Pellet Therapy FAQs

What is Bio-Identical Hormone Replacement Pellet Therapy?

Bio-Identical Hormone Replacement Therapy (BHRT) with pellets utilizes bio-identical hormones derived from natural, plant-based substances that are identical on a molecular level to those created by the body. Subcutaneous hormone pellets are often a preferred method of delivery as they metabolize in the body as the body intends. Hormones are released consistently over time and are less likely to cause fluctuations like other hormone treatments. Depending on your needs, your provider may employ a combination of pellets and other hormone treatments to optimize your hormones.

WHAT ARE HORMONE PELLETS?

Pellets are made up of either estradiol or testosterone. The hormones are pressed or fused into very small solid cylinders. These pellets are larger than a grain of rice and smaller than a ‘Tic Tac’..

WHY PELLETS?

Pellets deliver consistent levels of hormones for 3-5 months in women and 4-6 months in men. They avoid the fluctuations, or ups and downs, of hormone levels seen with every other method of delivery. Estrogen delivered by subcutaneous pellets, maintains the normal ratio of estradiol to estrone. This is important for optimal health and disease prevention. Pellets do not increase the risk of blood clots and other untoward side effects like conventional or synthetic hormone replacement therapy.

In studies, when compared to conventional hormone replacement therapy, pellets have been shown to be superior for relief of menopausal and andropausal symptoms, maintenance of bone density, restoration of sleep patterns, and improvement in sex drive, libido, sexual response and performance.

Testosterone delivered by a pellet implant, has been used to treat migraine and menstrual headaches. It also helps with vaginal dryness, incontinence, urinary urgency and frequency. In both men and women, testosterone has been shown to increase energy, relieve depression, increase sense of well being, relieve anxiety and improve memory and concentration.

Testosterone, delivered by pellet implant, increases lean body mass (muscle strength, bone density) and decreases fat mass. Men and women need adequate levels of testosterone for optimal mental and physical health and for the prevention of chronic illnesses like Alzheimer’s and Parkinson’s disease, which are associated with low testosterone levels.



Even patients who have failed other types of hormone therapy have a very high success rate with pellets. There is no other method of hormone delivery’ that is as convenient for the patient as the implants. Pellets have been used in both men and women since the late 1930’s. There is more data to support the use of pellets than any other method of delivery of hormones.

HOW ARE PELLETS INSERTED?

The insertion of pellets is a simple, relatively painless procedure done under local anesthesia. The pellets are usually inserted in the lower abdominal wall or upper buttocks through a small incision, which is then taped, closed.

IS THE PELLET IMPLANT PROCEDURE PAINFUL?

The procedure itself is quick and easy and takes just a few minutes. We use a mixture of Lidocaine and Epinephrine with Sodium Bicarb to numb the area so you won’t feel a thing during the actual pellet insertion process.

Are there any side effects or complications from the insertion of the pellets?

Complications from the insertion of pellets include; minor bleeding or bruising, discoloration of the skin, infection, and the possible extrusion of the pellet. Other than slight bruising, or discoloration of the skin, these complications are very rare.

The most common side effects are increased hair growth and possible skin breakouts with the first round of therapy, because the body is getting used to increased oil production in the skin. Patients may want to change their skin care regimen from heavy anti-aging products to lighter, oil-free skin care lines. Side effects may be avoided with decreasing doses on subsequent rounds of therapy

IS THERE ANY DOWNTIME FOLLOWING PELLET THERAPY?

Patients should take it easy and avoid strenuous exercise for a few days following the procedure – 72 hours for women and 4 to 5 days for men. This helps ensure the tiny incision heals properly and can prevent extrusion of the pellet from under the skin.

HOW SOON CAN PATIENTS EXPECT TO EXPERIENCE RESULTS FOLLOWING THE BHRT PELLET PROCEDURE?

Most Women begin to “feel better” within 48 to 72 hours, though it may take a week or two for some women to notice a difference. 

Men can expect to experience the benefits of their pellet implants within 1 to 2 weeks. .

While most people experience substantial benefits after the first round of therapy, many patients experience more pronounced benefits after the second round of pellet implants. Therefore, patients should expect to have the procedure performed at least twice before experiencing optimum results.

People don’t get out of balance overnight, so it often takes a few months to get back on track.

Female FAQs

WHAT HORMONES DO WOMEN NEED?

Estrogen loss puts women at risk for premature ovary failure, osteoporosis, heart disease, colon cancer, Alzheimer’s disease, tooth loss, impaired vision, Parkinson’s disease and diabetes. These risks increase the longer a woman suffers from estrogen deficiency.

DO WOMEN NEED TESTOSTERONE THERAPY?

The short answer is yes, women need testosterone too. Women natural produce some testosterone in the ovaries. And much like the other female sex hormones, levels of testosterone can diminish with age, childbirth, or may never reach optimization. Women who have low levels of testosterone may experience low sex drive, decreased mental clarity, weight gain, poor muscle tone, as well as other unwanted side effects. 

Testosterone pellet therapy offers women an opportunity to relieve these symptoms and experience other valuable benefits, such as reduced risk of disease.

AFTER HOT FLASHES SUBSIDE AND MENOPAUSE SETS IN, DO WOMEN STILL NEED HORMONE REPLACEMENT THERAPY?

Research repeatedly links hormone imbalance to an increased risk for cancer, osteoporosis, stroke, thyroid disorders, diabetes, heart disease and other age-related disease processes. During perimenopause, menopause and andropause (the male version of hormone depletion), declining health is considered the norm. But feeling poorly doesn’t need to be the norm.

Can pre-menopausal women benefit from pellets?

Testosterone pellets may be used in pre-menopausal females (women who have not stopped menstruating). Testosterone has been shown to; relieve migraine or menstrual headaches, help with symptoms of PMS (pre menstrual syndrome), relieve anxiety and depression, and improve sex drive and libido. If a pre-menopausal female has a testosterone pellet inserted, she must use birth control.

Do Natural Pellets have the Risk of cancers as Synthetic Hormones?

Pellets do not carry with them the same risk of breast cancer as high doses of oral estrogens that do not maintain the correct estrogen ratio or hormone metabolites. Nor, do they increase the risk of breast cancer like the synthetic, chemical progestins used in the Women’s Health Initiative Trial. Data supports that balanced, bio-identical hormones are breast protective.

Testosterone, delivered by pellet implantation, has been shown to decrease breast proliferation and lower the risk of breast cancer, even in patients on conventional hormone replacement therapy. Clinical studies show that bio-identical testosterone balances estrogen and is breast protective.

Are there side effects to estrogen delivered by pellet implantation?

When a patient first starts on hormone therapy there may be mild, temporary breast tenderness, which resolves on its own. Hormone receptors may be very sensitive and take time to adjust. There may be a temporary water weight gain, which will also resolve on its own. Women, especially those who have not had a hysterectomy, may choose a different method of delivery of estrogen, as the risk of bleeding is significant

Male FAQs

DO MEN NEED HORMONE THERAPY?

Testosterone levels begin to decline in men beginning in their early 30’s. Men should be tested when they begin to show signs of testosterone deficiency such as brain fog, memory loss, mood changes, anxiety, joint pain, insomnia and erectile dysfunction, to name a few. Even men in their 30’s can be testosterone deficient and show signs of bone loss, fatigue, depression, erectile dysfunction, difficulty sleeping and mental decline. It is never too late to benefit from hormone therapy.