“When I started studying, I became fascinated by the chemistry of life. At the time, had just discovered the relationship of hormones with human reproduction. And playback is the most dynamic part of life.”

Dr. Elsimar Coutinho

Methods of Hormonal Replacement

Nowadays, there are several available methods used for hormone replacement therapy. Each one of these methods has a number of positive and negative points that should be explained to the patient. It is important to note that, most of the methods available in the market place are, unlike the hormonal implants, composed of synthetic substances - developed in laboratories. As mentioned before, these substances are not wholly absorbed by the organism, causing side effects during their administering. For public knowledge, some of these methods are presented herein with a small explanation about each one and the differences that make of the hormonal implants the option more in accordance with resuming the well being and health to each patient. HORMONAL IMPLANTS - the hormonal implants developed by Dr. Elsimar M. Coutinho are hypoallergenic and can be composed of bioidentic testosterone or oestradiol, male and female hormones respectively. Bioidentic hormones are made of the same exact chemical and molecular structure in hormones naturally produce by the body, which rules out most unwanted side effects. Additionally, other hormones characterized as Progestinics like Gestrinone, Nomegestrol Acetate and Elcometrine can be used. These hormones are associated according to each individual's necessity after evaluation of specific exams. The hormones are gradually released and have the duration of 6 months as for Elcometrine or one year as for all the others, ensuring the safety and practicality of the method. Capsules (oral use) - Are usually derived from oestrogen and testosterone - synthetic hormones. According to each patient's requirement can also contain progesterone. According to scientific research, oestrogen and testosterone help the deposition of calcium in the bones, which in turn, helps preventing osteoporosis. On the other hand there is the negative effect over the liver due to first passage metabolism, so the prescribed amount of these substances have to be high to compensate for the losses. The oral use hormones are destroyed by the gastric juices when going through the digestive tract, which compromises its efficacy - biodisponibility. Furthermore the required daily use can lead to the neglect of some capsule. INTRAMUSCULAR INJECTION - Can be used in weekly or monthly intervals. The hormone concentration can be very high on the first day, which means that the release does not imitate the body's natural production. It does not go through the liver but it can overload other tissues and cause the increase of the 'bad' cholesterol (LDL), acne, baldness, aggressiveness, infertility, impotence, and liver cancer amongst other. VAGINAL CAPSULES AND CRÈMES - Particularly used by women, they are applied directly to the vagina. Are composed basically by oestrogen. Its daily use is interrupted only during the menstrual period and continued all through the month. The cases of application neglect are common which leads to the interruption of the treatment prescribed by the medical specialist. ADHESIVES (Transdermic Replacement) - Are usually put over the gluteus region, weekly. The hormones contained in the adhesive get to the blood flow through the skin. The adhesive started being used mostly by individuals of a more advanced age because they already use other drugs that can overload the digestion of these substances. One of the most common side effects of this method is skin allergy. There are reports of over 80% of related cases of skin allergies. There are also cases of neglect besides not having a very rigid controlled dosage that should be administered to each patient. SPRAY (Nasal Use) - Formulation composed by semi-hydrated oestradiol or testosterone. It does not usually present skin complications but has its usage still restricted in Brazil. TESTOSTERONE GEL - Has just been released in Brazil. Its pharmacological profile is similar to the transdermic methods like crèmes and adhesives. Because of its obligatory daily use it is common to have cases of neglected application and problems related to the dosage variation during application. ORGANON® Implants - Have principles that come close to the Hormonal Implants developed by Dr. Elsimar Coutinho, but, because of the three year duration they have a much higher quantity of hormone to be administered. Besides, they are used only as a contraceptive method.