigh or the buttock. Depending upon the volume, you can do the deltoid if it’s one cc or less. Testosterone injections work so well for men because they require such a high dose. The testosterone injections do not work so well for women because the volume of testosterone that they need is so small, this is why women should not take testosterone injections. The volume’s so small that it would end up still in the barrel of the syringe and in the needle and not actually delivered to the human body. Women do not need much testosterone, so it’s just impractical to deliver such a small amount in an injection.
For men, typically, you’ll hear about men taking testosterone either once a week or once every two weeks. The best way to do it is once every two weeks, because then you get less estrogen being produced out of the testosterone. If the man is having a problem creating too much estradiol out of their testosterone injections, then we can write for a pill, which would be anastrozole, to block that conversion again, so that’s easy. The next option will be going to talk about is by far the best and the most popular. This option is taking testosterone or estrogen in the form of pellets. Pellets are about the size of a Tic Tac, and they get delivered into the fat layer at the hip. It’s a quick office procedure about 10 minutes. There’s a small incision. Numb it up. The numbing is the worst part. It burns before it starts to numb, and then just place the Tic Tacs into the fat layer at the hip, so I only need to see about a hand’s width of the hip. I don’t need to see all the buttocks. I just need a hand-width of skin, and I try and stay away from the belt line. There’ll be some bruising that develops over the next day or two. That’s normal.
The nice thing about pellets is that it’s just so convenient. You pop in here to the clinic once every three months, and then you’re back out on the road. You don’t have to worry about it or think about it until the next three months. You don’t have to worry about transferring hormone to somebody else. Get on with your daily life. You don’t want to get into the jacuzzi or sit in a bubble bath for the next day or two. You want to give the skin time to heal up. You don’t want to go from here and go to the gym and do a bunch of squats or do a bicycle marathon. You don’t want to work that gluteus hard and get that pellet to work itself back out and then pop out of the skin, but other than that, it’s pretty straightforward and easy.
Women, because of their fat layer, will convert the testosterone to the estrogen that they need, so I don’t have many female clients that need a biest pellet, but it’s available if a woman is not producing enough estrogen out of her testosterone pellet. For the men, I combine the anastrozole with the testosterone in the same pellet, so they don’t have to worry about that estrogen production, and again, we do still monitor that with a saliva hormone test kit once every 6 months. The pellet will completely dissolve on its own in three months, but it gives a nice, consistent, smooth, easy hormone level. Those are typically the best ways to take your testosterone and estrogen, either a lotion, intramuscular injections for men, or a pellet therapy. They all work great. I have clients on all three modalities. I hope this help. If you have questions, please post them or call Incredible Health at 480-418-3678, and have a great day. Thanks.