Pellets are made of bioidentical estrogen, progesterone or testosterone which is pressed or fused into very small solid cylinders about the size of a ‘Tic Tac’. Pellets have been used in both men and women since the late 1930’s. In the United States, the majority of pellets are made by compounding pharmacists and delivered in sterile glass vials.

Complications from the insertion of pellets could include; minor bleeding or bruising, discoloration of the skin, infection, and the possible extrusion of the pellet. It is possible to develop an allergic reaction to the pellets. These complications are very rare. 

With hormone therapy, you may notice more energy, better sleep and improved mood.  Muscle mass and bone density may increase while fatty tissue decreases. You may notice increased strength and physical performance, an improvement in skin tone and hair texture.Concentration and memory may improve as will overall physical and sexual health.  Libido typically is improved. 

Pellets deliver consistent levels of hormones for approximately 3 months. They avoid the fluctuations of hormone levels seen with most other methods of delivery. There is data to support the ‘long term’ safety of hormones delivered by pellet implants.

Even patients who have failed other types of hormone therapy have a high success rate with pellets.

Hormone levels will be evaluated before therapy is started. Levels will be reevaluated prior to insertion of the next set of pellets in 3 months. After the first year of therapy, hormones levels may be followed less frequently.

The pellets usually alleviate symptoms for 3-4 months for women and 5-6 months for men. They completely dissolve on their own and do not need to be removed.

The insertion of pellets is a simple, painless procedure done in the office under local anesthesia. The pellets are inserted in the upper buttocks through a small incision, which is then taped closed with steri-strips. The effects of the pellets can be felt as soon as 2-4 days after insertion with full effects in 6 weeks.

Some people begin to ‘feel better’ within 48 hours while others may take a week or two to notice a difference. 

Pellet insertion averages $350 for women. Men require a higher dose, so pellets are typically $650-$750 for men. Pellets need to be inserted 3 or 4 times a year depending on how rapidly you metabolize the hormones. Insurance companies usually do not cover the cost of pellets.