BHRT Female Post Care

Female 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 outerbandage

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.
• Exercise
  • No heavy lifting or major exercises for the incision area for 3-4 days.
• 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. If you are not feeling any better by 6 weeks, however, please call the office to have your labs drawn early.
• It may take 2-3 rounds for some to see symptom improvement.
• Most women will need re-insertion of their pellets 3-4 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 dose 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

This usually occurs most commonly in the first round of pellets, but does not usually continue thereafter. If this continues, contact the office for further instructions. 

Hair Loss

Can occur in some patients who convert testosterone to DHT. Dosage adjustment generally reduces or eliminates the problem. Prescription medications may be necessary in rare cases. Workup for other causes may also be needed.

Facial breakout

Some pimples may arise if the testosterone levels are too high and converts to DHT.

Uterine Spotting/Bleeding/Irregular Periods

This may occur in the first few months after an insertion, especially if you have been prescribed progesterone and are not taking properly: i.e. missing doses, or not taking a high enough dose. Please notify the office if this occurs. Bleeding should be evaluated by a gynecologist.

Hair Growth

Testosterone may stimulate some growth of hair on your chin, chest, nipples and/or lower abdomen. Fine, vellous hairs or “peach fuzz” often occurs but is not thick or coarse. You may also have to shave your legs and arms more often. Dosage adjustment generally reduces or eliminates the problem.