testosterone implants in HRT

Last edited 02/2020 and last reviewed 01/2023

A treatment option undertaken by an expert only.

Implants of oestradiol come in doses of 25, 50 and 100 mg and can be inserted into the subcutaneous fat tissues. There are also testosterone implants available which some gynaecologists recommend for improving libido.

Subcutaneous implants:

• E2 implants, replaced every 6-12 months. Particularly effective against the psychological manifestations of the menopause.
• the disadvantage of implants is the it cannot be taken out and so there is inflexibility
  • tachyphylaxis may also be a problem: a supraphysiological level of oestrogen is provided by the implant and as this level declines the women may feel the return of her
  menopausal symptoms (e.g. hot flushes) despite having an oestrogen level of above normal (1)

In November 2012, MSD made the commercial decision to discontinue the production of Testosterone Implants. There were no alternative suppliers here in Europe.

There is now availability of Testosterone 100 mg Implants from Smartway Pharmaceuticals Ltd (SP Ltd) in the UK. SP Ltd is the only distributor of the product across the world (excluding USA). The product is manufactured by Advanced Pharmaceutical Technology Inc in the USA, and SP Ltd is their main distributor for the Testosterone Implants.

There is also availability through SP Ltd for Estradiol 25 mg and 50 mg Implants. These are also manufactured by Advanced Pharmaceutical Technology Inc in the USA, and again, SP Ltd is their main distributor for these Implants.

Reference:

• BMJ (1989), 299, 601-2.
• British Menopause Society (23 September 2015). Testosterone and Estradiol implants.