What is PRP?
Platelet-Rich Plasma (PRP) therapy is a regenerative medicine approach that has gained popularity for its potential benefits in treating joint injuries and osteoarthritis. PRP is a component of your blood that is rich in platelets, growth factors, and other bioactive substances. When used in joint treatments, PRP is typically obtained from a small sample of your own blood and then injected directly into the affected joint. The concentrated platelets and growth factors are believed to stimulate the natural healing and regenerative processes in the joint. Here are some of the potential benefits of PRP therapy for joints:
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Pain Relief: PRP injections can help reduce joint pain and discomfort. The growth factors in PRP may promote tissue repair and regeneration, which can alleviate pain associated with joint injuries or osteoarthritis.
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Improved Function: Many patients report improved joint function and increased mobility after PRP therapy. This can lead to a better quality of life and increased participation in physical activities.
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Reduced Inflammation: PRP may help reduce inflammation in the joint, which is a common issue in conditions like osteoarthritis and tendinitis. By reducing inflammation, patients may experience less pain and stiffness.
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Low Risk of Allergic Reactions: Since PRP is derived from the patient's own blood, the risk of allergic reactions or adverse immune responses is minimal.
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Minimally Invasive: PRP therapy is a minimally invasive procedure that can often be performed on an outpatient basis. This means shorter recovery times and fewer complications compared to more invasive surgical options.
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Long-Lasting Effects: The effects of PRP therapy may last for an extended period, potentially delaying the need for more invasive treatments or joint surgery.
Where can you use PRP?
Platelet-Rich Plasma (PRP) therapy is considered beneficial for joint injuries and conditions primarily due to its regenerative and anti-inflammatory properties. PRP contains a concentrated mixture of platelets, growth factors, and proteins that can support the body's natural healing processes.
PRP contains a high concentration of growth factors, including platelet-derived growth factor (PDGF), transforming growth factor-beta (TGF-β), and vascular endothelial growth factor (VEGF). These growth factors play a crucial role in tissue repair and regeneration.
Joints
PRP can stimulate the repair and regeneration of damaged tissues in and around the joint.
Joint injuries and conditions often involve inflammation, which can lead to pain and tissue damage. PRP can help modulate the inflammatory response by releasing anti-inflammatory cytokines. This can lead to a reduction in pain and inflammation in the affected joint.​
Hair
When PRP is injected or applied to the scalp, these growth factors are believed to stimulate dormant or weakened hair follicles, promoting their transition from the resting phase (telogen) to the active growth phase (anagen).
PRP therapy enhances blood circulation in the scalp. Improved blood flow can provide hair follicles with more oxygen and essential nutrients, supporting their overall health and growth.
Skin
PRP growth factors are essential for collagen production, which is a protein responsible for the strength and elasticity of the skin. Increased collagen production can help improve skin texture, tone, and firmness.
PRP stimulates the repair and regeneration of damaged skin tissues. It can be used to treat a variety of skin issues, including scars, fine lines, wrinkles, and uneven pigmentation.
​PRP therapy can enhance skin texture by reducing the visibility of acne scars, sunspots, and other skin irregularities. It can provide a more even and radiant complexion. It can a reduce skin inflammation and redness associated with conditions like rosacea.
What are Bioidentical Hormone Pellets?
Bioidentical Hormone Pellets are compressed doses of the pure, non-synthetic hormone (~99%) compounded with a small amount (~1%) of cholesterol that is used as a binding agent (not the kind that raise your cholesterol). Hormone pellets are roughly the size of a grain of rice. They are inserted by a trained practitioner through a tiny incision in an inconspicuous area of the body- usually the lower back/upper buttock. The procedure is done in the office with local anesthesia and is very quick. Some discomfort with the injection of the anesthesia might occur.
How it can benefit men and women:
For Men:
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Improved Libido: Low testosterone levels are associated with a reduced sex drive, and testosterone pellet therapy can help increase sexual desire and function.
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Enhanced Mood and Well-Being: Testosterone plays a role in mood regulation, and low testosterone levels can contribute to symptoms like depression and irritability. Increasing testosterone levels through pellet therapy may improve mood and overall well-being.
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Increased Muscle Mass and Strength: Testosterone is an anabolic hormone, and its supplementation can lead to an increase in muscle mass and strength. This can be particularly beneficial for men looking to improve their athletic performance or physique.
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Better Bone Density: Testosterone is important for bone health, and its deficiency can lead to a decrease in bone density. Testosterone pellet therapy can help maintain or improve bone health.
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Enhanced Cognitive Function: Some studies suggest that testosterone may have a positive impact on cognitive function, including memory and concentration. Increasing testosterone levels may lead to cognitive improvements.
For Women:
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Relief from Menopausal Symptoms: Testosterone pellet therapy can alleviate certain menopausal symptoms, such as hot flashes, night sweats, and mood swings, by restoring hormonal balance.
