Hormone Therapy
HORMONE PELLET THERAPY
A rice-grain-sized pellet. Inserted once every 3-6 months. Steady hormone levels 24/7. No daily dosing, no peaks and valleys.
WHAT ARE HORMONE PELLETS?
Bioidentical hormone pellets are small, solid cylinders—about the size of a grain of rice—custom-compounded with testosterone or estradiol and inserted just beneath the skin. They dissolve slowly over months, releasing a steady, consistent dose of hormones that mimics your body's natural rhythm.
Bioidentical
The hormones are molecularly identical to what your body produces. Testosterone is derived from plant sources (yellow ginger), estradiol from yam or soy. These are not synthetic progestins or conjugated equine estrogens—they're the exact molecules your body recognizes.
Sustained Release
Unlike injections that spike and crash, or creams that fluctuate with application timing, pellets release hormones steadily as they dissolve. This means consistent levels 24/7—no daily dosing, no hormonal roller coaster.
Long-Lasting
Women typically get 3-5 months per insertion (3-4 visits/year). Men get 4-6 months (2-3 visits/year). That's it—no daily pills, no weekly injections, no messy creams. One quick office visit and you're set for months.
PELLETS VS. OTHER DELIVERY METHODS
Pellets
Steady 24/7 levels for 3-6 months. No daily dosing. No transfer risk.
Inserted every 3-6 months in a quick office procedure.
Injections
Peak-and-valley pattern. Levels spike after injection, then drop before the next one.
Weekly or biweekly self-injection. Requires supplies and refrigeration.
Creams/Gels
Variable absorption. Transfers to partners and children through skin contact.
Daily application. Must avoid contact for hours after applying.
Patches
Skin irritation common. Can fall off during exercise or sweating.
Changed 1-2x per week. Visible on skin.
Oral
First-pass liver metabolism reduces effectiveness and increases liver burden.
Daily pill. Least efficient delivery method.
NOT ALL PELLETS ARE THE SAME
The pellets we use are manufactured in an FDA-registered 503B outsourcing facility and feature a patented formulation designed to solve the two biggest problems with traditional hormone pellets.
Triamcinolone Acetonide
The patented testosterone pellet formulation includes trace amounts of triamcinolone acetonide, a corticosteroid with well-established anti-inflammatory properties. In the context of pellet therapy, triamcinolone serves a specific purpose: reducing the inflammatory response at the insertion site.
The result: less scar tissue formation, reduced post-procedure discomfort, and fewer pellet extrusions. In clinical observation, patients receiving pellets with triamcinolone experienced a greater than 50% reduction in extrusion rates compared to standard pellets—with male patients seeing a 75% reduction.
Less scar tissue also means more consistent absorption over the life of the pellet, so you get steadier hormone levels from start to finish.
Controlled-Release Excipients
The pellets use ethylcellulose as a rate-controlling excipient alongside stearic acid. This isn't just compressed hormone powder—it's an engineered matrix designed to dissolve at a controlled rate rather than releasing a large dose up front that tapers off.
This means more consistent hormone levels throughout the entire lifecycle of the pellet, rather than a strong initial effect that fades before your next insertion.
Patients report quicker initial symptom relief and more sustained results compared to standard compounded pellets.
Manufacturing Quality
- • Manufactured in an FDA-registered 503B outsourcing facility
- • Current Good Manufacturing Practices (cGMP) compliant
- • Every batch undergoes potency, endotoxin, and sterility testing
- • All ingredients sourced from FDA-registered suppliers
- • Plant-derived hormones (yellow ginger, yam, soy)—no animal products
- • Third-party sterilization in final container
THE PELLET THERAPY PROCESS
Comprehensive Lab Work
Everything starts with blood work—our 60+ biomarker panel covers your full hormone profile, thyroid, metabolic markers, vitamins, and inflammation markers. We need the complete picture before designing a protocol, not just a total testosterone or estradiol number.
Personalized Protocol Design
Your dosing is customized based on your lab results, symptoms, body weight, activity level, and health history. There's no standard dose—every pellet insertion is calculated for your specific needs. We may also address thyroid, progesterone, or metabolic issues alongside pellet therapy.
The Insertion (15-Minute Office Visit)
The procedure is straightforward:
- • The insertion site (typically upper hip/buttock area) is cleaned and numbed with local anesthetic
- • A tiny incision is made—smaller than a standard blood draw
- • The pellets are placed into the fatty tissue just beneath the skin
- • The incision is closed with medical tape (no stitches)
- • A sterile dressing is applied
Most patients describe it as easier than a dental visit. The local anesthetic means you feel pressure but not pain. Post-insertion soreness is mild and resolves within a day or two.
Post-Insertion Care
Keep the insertion site dry for 3-5 days. Ice if needed for comfort. Avoid lower body heavy lifting, strenuous leg exercise, and submerging in water (pools, baths) for about 5 days. Normal daily activity is fine immediately. The incision heals quickly and the tape falls off on its own.
