Not All Bioidentical Pellet Therapies Are Alike

In hormone replacement therapy, it seriously matters which delivery method is used and the dosage administered. To that point, pellet implant therapy is widely accepted as the most effective and safest form of HRT available. The subcutaneous pellet implant is, in fact, one of the oldest and most researched hormone delivery methods in use.1 This approach to HRT most closely simulates the body’s own hormone delivery method in that it circulates physiologic amounts of hormone in the bloodstream around-the-clock. And it lasts for months at a time. Pellets can also respond to the body when it needs more hormone, for instance during exercise or stressful situations. Research shows that pills, patches and other common delivery methods simply cannot provide the same desirable steady dose that pellets can.2 Importantly, it’s this stable supply of low dose hormones that’s required to support homeostasis (internal equilibrium) and good health.
All that being said, many practitioners do not fully understand how to achieve hormonal balance using this method. It is not a one size fits all solution, nor is it a hit and miss proposition. Precision dosing and careful monitoring are imperative to avoiding the side effects or adverse reactions from hormone levels that are too high. Like any medication you take, the dosage determines the outcome. Too much or too little can sometimes result in serious health issues. When you read of patients having problems with pellets, it’s generally attributable to physicians who are not correctly dosing them.

The SottoPelle® Difference

If you are already on or thinking about trying SottoPelle® bioidentical pellet implant therapy, here are some facts you need to know about why our method is different from others.

1. Our treatment is science-based and has a proven track record. The pellet method of delivering hormones has been in use and studied since the 1940s.3 It’s shown to be the safest and most effective method available. Abundant scientific literature dating back decades likewise supports the use of bioidentical hormones versus pharmaceutical synthetics. When properly administered, these human-identical hormones can provide relief from menopausal symptoms in addition to many health benefits.4,5

2. After years of personal research and evaluation, our founder, Dr. Gino Tutera developed a uniquely precise bioidentical pellet implant system that includes:

• Proper testing and diagnosis of hormone deficiency;
• A proprietary algorithmic-based dosing software that provides customized treatment appropriate to each individual patient;
• A unique implantation method that helps prevent extrusion of pellets;
• Proper follow-up and monitoring of hormone levels (including thyroid), blood lipids, and other indicators of health.

Of course, the most crucial factor in providing SottoPelle® patients with a unique and beneficial BHRT experience is the expertise of our highly trained physicians and the partnership they create with each patient. By precisely adhering to our unique system and establishing open communication with patients, our physicians can help them regain the quality of life they once had. That’s what hormonal balance is all about.

SottoPelle® BHRT Pellet Experts

SottoPelle® has specialized in BHRT using the pellet method longer than most. Our founder, Dr. Gino Tutera, developed the proprietary method that makes us a leader in our field. We have a long history of success when it comes to balancing hormones and helping people take control of their health. In fact, we are honored to say that, according to Ranking Arizona, an annual consumer publication by AZ Big Media, our patients have voted us Arizona’s #1 Hormone Therapy Clinic in 2015.

Call Us Today!

Learn more about SottoPelle® at and then give us a call at (877) 473-5538 to schedule a consultation.

1Greenblatt R. Indications for hormone pellets in the therapy of endocrine and gynaecological disorders. Am J Obstet-Gynecol 1949; 57:294-301.
2 Smith RN, Studd JW. Recent advances in hormone replacement therapy. (Review) Brit Jour Hosp Med, 1993, 49(11) 799-808.
3 Cardozo L, Gibb D, Tuck S, et al. The effects of subcutaneous hormone implants during the climacteric. Maturitas 1984;5:177-184.
4 Schwartz E, Holtorf K. Hormones in wellness and disease prevention: common practices, current state of the evidence, and questions for the future. Prim Care Clin Office Pract 2008; 35 (4): 669–705.
5 Moskowitz D. A comprehensive review of the safety and efficacy of bioidentical hormones for the management of menopause and related health risks. Altern Med Rev. 2006 Sep;11(3):208-23.

