Six-week changes in follicle-stimulating hormone following individualized subcutaneous hormone pellet therapy in postmenopausal women: a retrospective study

Background

Menopausal symptoms can substantially affect quality of life, and hormone therapy is an established treatment option for appropriate patients. Subcutaneous hormone pellets provide sustained delivery of estradiol and testosterone; however, evidence regarding short-term biochemical responses to individualized pellet therapy remains limited. This study evaluated changes in serum follicle-stimulating hormone (FSH) following individualized subcutaneous hormone pellet therapy.

Methods

We conducted a retrospective chart review of 51 women with paired serum FSH measurements obtained before and approximately six weeks after individualized subcutaneous hormone pellet therapy at a private gynecology practice. The primary outcome was change in serum FSH from baseline to follow-up. Secondary outcomes included the proportion of patients with any decrease in FSH and the proportion achieving a ≥50% reduction from baseline. Patient-reported symptoms documented in the medical record were reviewed descriptively but were not analyzed as standardized efficacy endpoints. Paired FSH measurements were evaluated using paired statistical testing.

Results

Mean serum FSH decreased from 59.7 ± 30.6 mIU/mL at baseline to 33.6 ± 22.1 mIU/mL at follow-up, corresponding to a mean absolute decrease of 26.0 mIU/mL (p<0.001). FSH decreased in 45 of 51 patients (88.2%), remained unchanged in 1 (2.0%), and increased in 5 (9.8%). A ≥50% reduction from baseline occurred in 26 patients (51.0%). Clinical records documented changes in menopausal symptoms, energy, libido, hot flashes, sleep, weight, and other symptoms; however, these observations were not collected using a standardized symptom instrument and were therefore not analyzed quantitatively.

Discussion & Conclusion

Individualized subcutaneous hormone pellet therapy was associated with a significant reduction in serum FSH over approximately six weeks, although biochemical responses varied among patients. These findings describe a short-term biochemical response and should not be interpreted as evidence that FSH reduction represents clinical efficacy. The retrospective design, absence of a comparator group, heterogeneous dosing, short follow-up, and nonstandardized symptom documentation limit causal inference. Prospective controlled studies incorporating standardized clinical outcomes and longer follow-up are needed to determine whether biochemical changes correspond to meaningful clinical improvement.