What Are the Pros and Cons of Pellet Hormone Replacement Therapy?

by Charlotte

If you are experiencing menopause, andropause or a hormonal imbalance, you know that hormones can have a profound impact on your physical and emotional health. You may already realize the potential value of hormone replacement therapy (HRT) to replenish your hormone levels and regulate your body. 

Today, there are more choices than ever before when it comes to HRT, and treatments such as bioidentical hormone replacement therapy (BHRT) can significantly minimize or even eliminate many of the symptoms related to hormonal changes. However, even if you know hormone therapy is the best option to address your discomfort, you may struggle to choose the best administration method.

In recent years, hormone replacement pellet therapy has become an increasingly popular option for both men and women seeking to re-establish their sense of well-being. So, how do you know if pellet therapy is right for you? By exploring the pros and cons of this innovative treatment method, you can gain the insight you need to make an informed choice and take the next step toward wellness.

What Are Hormone Pellets?

Hormone replacement therapy has been used for almost a century to provide relief from hormone-related symptoms and improve quality of life. During that time, both the medications and the administration methods used to deliver them have evolved to better meet the needs of patients. For many, hormone pellets are the most exciting method to date.

Pellet therapy administers hormones via small pellets implanted under the skin, typically in your hip or lower abdominal wall. These pellets measure only 3mm by 9mm — about the size of a grain of rice — and contain custom hormone preparations that are gradually metabolized by your body over the course of three to six months. How many pellets you need and how often they need to be replaced depends on your personal symptoms and hormone levels. 

The number of pellets does not affect the size of the wound. Implantation is performed in your doctor’s office, usually under local anesthesia, and is painless for most patients. Significantly, pellets do not have to be removed, as they dissolve in your body.

What are the Pros and Cons of Hormone Replacement Pellet Therapy?

If you’re wondering if hormone pellets are right for you, it is important to consider the pros and cons of hormone replacement therapy vs. other administration methods.


  • Ease of Use: Unlike other hormone administration methods, pellet therapy does not require you to remember to take medication on a daily or weekly basis. Instead, hormone pellets require only a short outpatient procedure two to four times a year.
  • Steady Dosage: Hormone pellets are designed to deliver a more physiologic, steady, and predictable dose of hormones over the course of several months. This helps you avoid the noticeable peaks and valleys caused by some other administration methods and may help improve symptoms more consistently.
  • Better Adherence: Methods like pills, patches, creams, gels, and injections may produce good results, but they only work if you remember to take them. Even a small deviation from your dosing schedule could compromise your results. Hormone pellets eliminate this risk by taking patient error out of the equation, potentially allowing you to experience greater therapeutic benefits.


  • Minor Surgery: The implantation process for hormone pellets is a minor surgical procedure. While this surgery is quick, often painless, and carries a low risk of complications, it does carry a small risk of infection or extrusion of the pellets and may cause discomfort both during and/or after the procedure.
  • Recovery Period: You should avoid strenuous physical activity and prolonged water exposure for several days after implantation. During this time you may experience swelling, bruising, or redness of the incision site, although these are typically mild.
  • Limited Alterations: While more pellets can be added after your initial procedure, pellets cannot be removed. As such, it is critical that you work with a highly trained and experienced practitioner to avoid over-treatment.

While the cons outweigh the pros for some, data suggests that patients who choose hormone pellets tend to be more satisfied with their treatment and experience fewer side effects than patients who choose other methods. For example, in one study of men taking testosterone therapy, over 95% of patients using pellets for 6 to 12 months reported being satisfied with their treatment compared to 75.2% of those using injections and 62.5% of those using testosterone gel. These results are remarkable and suggest that the benefits of hormone pellets drastically overshadow any drawbacks for most patients.

Are There Side Effects for Hormone Pellet Therapy?

Although hormone pellet therapy is well-tolerated by most patients, there are several potential side effects to be aware of before you decide to undergo surgery. Many side effects are temporary and resolve once your body adjusts to the implant. Some side effects include:

Mood swings

Estrogen modulates mood via the serotonergic system, and serotonin is a crucial component of estrogen production. This biofeedback loop can be disrupted by introducing a subdermal hormone pellet, particularly estrogen-only formulas. The disruption can cause an excess of either serotonin or estrogen, leading to fluctuations between depressive and euphoric episodes.


