Q: What are Pellets?

A: Pellets are natural implants composed of testosterone. Using strict federal guidelines, a compounding pharmacist compounds and fuses hormones into pellets about the size of a grain of rice.

Q: Why pellets?

A: Patients seeking bioidentical hormone therapy in many cases find that pellet therapy is the most convenient and consistent method of delivery. Pellets deliver steady levels of hormone throughout the course of treatment, mimicking the natural secretion process of the body. Patients do not experience the hormonal fluctuations that may be seen with other delivery methods.

Pellets, in many cases, are the preferred method of testosterone therapy since it is natural, painless, and produces quick results. Pellet implantation has consistently proven to be an effective hormone therapy method to boost sex drive, libido, sexual response and performance in men and women.

Pellets are exclusively available for bioidentical hormone replacement therapy, further reducing risks associated with synthetic (traditional) hormone therapy.

Q: How and where are pellets inserted?

A: Pellets insertion is a simple and painless procedure completed during a short office visit. After local anesthesia is administered, the pellets are inserted underneath the skin in the upper hip area through a small incision which is then closed with a piece of medical tape. The discomfort level has been compared to a standard blood draw.

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

A: An expert healthcare professional can determine the correct dosage of hormones to be administered for the patient’s unique needs so there is minimal risk of complications or side effects. Patient may have slight bruising or discoloration of the skin at the site of the insertion. Rare complications, such as infection and extrusion of the pellet may occur. It is recommended that women avoid vigorous physical activity for 72 hours and men should not participate for up to 5 days to ensure the pellet does not work its way out of the skin.

  • For women, testosterone may cause a slight increase in facial hair, but this will resolve as the dosage is optimally assessed and adjusted over time to meet her specific needs.
  • For men, testosterone could cause an elevation in the red blood cells. If this is the case, a unit of blood may be donated to decrease the blood count.

Q: Why haven’t I heard about Pellets?

A: Hormone replacement using pellet implants has had great success in the United States since the 1930s. Pellets were a popular mode of hormone administration until the 1970s when the introduction of oral patented commercial products became mainstream. Even though the popularity of pellet therapy declined, the use and research of pellet implants continued throughout Europe and Australia where pharmaceutical companies continue to produce pellets. Advances have been made in the process of pellet therapy in the last 10 years and the benefits of pellet implants for hormone replacement are more realized leading to the current surge in popularity in the U.S.

Q: Do men need hormone therapy?

A: Beginning in their thirties, men may notice a decrease in testosterone levels and may even become testosterone deficient, showing signs such as bone loss, lack of sleep, moodiness, and sexual dysfunction. Men should be tested when they begin to show signs of testosterone deficiency to avoid long-term effects on health and quality of life. At the age of 50, most men experience symptoms of low testosterone that impair their lifestyle and/or overall health. By the age of 70, a man’s testosterone is a mere fraction of what it was in his twenties.

Testosterone pellets have been shown to increase energy, relieve depression, boost sexual function, increase sense of wellbeing, relieve anxiety, and improve memory and concentration among men with low testosterone.

Q: What if my primary care physician or my gynecologist says that there is ‘no data’ to support the use of testosterone implants?

A: Busy practitioners usually do not take the time to read the research on bioidentical hormone therapy. It is important for the patient to seek the guidance of a physician who is an expert in bioidentical hormone therapy and consult with a doctor who has specialized knowledge and skills in pellet therapy.

Q: Do testosterone implants have the same danger of breast cancer as other forms of hormone replacement therapy?

A: Clinical studies have shown that testosterone balances estrogen in women and testosterone pellet therapy has lowered the risk of breast cancer and decreased breast cancer cell proliferation. Women who partake in estradiol therapy actually increase their risk of breast cancer as studies have shown that estradiol stimulates breast cancer tissue.

Q: Why isn’t estrogen therapy or Estradiol pellet therapy recommended?

A: Women who receive estradiol therapy often notice weight gain, anxiety, mood swings, and tender breasts and even cysts. Estrogen therapy alone has been associated with increased risks of certain diseases. With estrogen therapy, over half of female patients experience uterine bleeding and may need a vaginal ultrasound and endometrial biopsy.

Testosterone pellet implants deliver a sustained amount of testosterone to relieve menopausal symptoms, including hot flashes.

Q: Will hormone therapy with testosterone pellets help with hair loss?

A: An inadequate amount of testosterone can cause hair loss. Testosterone pellet therapy can help stimulate hair regrowth and patients have found that their hair becomes thicker and less dry with sustained hormone levels.

Q: How long until a patient feels better after pellets are inserted?

A: Some patients may experience noticeable differences within a day or two, however more evident results are often observed within one to two weeks. As always, a healthy diet and exercise are vital components to any treatment plan for optimal improvement of overall health.

Q: How long do pellets last?

A: Pellets usually take three to four months to metabolize in women and four to five months for men. Since the pellets dissolve on their own there is no need for them to be removed.

Q: Do patients need progesterone when they use the pellets?

A: Women who are treated with testosterone pellets do not need progesterone. Only women who are treated with estradiol therapy will need progesterone in order to prevent stimulation of bleeding in the uterine lining.

Q: How are hormones monitored during therapy?

A: Hormone levels are drawn and evaluated before therapy begins—every patient receives a customized treatment plan. Levels of estradiol and testosterone are evaluated before therapy is initiated in both men and women. Men will need a blood count taken as well to ensure follow up levels remain stable after implantation. Patients on hormone therapy should maintain routine appointments and follow-ups with their attending physician.

Q: Will insurance cover the procedure?

A: Some insurance companies do cover pellet therapy. Patients are advised to contact their insurance company to determine eligibility of coverage.

Q: Can a patient be allergic to the implants?

A: Since the components of the pellet are derived from natural plant sources, there is little to no risk of allergic reaction to the pellet. Very rarely, a patient will notice redness and itching at the site of the implant. Most often this problem is caused by a reaction to the skin adhesive or medical tape used to close the incision.

Q: Is there a role for testosterone pellets in a pre-menopausal female?

A: Yes. Testosterone has been shown to relieve migraines or menstrual headaches, help with symptoms of PMS, and relieve vaginal dryness. It is often recommended that pre-menopausal women who seek testosterone pellet therapy use birth control to help balance their hormone levels.

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