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Pellets—Hormone Implants FAQ


As people age, the human body produces less testosterone and estrogen. Both of these essential hormones act as an energy source for men and women. But as the human body produces less and less of these hormones, a person’s quality of life and health can be severely impacted. Natural and Bio-Identical Hormone Replacement Therapy (BHRT) is an individualized treatment that can address symptoms associated with this drop in hormone levels. Solutions Wellness uses only bio-identical hormone pellets. Pellets, placed under the skin, consistently release small, physiologic doses of hormones providing optimal therapy.

What are Pellets?

Pellets are made up of either estradiol or testosterone. The pure hormone is naturally derived from yams, chemically changed to be bio-identical to the natural hormone and then pressed or fused into very small solid cylinders. These pellets are about the size of a grain of rice and are inserted painlessly under the skin. In the United States, the majority of pellets are made by compounding pharmacists and delivered in sterile glass vials. We receive our pellets from an in-state compounding pharmacy.

Why pellets?

Pellets have been used in both men and women since the late 1930s. There is significant data in support of the use of pellets as an effective method of delivery of hormones. Pellets can maintain consistent levels of hormones for 3 to 5 months in women and 4 to 6 months in men. 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. Men and women need adequate levels of testosterone for optimal mental and physical health.

Even patients who have failed other types of hormone therapy can 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 as they dissolve slowly into the body over a period of 3 to 6 months.

How and where 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. The experience of the health care professional matters a great deal, not only in placing the pellets, but also in determining the correct dosage of hormones to be used.

What side effects, complications or risks are associated with 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. After the insertion of the implants, vigorous physical activity is discouraged for 3 to 5 days for women and 5 to 7 days in men. Early physical activity increases risk of extrusion, which is a pellet exiting the body from the incision point.

All HRT has associated risks, including bio-identical hormone replacement. Our provider will discuss the benefits and risks with you at your consultation so you can make an educated decision about your treatment.

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

Some patients begin to ‘feel better’ within 24 to 48 hours while others may take a week or two to notice a difference. Full benefits are usually experienced within 3 to 4 weeks. Healthy diet and lifestyle are recommended, along with hormone balance, for optimal health.

How long do pellets last?

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

How are hormones monitored during therapy?

Hormone levels will be evaluated prior to BHRT treatment based on required blood tests. Men are required to have blood work done before every insertion, specifically to monitor testosterone and PSA levels. Hormone levels are evaluated post-treatment, typically 3-4 weeks after insertion. After the first year of therapy, hormones levels are expected to maintain steadier levels. Men must notify their primary care physician and obtain a digital rectal exam each year. Women are advised to continue their monthly self-breast exam and obtain a mammogram and/or pap smear as advised by their gynecologist or primary care physician.

How much does this cost?

Solutions Wellness offers FREE initial consultations with our provider. Blood work is required prior to treatment and can conveniently be done at our office. Cost of BHRT procedure for female patients typically ranges between $380-$480 and for male patients between $500-$600.

Will insurance cover the procedure?

Some insurance companies do cover the cost of pellets, especially in men, but we cannot guarantee coverage. Patients may want to contact their insurance companies to see if their costs will be reimbursed. Patients are able to ‘appeal’ a denied claim.