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Improved Libido: Just like in men, testosterone therapy can boost libido in women and improve sexual satisfaction.
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Enhanced Energy and Vitality: Increasing testosterone levels may lead to increased energy levels and an overall sense of vitality and well-being.
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Enhanced Cognitive Function: Testosterone may have a positive impact on cognitive function, and women may experience improvements in memory and mental clarity.
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TREATMENT FREQUENCY:
Men typically require hormone pellet insertion two to three times per year (every 4-6 months) and women require it four times per year (every 3 months).
The procedure carries a minimal risk of infection or pellet extrusion (less than 1%).
In comparison, patients who select injections as their hormone replacement method need to receive injections roughly 2-3 times per week to keep their hormone levels steady.
DOSAGES:
Unlike the spiking and crashing effect that can happen with pills, creams, or injections, once a hormone pellet is inserted, it begins dissolving and delivers a controlled, consistent, steady daily dose of the hormone into the body, much like how the hormone was secreted by the much younger body.
Pellets give the most physiologically correct dosing of hormones and thus are regarded by experts as the safest and most effective way to derive the benefits of bioidentical hormone replacement therapy.
Are Topical hormone replacements cheaper and better?
Although hormone creams and gels may be the least expensive way to replace the hormones lost as we age, and can in some cases work, they are by far the least effective and least convenient method.
The skin is a barrier designed to keep things out of the body, and it does an excellent job at that. Creams and gels need to be rubbed in completely — and this is a messy and time-consuming process. When applying topical hormone creams, one needs to put on 5 to 10 times the dose on the skin that is desired in the body, and what is not rubbed in goes somewhere else (like on your spouse, children, grandchildren, pets, or down the drain)!
Are Injections are a better way to get hormone replacement therapy because the dosage is more controllable?
While it is true that testosterone dose can be varied with every single injection, there is no advantage to that if you have the option of a practitioner who is skilled in dosing pellet therapy (and in fact, most of the time, standard dosages of injectable hormones are used and rarely varied).
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The natural form of these hormones (testosterone / estradiol) when purified is a powder, and the powder must be dissolved in something to be injected into the body. Most of the time injectable testosterone is mixed with either cottonseed oil or grapeseed oil, so the vast majority of what is being injected is not even the pure hormone — these oils can lead to allergies and intolerances, and potentially other health issues.
The principal issue with injections (other than the frequent painful needle poke) is that the hormones are delivered in a large dose all at once, and then over time, there is less and less available to the body, so the dosing is not all like the consistent steady state achieved with pellets. The half-life of injectable testosterone, depending on the formulation, ranges from 4-8 days. Thus, to have a meaningful testosterone level one week after injection requires injecting about two to four times as much as one needs on the first day — this is even more pronounced when one is getting injections monthly (a terrible idea!) or every 2 weeks. The best way to inject testosterone to keep levels right where they should be, without extremely high levels and extremely low levels, is to inject a small dose daily. Most patients are unwilling or unable to comply with that therapy, so the compromise is to have patients inject testosterone about every 3 days or twice per week. This is inconvenient, uncomfortable, and if one is traveling, requires taking syringes, needles, and associated supplies along. Most of our patients prefer the smooth, continuous, and physiologic dosing achieved with hormone pellets.
Are Synthetic hormones safe and effective ways to manage the hormonal declines of age?
Although there are some synthetic hormone solutions available for treatment of peri- and post-menopausal symptoms (ie. Premarin and Provera), and they have shown promise in symptom reduction and cardiovascular risk, the largest studies of these (The Women’s Health Initiative Study) have shown they carry an increased risk of both breast and endometrial cancer. Thus, most practitioners will only prescribe these hormones for a limited period and try to make sure a patient is well aware of the potential risks. BHRT is safe, effective, can be used indefinitely without additional risks of cancer or other problems, and has been shown to convey the same protective benefits against cardiovascular disease, osteoporosis, cognitive decline and the ravages of aging.
Regarding men, there is no substitute for natural bioidentical testosterone. Nothing else works the same or has the same effects. The same is true with women. Women have natural declines in their testosterone levels as they age and in fact, they make their estradiol from testosterone. Thus, in our practice we focus on bioidentical testosterone replacement therapy as the first line in both men and women. There is no synthetic solution that even compares in terms of safety and efficacy.
Are Injectables or pills cheaper than pellets?
First, there is no pill that will do what hormone pellet therapy can do. So, we can rule them out right away. Injectable testosterone might be cheaper, but it depends on how you value your time, discomfort, and convenience.
The vast majority of patients love pellet therapy because it requires only a few visits a year, it gives them consistent, optimal hormone levels and great results, without the hassle, pain and inconvenience of injecting hormones at home or on vacation, or going to visit a practitioner monthly for injections.
Many of our patients tell us that their hormone pellet therapy has allowed them to lead fuller, more productive, more energetic, and happier lives. And what price can we place on that?