Health & Wellness as You Age

by Gino Tutera, M.D., F.A.C.O.G.
Your body is like a precision machine. Everything must work together in order for it to operate at its best. This internal collaboration regulates every organ, gland, cell, and physiologic process in your body. Upset any part of the delicate balance, especially the production of endocrine hormones, and, like a chain reaction, you disrupt the entire system. This can have a negative impact on your health and wellness as you age.

As life would have it, the arrival of middle age begins this process of physical disruption and imbalance. That’s when hormone production declines in women and men alike. By the time a woman reaches her early 50s, she completely stops making her most important estrogen—estradiol. At the same time, her progesterone and testosterone levels all but disappear. Diminished testosterone production in middle-aged men can actually cause them to become estrogen dominant at this stage of their lives.

Beyond creating sexual performance issues, a long list of other distressing symptoms often accompanies midlife hormone deficiency. Unwanted weight gain, loss of sexual desire, fatigue, depression, increased anxiety and irritability, hot flashes, night sweats and migraines are just a few of the signs of a body out of sync. It’s also a time when relationships falter and physicians too often prescribe counseling and anti-depressants instead of hormone replacement.

Perhaps the most alarming outcome of hormone deficiency, however, is the growing vulnerability to aging-related diseases. Abundant research continues to link low levels of key hormones with increased risk of diseases like osteoporosis, prostate and breast cancer, coronary artery disease, diabetes, Alzheimer’s and others.

Healthy Hormone Levels Are Vital to Good Health

Healthy hormone levels are associated with optimum brain function, emotional and physical well-being, cardiovascular and bone health, breast and prostate health, cell growth regulation, beneficial blood sugar levels, better sexual function and satisfaction, and more.

Properly restoring testosterone and estrogen (specifically estradiol) to the levels of younger years replenishes your body and gives it what it needs. Hundreds of body functions depend on the presence of these key hormones in order to work properly. This is true whether you’re male or female, 19 or 91. Your need for hormonal balance never goes away.

BHRT Using Pellet Implants Could Be Your Passport to Health and Wellness as You Age

Did you know that bioidentical pellet therapy can help keep you on the road to more vibrant aging? When you combine appropriately administered pellet implant BHRT with a healthful diet, regular exercise and other aspects of a beneficial lifestyle, you will reap the rewards thousand fold.

Why pellets? Many people don’t realize that bioidentical pellets have been prescribed and researched since the 1930s. Abundant medical literature in respected international journals supports pellet implants as the safest and most effective hormone delivery system available. Pellet doses can be individualized and will go to work for you around the clock for up to 6 months. Additionally, pellet therapy is more convenient and cost effective than other HRT methods. Pills, patches, injections, creams and gels all come with a long list of downsides. Hormonal balance can be difficult or impossible to achieve with these. And besides the mess, the expense and the bothersome repeat dosages, why take a chance on the side effects and serious health risks of synthetic hormone treatments?

Be proactive. Have your hormone levels tested before symptoms and health issues get out of hand. Find a specialist, preferably someone with expertise in bioidentical pellet implants. The key to your well-being has everything to do with the type and quality of the hormones you’re taking, the method being used, and the skill and knowledge of your practitioner.

For more information about SottoPelle and how we can improve your health and wellness as you age, go to or contact us at: 480.874.5515.

SottoPelle® Continues its Mission to Raise Awareness for Traumatic Brain Injury

The leader in Bio Identical Hormone Therapy (BHRT) is committed to advancing its reach in assisting and treating concussion patients in 2016.
Football players and other athletes are being hit so hard that concussions are occurring at a higher rate now than in the past. According to the statistics on called “Concussion Watch:”Carolann Tutera president of SottoPelle® attended the premiere of the movie Concussion in Scottsdale, Arizona along with NFL Football Legend and SottoPelle patient, Jim McMahon.  Both felt it was important to attend the movie premiere and help raise awareness to the serious issue of Traumatic Brain Injury (TBI).