Hormone pellets used to treat symptoms of perimenopause and menopause may increase migraine and tension headache frequency. Low estrogen levels are believed to contribute to the onset of headaches, and you may need to discuss your HRT dosage with your doctor if your headaches worsen after implantation.

Increased risk of breast cancer

A 2019 study suggests that using combination progesterone-estrogen hormone replacement therapy may increase the risk of developing breast cancer. This risk can persist for over a decade after patients stop using combination HRT.

If you have a family history of breast cancer, discuss this potential side effect with your doctor before deciding on implantation.

Changes in hair growth

Hair growth is controlled by hormones. Estrogen and progesterone are responsible for controlling the hairs’ growth (anagen) phase, helping your hair grow faster and remain on your head longer. As these hormones decline, your hair may start to fall out or become thin. 

Although hormone pellet therapy can help regulate estrogen and progesterone levels in the body, the implant may not increase hormone levels enough. It may need to be adjusted by your doctor.

Skin changes

Your skin is sensitive to hormonal changes. You may experience acne breakouts due to increased sebum production after the implant is embedded. This may be due to the rapid fluctuations in hormone levels. 

Breakouts may last for several weeks following implantation, but, once your body has adjusted to the pellet’s hormone release, your complexion may be better than it was before. Estrogen has been shown to delay the signs of aging by improving skin elasticity, thickness, and smoothness.

AM I a Good Candidate for Pellet Hormone Replacement Therapy?

Virtually anyone who is a candidate for hormone replacement therapy is a candidate for pellets. You may be a good candidate for hormone pellet therapy if you experience any of the following:

  • Severe menopausal symptoms that include headaches, sleep problems, painful intercourse, mood changes, night sweats, decreased cognitive function, or memory loss
  • Premature menopause before age 40 
  • Surgical menopause (oophorectomy) by age 45
  • Menopause before age 45 due to chemotherapy
  • Primarily non-vaginal symptoms of menopause, making topical treatments ineffective
  • No long-term relief from other recommended treatments and lifestyle strategies

The pellet administration method may be particularly suitable for patients with busy lifestyles who want to avoid adding “take hormones” to their daily schedule. It may also be ideal for those who have trouble remembering to take daily medication. Patients who travel often especially find it more convenient.

When Will I See Results?

Some people begin to notice an improvement in symptoms a few days after implantation. Others take a few weeks to see effects. If you are not experiencing the effects you expected, follow up with your health care practitioner. They will be able to make any adjustments necessary to optimize your results and give you the support you need to feel your best.

How Do I Start?

If you are thinking about starting hormone replacement pellet therapy or any other kind of HRT, it’s important to seek out a practitioner with the training and experience necessary to provide the best treatment. Practitioners like those within the BodyLogicMD network will address any concerns you have, take the time to understand your symptoms, and offer comprehensive hormone testing to gain greater insight into your needs. They will then craft a treatment plan that is customized for you and offers the ongoing monitoring and guidance necessary to guide you to the results you’re looking for.

Hormone fluctuations and imbalances can be disruptive and uncomfortable. But with the right care, you can find lasting relief from hormone-related symptoms and live life to its fullest.

Want to know more about hormone replacement pellet therapy? BodyLogicMD can help. The practitioners within the BodyLogicMD network are among the top medical professionals in the country and specially certified to help you address hormonal issues using the best treatment methods available so that you can experience the life you deserve. Get started on a custom treatment plan designed to fit your lifestyle and help you reach optimal wellness—contact a local practitioner to schedule your first appointment, or take the BodyLogicMD Hormone Balance Quiz today.

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended to diagnose, treat, cure or prevent diseases.


  • Charlotte

    Charlotte is a patient care coordinator specializing in bioidentical hormone replacement therapy. She is committed to helping patients who struggle with the symptoms of hormonal change and imbalance explore their treatment options and develop effective strategies to optimize wellness.