Follow-Up & Optimization
We recheck labs approximately 6 weeks after insertion to see how you're responding. Dosing is adjusted for your next insertion based on both your labs and how you feel. The goal is optimization—not just getting you into the "normal" range, but finding the level where you feel your best.
WHAT TO EXPECT: TIMELINE
First 72 Hours
Some women notice initial symptom improvement (energy, mood) within the first few days as hormone levels begin to rise.
Weeks 2-4
Most patients notice meaningful improvement in energy, sleep quality, mood, and mental clarity. Libido typically begins improving. Men may take closer to 2-4 weeks for initial changes.
Week 6
Follow-up blood work to assess levels and response. Protocol adjustments made for next insertion if needed.
Months 3-6
Full benefits realized. Body composition changes (muscle gain, fat loss) become measurable. Next insertion scheduled based on your cycle length.
Second Insertion Onward
Dosing has been refined based on your first cycle. Most patients report the greatest improvement after the second insertion, once levels are dialed in.
WHO IS PELLET THERAPY FOR?
Women
Pellet therapy is particularly effective for women in perimenopause and menopause, where fluctuating hormones cause the most disruption. Common symptoms that respond well to pellets:
- • Hot flashes and night sweats
- • Insomnia and sleep disruption
- • Brain fog and difficulty concentrating
- • Low libido
- • Anxiety and mood changes
- • Fatigue despite adequate rest
- • Weight gain and difficulty losing weight
Both estradiol and testosterone pellets are available for women. Progesterone is typically prescribed alongside as an oral capsule.
Men
For men with low testosterone, pellets offer an alternative to weekly injections or daily topicals. Symptoms that respond to pellet therapy:
- • Persistent fatigue and low energy
- • Decreased sex drive
- • Erectile dysfunction
- • Brain fog and poor focus
- • Loss of muscle mass
- • Increased body fat
- • Irritability and mood changes
Men who dislike needles or who struggle with injection consistency are often the best candidates for pellet therapy. No weekly shots, no daily creams.
COMMON QUESTIONS
What if I don't like the effects—can pellets be removed?
Pellets can technically be removed, but it's not standard practice. Because dosing is based on comprehensive lab work and tailored to you, adverse reactions are uncommon. The more important safeguard is proper testing and conservative initial dosing—which is why we don't skip the lab work step.
What is pellet extrusion?
Extrusion is when a pellet works its way back out through the insertion site before fully dissolving. It's the most common complication of pellet therapy, but with the patented formulation we use (which includes triamcinolone to reduce scar tissue and inflammation), extrusion rates are well under 1%. Proper post-insertion care also helps—avoid strenuous lower body activity for 5 days.
Are pellets "bioidentical"?
Yes. The testosterone and estradiol in pellets are molecularly identical to the hormones your body produces. They're derived from plant sources (yellow ginger, yam, soy) through fermentation and chemical processing—not synthesized from horse urine (like Premarin) or created as synthetic analogs (like medroxyprogesterone). Your body can't tell the difference between these hormones and the ones it makes naturally.
Can I exercise with pellets?
Avoid strenuous lower body exercise (squats, deadlifts, running) for about 5 days after insertion. Upper body training is fine. After 5 days, full activity with no restrictions. The pellets are placed deep enough in the subcutaneous tissue that normal activity won't dislodge them.
Will pellets affect my fertility?
For men, testosterone pellets (like all exogenous testosterone) can suppress sperm production. If fertility is a current priority, discuss this before starting. Options like HCG or enclomiphene can help maintain fertility. For women, hormone pellets are not a contraceptive and don't reliably prevent pregnancy—separate contraception should be used if needed.
Are there allergy concerns?
The pellets contain no dairy and no animal-derived ingredients. While the starting materials include soy and yam, the sterols used are not proteins and are not classified as soy allergens. If you have known allergies, let your provider know and we'll review the full ingredient list with you.
References
- 1. Handelsman DJ, et al. "Testosterone pellet implants: pharmacokinetics and use in hypogonadal men." Horm Res. 1990;33(2-3):119-126.
- 2. Cavender RK, Fairall M. "Subcutaneous testosterone pellet implant (Testopel) therapy for men with testosterone deficiency syndrome." J Sex Med. 2009;6(12):3177-3192.
- 3. The 2022 Hormone Therapy Position Statement of The North American Menopause Society. Menopause. 2022;29(7):767-794.
- 4. Glaser RL, Dimitrakakis C. "Testosterone pellet implants in the treatment of breast cancer." Maturitas. 2015;82(4):406-416.
INTERESTED IN PELLET THERAPY?
Start with comprehensive lab work. We'll determine if pellets are the right delivery method for your hormones.
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