Pellet Therapy Frequently Asked Questions and Answers


Here are some frequently asked questions and answers about hormone pellet therapy.  For more information on pellet therapy and to watch videos of pellets being inserted, click here.


What is Pellet Therapy?  Pellet therapy is the insertion of bioidentical hormone pellets made of testosterone and estrogen (estradiol) under the skin to restore optimal hormone levels in men and women.


What is BHRT?  BHRT stands for “bioidentical hormone replacement therapy.”  Pellet Therapy is one type of BHRT.  Other types of BHRT are skin creams containing hormones, pills and capsules containing hormones, skin patches containing hormones.

What does “bioidentical mean”?  Bioidentical means identical to the hormone naturally produced by the human body.  Bioidentical hormones are identical to the hormones naturally made by the ovaries or testicles.  They are not synthetic drugs.  This is important because the cells of the human body respond best to natural, bioidentical hormones.


Why is pellet therapy preferred over other types of BHRT?  Once they are inserted under the skin, pellets produce a steady hormone level, like that produced by the ovaries or testicles, leading to better results compared to alternative forms of hormone replacement.


How long do pellets last?  Pellets last longer than other forms of BHRT, typically 3-6 months, so there is less to think about or manage.


What are the results of pellet therapy?  Patients report renewed energy, increased vigor, increased libido, improved mood, better motivation and drive, relief of hot flashes and night sweats, weight loss, better exercise results, more muscle, less fat, better sleep, stronger bones, reversal of osteopenia, better sex, improved erections (men), relief of vaginal pain and dryness (women), better skin tone, better hair growth on scalp.


How soon will I feel the benefits of the pellets?  Patients typically feel better within 1-2 days of the procedure and continue to feel well until the next planned insertion date.


Does pellet therapy hurt?   NO, the pellet is inserted under the skin using local anesthesia, so no pain is felt by the patient.


What can I expect after the pellet insertion?  After the pellet is inserted, a small bandage is applied to the skin, which comes off after 1 week.  You may shower because we use a special waterproof bandage, but you must stay out of pools, bathtub, hot tub for a week.  Low intensity exercise and walking is fine but avoid high-intensity exercise for a few days after the pellets are inserted.


What happens at the office before a pellet is inserted?  Your doctor will do a complete evaluation and check your blood tests to verify that you are a good candidate for pellet therapy and to determine your specific dose.  Once that is done, pellets are scheduled.   Sometime this can be done the same day (if you already have labs from another provider or have been on pellet therapy elsewhere), otherwise you will be scheduled once the blood testing is completed.


Is fasting required before pellet insertion?  No, no fasting is required before pellet insertion.


Where on the body are pellets inserted?  Usually pellets are inserted on the buttock cheek area, where the site is covered by underwear or swimsuit, ie, the “back pocket of a pair of jeans.”  However, pellets can be inserted elsewhere such as the tricep area or the flanks, “love handles” if there is a reason to do so.


What blood tests are done before pellet therapy?  We check estradiol, estrone, testosterone, DHEA, FSH, LH, CBC, kidney and liver function, metabolic profile, cholesterol profile, blood sugar and A1c, thyroid tests, vitamin levels, growth hormone, IGF-1, and many others.


How long do pellets last?  The duration of the pellet depends on activity level and dosage.  Typically pellets last 3-6 months.


Do pellets have to be removed?  No, pellets are made of 100% pure bioidentical hormone, so they dissolve completely and disappear, so they do not have to be removed.


Are pellets FDA approved?  The FDA has approved the ingredients of the pellets (testosterone and estradiol and others) for use in the human body and for insertion as pellets, and has approved  brand name versions of pellets.  The FDA also allows special sterile compounding pharmacies (503B pharmacies) to manufacture pellets of different dosages and formulas for clinics to use.  The pellet manufacturing pharmacies are FDA-inspected and operate under the highest level of sterility to ensure your pellets are safe and effective without any risk of contamination.


How often do pellets have to be inserted?  This depends on your dosage and activity level.  Typically, we reinsert pellets every 3-6 months depending on the patient.  This is determined by blood testing and evaluation of your symptoms after 3-4 months.


What diseases and health concerns can pellets improve?  Estrogen and Testosterone pellets improve menopause symptoms, osteopenia and osteoporosis, low testosterone in men, erectile dysfunction (ED) in men, fatigue, depression, anxiety.  They improve exercise tolerance and muscle growth, which in turn may improve high blood sugar and diabetes, insulin resistance, and cardiovascular disease, and help with weight loss.


How do estrogen and testosterone levels change as we age?  In women, at menopause, estrogen, testosterone, and progesterone levels drop to nearly zero, causing severe symptoms called menopause.  Hormone pellets can restore these levels to normal range iin women.  In men, there is a slower decline of testosterone with age; testosterone pellets can restore a mans testosterone levels to the normal range.


Is it important to monitor hormone levels when using pellets?  Yes, hormones dosage must be closely monitored and levels of estrogen and testosterone and DHT as well as hemoglobin and hematocrit must be measured in men and women to be sure the correct dose of pellets is used.


What are the different types of pellets?  There are many different types of pellets.  Your doctor will decide which is best for you based on your medical history and lab testing.  There are testosterone, estradiol, progesterone, anastrozole, and finasteride pellets available in varying doses.  They each have different uses.


What is in a testosterone pellet?  Our testosterone pellets are made of 100% pure bioidentical  testosterone without dangerous fillers or binders (such as stearic acid, used by other clinics).  Stearic acid can cause inflammation and redness at the pellet site, so we do not use these pellets at our office.


What is in an estrogen pellet?  Estrogen pellets are made of 100% pure bioidentical estradiol, which is identical to that made by the ovaries, without any dangerous fillers or binders such as stearic acid.








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