“Watching the amazing movie Concussion reaffirmed the importance of Dr. Omalu’s work, as was my late husband’s Dr. Gino Tutera in helping those who have TBI. Just as Dr. Omalu’s struggled to raise awareness, SottoPelle is determined to help improve the quality of life for those impacted by TBI.”

The number of players with concussions listed on injury reports is on pace to increase more than 9 percent from last year, to an average of nearly 9 per week. The NFL averaged 5.4 per week in 2009, 7.6 in 2010, and 8.4 last year. [1]

Awareness for Traumatic Brain Injury

These numbers only represent those being reported as “concussions” in the NFL, and dependent on other reporting variables.  Many sustain long term damage to their brain from game related activities. Players can experience repeated concussions in the course of their careers as in the case of NFL quarterback Jim McMahon, Hall of Famer Paul Krause, Joe DeLamielleure and countless others.  When this happens the brain doesn’t function normally. The movie centers on the accomplished pathologist Dr. Bennet Omalu who uncovers the truth about brain damage in football players who suffer repeated concussions in the course of normal play. The movie Concussion again raises awareness into this issue and the implications of all involved in the consequences of CTE (chronic traumatic encephalopathy) for athletes. It is important to remember, that concussions are also prevalent in our veterans who are similarly injured in the course of their service to our country.

SottoPelle® has been actively treating those with TBI for years. Life Extension[2] discussed the link between traumatic brain injury and hormone deficiency last year. Studies show the critical role of hormones in traumatic brain injury and disease.

Many studies demonstrate that hypopituitarism—a condition in which the pituitary fails to produce normal hormone levels—is relatively common following TBI,29 affecting at least 50 to 76% of victims.30-32 Sometimes hypopituitarism diagnoses are not made for more than 20 years after the injury.33

Brain-injured patients who have a deficiency in growth hormone exhibit greater deficits in attention, executive functioning, memory, and emotion than patients with normal growth hormone levels.34 Growth hormone binds to receptors found in the brain, especially in regions responsible for learning and memory.3

The late founder of SottoPelle® Dr. Gino Tutera dedicated his life to helping others and was very focused on the use of BHRT on TBI in the last twenty years.  His efforts are realized by the benefits voiced by NFL players like Jim McMahon, Paul Krause, Bobby Bell and many others who are experiencing an improved quality of life and relief of some of their symptoms. Recent media and now the movie Concussion have again highlighted the prevalence and damage of TBI suffered by athletes over the decades.  The movie also seems to emphasize the resistance of many to acknowledge the scope of the problem,

SottoPelle® is committed to helping NFL players, veterans, and anyone else with TBI to improve their quality of life.  SottoPelle recognizes and understand that TBI can cause devastating quality of life issues for many are dedicated to expanding their reach and efforts to minimize the cognitive and physical effects that standard therapies cannot fully alleviate in many patients.


COMPANY INFORMATION: SottoPelle® is an international leader in Bio-Identical Hormone Therapy headquartered in Scottsdale, Ariz. The company is also creator of BioCalc®, a pellet-dosing tool that has a patent pending to SottoPelle® for more information on SottoPelle® visit:

SOTTOPELLE® MEDIA CONTACT:  Carolann Tutera Phone: 480-682-4814




Can Discharge from Vaginal Atrophy Resemble Cervical Mucus?

Can Discharge from Vaginal Atrophy Resemble Cervical Mucus?

Is cervical mucus even present when there’s vaginal atrophy?

Atrophic vaginitis (vaginal atrophy) is the result of menopause, when a woman’s estrogen levels drop so much that her vagina literally dries out or loses its natural lubricant.

According to, one of the possible symptoms of moderate to severe vaginal atrophy is “vaginal discharge.” Does this resemble cervical mucous?

“The answer is absolutely no,” says Dr. Gino Tutera, an OB/GYN and specialist in bioidentical hormone replacement therapy.

