Bio Identical Hormone Replacement Therapy Specialist

Everest Medical Group

Multidisciplinary Medical Center located in Mesa, AZ

Data supports that hormone replacement therapy with pellet implants is the most effective and most bio-identical method to deliver hormones in both men and women. Implants, placed under the skin, consistently release small, physiologic doses of hormones providing optimal therapy.

Bio Identical Hormone Replacement Therapy Q & A

What are Pellets?


Why pellets?

Pellets deliver consistent, healthy levels of hormones for 4-5 months in women and 3-4 months in men. They avoid the fluctuations, or ups and downs, of hormone levels seen with every other method of delivery. Estrogen delivered by subcutaneous pellets maintains the normal ratio of estradiol to estrone. Several studies have suggested that when compared to conventional hormone replacement therapy, pellets have been shown to be superior for relief of menopausal symptoms, maintenance of bone density, restoration of sleep patterns, and improvement in sex drive, libido, sexual response, and performance.

Testosterone delivered by a pellet implant has been used to treat a migraine and menstrual headaches. It also can help with vaginal dryness, incontinence, urinary urgency, and frequency. In both men and women, testosterone has been shown to help increase energy, relieve depression, increase a sense of well being, relieve anxiety and improve memory and concentration. Testosterone, delivered by pellet implant, can increase lean body mass (muscle strength, bone density) and decreases fat mass.

How and where are pellets inserted?

The insertion of pellets is a simple, relatively painless procedure done with a small injection of a local anesthetic. The pellets are usually inserted in the upper buttocks through a small incision (the length of 2 grains of rice), which is then taped closed with a bandage over the site.


Complications from the insertion of pellets include; minor bleeding or bruising, discoloration of the skin, infection, and the possible extrusion of the pellet. This procedure is performed in a sterile manner, thus greatly reducing the likelihood of infection. Other than slight bruising, or discoloration of the skin, these complications are very rare. Testosterone may cause a slight increase in hair growth in some women. After the insertion of the implants, vigorous physical activity is avoided for 72 hours in women and up to 5 to 7 days in men. Early physical activity is a cause of ‘extrusion’, which is a pellet working it’s way out.

Do men need hormone therapy?


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


How long do pellets last?

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

Is hormone pellet therapy only for menopausal women?


How are hormones monitored during therapy?

Hormone levels will be drawn and evaluated before therapy is started. This will include estradiol, total testosterone, free testosterone for women, as well as a complete blood panel to monitor for overall health and possible contributing causes of symptoms. Levels will be reevaluated during hormone therapy, usually 6 weeks after the initial pellet to ensure the right dosage has been given. 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.