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Under some circumstances it is best to use an estrogen and testosterone pellet.

These pellets are a compounded substance where each pellet consists of a hard crystal of 17 beta estradiol, which gradually releases into the blood stream and maintains a constant level of dosage.

Eventually after about 3-4 months, they will get used up as the estrogen is metabolized in the body. This will provide a very steady estrogen level of approximately 150 - 250 picograms per ml, which is a therapeutic level.

While the pellets are still under investigation by the FDA at the present time, they have not been approved. These pellets have been available for use in this country for over 60 years without adverse effects.

The use of this substance has been very dramatic with decreased physician visits by these patients for other related problems. When the patient has been stabilized, the number of visits to the doctor and the number of tests for these patients declined dramatically.

Most patients require pellets two to three times a year with very little in the way of other medical therapy in between times. It is essential that these patients have yearly mammograms.

The most notable effects due to a loss of androgens are a decrease of energy and decrease in sex drive and vaginal lubrication in a percentage of women.

Oral androgens may be administrated with the use of methyltestosterone which is not an ideal androgen in some patients, as it does pass through the liver and can cause reductions in HDL cholesterol to some extent, reversing the beneficial effect of the estrogens.

For a significant group of patients, the oral testosterone does not seem to have the desired effects.

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