Dr. Tutera explains, “Cervical mucous is quite different than the natural moisture from a normally functioning vagina. Cervical mucous consistency varies considerably based on the woman’s level of estrogen. Vaginal atrophy is caused by lack of estrogen, so there will be very little, if any, cervical mucous.”





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Is Heavy Bleeding Normal During Menopause?

If you’re bleeding heavy and you know you’re also going through menopause, don’t delay in seeing a doctor.
I asked Dr. Gino Tutera, an OB/GYN and specialist in bioidentical hormone replacement therapy, if heavy bleeding was normal during menopause. I found this question in a woman’s health forum and it had a lot of views.

“No,” says Dr. Tutera. “But this is the answer if the woman is fully into menopause as evidenced by laboratory testing or having no menses for a full year.”

Heavy Bleeding During Menopause

If you’re bleeding from your cycle, then this contradicts going through menopause, as by definition, menopause is the end of menstruation. So if you’re going through menopause but experiencing heavy bleeding—the cause is certainly not your cycle—and you’d better get this checked out.

But are you sure you’re going through menopause in the first place?

A woman, close to the beginning of menopause, may go several months without a period. Then she starts bleeding heavily—another period. However, if the bleeding doesn’t resemble menstruation, maybe you are in menopause. As mentioned, lab testing (blood test) can show if a woman is in menopause.

“During the transition into full menopause it is very common to have significant variations in the timing of periods and amount of bleeding,” says Dr. Tutera. “The ovaries are just not functioning consistently from day to day.”

What could heavy bleeding during menopause be caused by?

First off, it would have nothing to do with “the change.” Causes include: benign uterine or cervical polyps, endometrial thinning, endometrial thickening, uterine cancer, vaginal cancer, and uterine or cervical infection. This list of causes, including the cancers, is not complete.




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How Can Periomenopause Cause Unexplained Anxiety, Feelings of Doom?

What’s going on with the hormones of periomenopause that may cause anxiety in a woman?
“These feelings are primarily due to lack of testosterone,” says Dr. Gino Tutera, an OB/GYN and specialist in bioidentical hormone replacement therapy.

Periomenopause Can Cause Anxiety

Yes, younger women naturally product the “male hormone” testosterone, but in general, the amount is only one-tenth of what a man normally produces. This is why women do not have the capacity to naturally develop the musculature that men can.

Dr. Tutera continues, “With the loss of ovarian function (menopause), a woman loses at least half of her normal production of testosterone.”


Is there a natural and safe way to get some of this testosterone back?

YES. As a fitness expert and former certified personal trainer for a health club, I recommend that women suffering the anxiety and feelings of doom associated with periomenopause take up the following exercises, which boost circulating levels of testosterone:

High intensity interval training

Intense and heavy deadlifts, back squats, leg presses, bench presses, kettlebell swings, overhead presses, and if available, tractor tire flipping (as depicted in the above image) and sled pushing/pulling.

These exercises cause a chemical chain reaction in the body that culminates in elevated levels of testosterone. But there’s a catch: The training must be intense, heavy and fierce.

Will this result in your body looking like a man’s? Remember, testosterone production drops during periomenopause. There is absolutely NO way that any kind of exercise could skyrocket a woman’s testosterone levels—especially during periomenopause—to match that of a man’s.
But the boosted production WILL have a youth-promoting effect, as this chemical messenger is a so-called youth hormone.

Something else needs mention, when it comes to anxiety, depression and feelings of doom and gloom as periomenopause gets underway. Some of this anxiety and the blues could simply be the result of knowing that periomenopause has arrived. To some women, it signals bad things, namely, the aging process, or the loss of youth and vitality.

Now here’s a fair question, ladies: Is it possible to feel depressed and gloomy about “the loss of youth” concurrent with the ability to pick something heavy off the ground or lift something heavy overhead? In other words, train hard at the gym. Get back some youth by getting strong and losing body fat. Fight periomenopause with intense and heavy strength training!




