BHRT Male Post Care

Male Post-Insertion Instructions

What’s normal?

• Swelling, Redness: Possible, can last a few days
• Bruising: Possible, can last a few weeks
• Tenderness, discomfort: Possible, can last 2-3 weeks
• Bandage discoloration: Pink or bloody discoloration on outer bandage

When to Call us Immediately

• Redness worsens after the first 2-3 days
• Bleeding (not oozing) that is not relieved with pressure
• Signs of infection: fever, spreading warmth, pus

Post Care Instructions

• Bandages
  • Your insertion site has been covered with two layers of bandages. The inner layer is a steri strip, and the outer layer is a waterproof dressing. 
• Showers & Baths
  • Avoid taking tub baths or getting into a hot tub or swimming pool for 7 days.
  • You may shower, but do not remove the bandage for 3-4 days. Leave the steri strips in place until they come off naturally
• Flank insertion
  • Avoid using the affected area in activities such as rowing, golfing, lower back exercises, abdominal twists.
  • Okay to use lower glutes, leg muscles and upper body
• Bleeding
  • If you experience bleeding form the incision, apply firm pressure for 5 minutes.
• Cold Compress
  • Apply gently in 20 minute increments for the first 4-5 hours for discomfort. 
  • You can continue to apply for swelling.
  • Always have something between the ice pack and the bandages/bare skin.

Reminders:

• Remember to have your post insertion blood work 1-2 weeks prior to your next insertion and as outlined by your health care provider.
• Most men will need re-insertion of their pellets 4-5 months after their initial insertion. If you experience symptoms prior to this, please call the office.
• Please call as soon as symptoms that were relieved form the pellets start to return to make a plan for your next insertion. 

What Might Occur After a Pellet Insertion for Males

A significant  hormonal transition may occur in the first four weeks after the insertion of your hormone pellets. Therefore, certain changes might develop that can be bothersome. 

Infection:

Infection is a possibility with any type of procedure. Infection in uncommon with pellet insertion and occurs in <0.5 to 1%. If redness appears and seems to worsen (rather than improve), is associated with severe heat and/or pus, please contact the office. Warm compresses are helpful, but a prescription antibiotic may also be needed.

Elevated Red Blood Cell Count

Testosterone may stimulate growth in the bone marrow of the red blood cells. This condition may also occur in some patients independent of any treatments or medications. If your blood count goes too high, you may be asked to see a blood specialist call a hematologist to make sure there is nothing worrisome found. If there is no cause, the testosterone does may have to be decreased. Routine blood donation may be helpful in preventing this. 

Pellet Extrusion

Pellet extrusion is uncommon and occurs in <5% of procedures. If the wound becomes sore again after it has healed, begins to ooze or bleed or has a flister-type appearance, please contact the office. Warm compresses may help soothe discomfort. 

Itching or Redness

Itching or redness in the area of the incision and pellet placement is common. Some patients may also have a reaction to the tape or glue. If this occurs, apply hydrocortisone to the area 2-3 times daily. If the redness becomes firm or starts to spread, please contact the office.

Breast tenderness or nipple sensitivity

These may develop. The increase in estrogen sends more blood to the breast tissue. Increased blood supply is a good thing, as it nourishes the tissue. Take 2DIM daily to support healthy estrogen metabolism. In males, this may indicate that you are a person who is an aromatizer (changes testosterone into estrogran). DIM supports healthy estrogen metabolism. Testosterone normally converts to estradoil, and high estradoil levels in males may lead to break and nipple tenderness, as well as sexual dysfunction. 

Mood Wings/Irritability

These may occur if you were quite deficient in hormones these symptoms usually improve when enough hormones are in your system. 5HTP can be helpful for this temporary symptom and can be purchased at many health food stores.

Facial/Body breakout

Acne may occur when testosterone levels are either very low or high. This lasts a short period of time and can be handled with a good face cleansing routine, astringents and toner. If these solutions do not help, please call the office for suggestions and possible prescriptions.

Aromatization

Some men with form high-than-expected levels fo estrogen from the testosterone. Symptoms such as nipple tenderness or feeling emotional may be observed.

High or low hormone levels

The majority of times, we administer the hormone dosage that is best for each patient, however,every patient breaks down and uses hormones differently. Most patients will have the correct dosage the first insertion, but some patients may require dosage changes and blood testing. If your blood levels are low, results are not optimal and it is not too far from the original insertions, we may suggest you return so we can administer additional pellets or a “hoost” (at no charge). This would require blood work to confirm. On the other hand, if your levels are high, we can treat the symptoms (if you have any) by supplements and /or prescription medications. The dosage will be adjusted at your next insertion.

Testicular shrinkage

Testicular shrinkage is expected with any type of testosterone treatment.

Lower sperm count

Any testosterone replacement will cause significant decrease in sperm count during use. Pellet therapy may affect sperm count, which may lead to permanent infertility. If you are planning to start or expand your family, please talk to your provider about other options.