MENOPAUSE

Hormone Implants

Implants of the natural oestrogen, oestradiol have been used for over forty years, but their use has only recently become popular in Australia and is not very common in the USA. The implants consist of small pellets of pure crystalline oestradiol and resemble a tiny piece of spaghetti. They come in various strengths to suit individual needs and are somewhat expensive, although the cost can be claimed from some private health funds. They can be painlessly implanted into the fatty layer of your abdomen or buttocks under a local anaesthetic and many doctors use a small hollow tube with a sharp cutting edge to slide the pellet neatly into your fat.
Depending upon the strength of the implant chosen by your doctor, an implant will continue to release oestrogen directly into your blood stream for between four to twelve months which is great for those who cannot remember to take tablets.
Of all the types of HRT, an implant comes closest to copying the function of your own ovaries as in both cases oestrogen is released directly into the bloodstream and carried to the various oestrogen-dependent tissues of your body. Thus, your hungry cells get their supply of precious oestrogen before the liver enzymes can break it down. Unfortunately, this is not so with oestrogen tablets which are first broken down during passage through the liver after their absorption from the gut. Thus, the liver could be said to weaken the effect of oestrogen tablets upon your cells, whereas the oestrogen implant is able to deliver an unweakened supply of oestrogen.
Janet, a 56-year-old woman was having a stressful menopause despite taking oestrogen and progesterone tablets regularly. Her hot flushes and sweats made her feel dirty, her clothes clung to her flesh and she felt as if ants were crawling under her skin. Her libido had vanished and a deep depression had set in. Janet was told that these symptoms were all in her mind and that she needed a good psychiatrist. A blood test revealed low levels of oestradiol and testosterone and we decided to give her an oestrogen and testosterone implant. Three weeks later her blood test showed normal levels of oestrogen and testosterone and Janet was relieved of her symptoms that were supposedly "all in her mind".
Some of the world's foremost experts on the menopause use hormone implants as first-line therapy in menopausal women who complain of fatigue, depression or loss of libido5. Oestradiol implants have been shown to increase bone density and can be used to prevent osteoporosis. Psychological and sexual problems occurring after the menopause may be greatly helped by taking the male hormone testosterone. Generally, it is only necessary for a few months. Testosterone does not work in tablet form and an implant or intra-muscular injection of natural testosterone provides an ideal alternative6. Testosterone implants and/or injections generally produce a feeling of mental, physical and sexual wellbeing and most women are very happy with their effects. It is only fair to warn any woman considering a testosterone implant that it may cause a slight increase in facial hair or pimples, but, these decreases when the dose of testosterone is reduced or left off in subsequent implants of oestrogen.
It is important that your suitability for and dosage of oestrogen implant is carefully considered as, once inserted, the implants are difficult to remove in case of overdose or side-effects. If side-effects occur, they are usually confined to tender breasts or an increase in the heaviness of menstrual bleeding, but, the latter can usually be controlled by increasing the dose of progesterone.
Towards the end of the life of your implant you should have a blood test to check your oestrogen and Follicle Stimulating Hormone (FSH) levels so that another impact can be inserted before oestrogen deficiency returns.
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