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Dr. Gino Tutera, MD, FACOG SottoPelle® Founder and Anti-Aging Pioneer, Passes Away

Internationally recognized and respected leader, innovator in Bio-Identical Hormone Replacement Therapy and Anti-Aging died peacefully on November 7, 2015
Gino Tutera, MD, FACOG, an early pioneer of bio-identical hormone replacement therapy (BHRT), died on Saturday, November 7 in Scottsdale, Arizona with his wife Carolann and family by his side.

An accomplished physician, Dr. Tutera was listed in America’s Top OB/GYN in Arizona; The Leading Physicians of the World, as well as The International Association of Obstetricians and Gynecologists. He served with distinction as a Medical Director, Vice Chairman, and Chairman of multiple hospitals and medical centers.

Dr. Tutera successfully practiced medicine as a board certified OB/GYN for over four decades in Kansas City, Missouri, Rancho Mirage, California and Scottsdale, Arizona.

He initially specialized in obstetrics & gynecology and then moved onto treating hormonal imbalances in women. After recognizing the potential benefits of hormone replacement therapy for both men and women, he performed his own research, testing, and analysis in the field of bio-identical hormone replacement therapy. The result was the development of SottoPelle®, his own proprietary, pellet-based individualized bio-identical hormone delivery system now utilized by physicians around the world.

Dr. Tutera was a visionary and saw the importance of treating hormonal imbalance in relation to a myriad of medical conditions and symptomology. This was well before the connection of nutritional and hormonal health were mainstream, and the connection between diet, health, and hormones was readily accepted or understood. Dr. Tutera was committed to helping everyone live and age well. Above all else, Dr. Tutera was a healer and was devoted to improving the quality of life for everyone. His efforts also included working with those with Parkinson’s disease, traumatic brain injuries, and countless other conditions where BHRT is able to play a vital role in healing and improving health.

Dr. Tutera was kind, caring, and devoted to the health and well-being of his patients and there has been an immediate outpouring of accolades and sorrow from around the world:

“Many of us in the NFL have suffered head injuries. If it had not been for Dr. Tutera I am not sure if I would have any quality of life. Because of SottoPelle I enjoy life again and look forward to tomorrow. I will miss my dear friend Gino but will continue my treatments as I believe they have greatly improved every aspect of my life.” Paul Krause, NFL Hall of Fame Player and SottoPelle Patient

“THIS BEAUTIFUL MAN has changed/saved so many lives. He is loved and cherished. Prayers please for his peaceful passing and may God give his beautiful wife and soulmate peace and be surrounded by love.” Paula Trickey, Actress and SottoPelle Patient

His colleagues and peers noted his professionalism, experience, and vast knowledge which he eagerly shared with them:

“To countless colleagues, friends and patients, he was a skilled physician, innovative healthcare provider, exceptional communicator, and inventor and overall he spent his life dedicated to the health and well-being of mankind. As a member of his selected Medical Advisory Board we will honor his legacy and continue to teach and train healthcare providers around the world the treatment modalities he created. His life will live on through his patients, family and health care providers around the world!” Dr. Jim Mirabile

“The world lost a wonderful leader in the healthcare industry.” Al Maag

“The health world, Nerium Family, family and friends, we lost an innovator in making people feel better. A caring doctor who actually cared about patients as if they were family. Thank you for being a leader in love thy neighbor. You will be missed.” Dori Zuckerman

Dr. Tutera’s wisdom and legacy, encompassed and embodied within SottoPelle®, will continue to be practiced by the countless physicians he has trained and that will continue to be trained by SottoPelle® in the years ahead.

Dr. Tutera will remain in our hearts and minds as we continue to grow and help others live and age well.

Dr. Tutera is survived by his loving wife, children, grandchildren, friends, and countless patients.

For more information on Dr. Gino Tutera, please visit his bio page at: