Everything You Should Know About Pellet Implantation

by | Feb 5, 2021

Are you looking to learn more about hormone replacement therapy via pellet implantation?

Bioidentical hormone replacement therapy (BHRT) is an effective way for both women and men to ease symptoms related to hormone imbalance.

Pellet implantation is a convenient choice of delivery method and may be the best choice for some BHRT patients.

What is pellet implantation?

BHRT pellet implantation involves placing small implants under the skin which release specific doses of hormones over several months. The pellets are replaced as needed once they have dissolved.

Typically the hormones in the pellets are compounded and “fused” into cylinders. The typical hormones used in pellet therapy are estradiol and testosterone for male and female patients.

Estradiol and testosterone in pellet form are effective in improving health problems including:

  • Poor libido
  • Hot flashes
  • Aches and pains
  • Vaginal dryness
  • Insomnia
  • Low mood
  • Headaches and migraines
  • Lethargy
  • Irritability
  • Fatigue

Health practitioners treating male patients should bear in mind that male patients may find pellets more convenient than weekly testosterone injections.

How are hormone pellets inserted and how long do they last?

Hormone pellets are usually inserted in the hi buttock, area via an in-office procedure.

A syringe is usually used with a local anesthetic and the incision is covered with steri strips.

The process should not impact the patient’s lives beyond the initial procedure, but it is advised to avoid vigorous exercise for the following few days

Patients can expect pellets to last for 2.5 to 5 months a few months before a replacement is needed. The pellets dissolve completely in the body.

Patients typically feel the effects in 2-14 days.

What are the possible side effects of pellet implantation?

When administered properly, side effects with BHRT are extremely rare. The pellet insertion process itself may cause minor bleeding or bruising.

When testosterone is administered to women in low doses, such as 6mg there typically is little to no increase in facial hair and/or acne.

There is also a small chance of a minor allergic reaction occurring at the site of insertion, which may indicate low cortisol levels.

If this should occur, recommendations include regular doses of Benadryl, hydrocortisone therapy, and Keflex.

Hormone Testing and Monitoring

Regular hormone testing is important for both women and men when administering any type of BHRT, where labs should be run for:

  • FSH
  • Estradiol (women)
  • Testosterone
  • PSA
  • Sensitive estradiol (men)
  • Liver profile
  • Blood count
  • Thyroid
  • Progesterone
  • DHEA
  • Cortisol

Practitioners should monitor levels through hormone therapy prior to pellet insertion so every few months for the first year, then less frequently so long as the therapy is effective.

This should become part of a patient’s yearly testing and physical exam procedure.

Benefits and Drawbacks of Bioidentical Pellet Implantation

The key benefit of pellet implantation is that it offers a specific, consistent dose of hormone treatment over time, whereas, with creams or patches, hormone release may not be as even or consistent.

After an implant is done, the pellet dissolves into the body over a period of time, and the patient does not have to remember details about application or dosing — for instance, with other formats, they may forget to take a pill or apply too much cream.

The assurance of a consistent physiological level is the main benefit here. With this delivery method, hormones can be easily monitored and tested via saliva, serum, or dried urine.

But BHRT pellets may also:

  • Improve bone density
  • Prevent bone loss
  • Improve cardiovascular health
  • Be more effective than other formats for menopausal symptoms

It should be noted that BHRT hormone pellet implantation does not typically have a negative impact on blood clotting, blood pressure, glucose, or liver function.

Possible drawbacks for patients include:

  • A small risk of infection or allergic reaction at the site
  • Possible soreness
  • Cannot adjust the dosage or remove pellet at a later date
  • It may not be as cost-effective as other delivery methods
  • The invasive nature and permanency of pellet implantation

Help Your Patients Make Informed Choices About BHRT

Effective pellet implantation and resulting therapy require skilled health care practitioners and tailored prescriptions. Pellet placement also matters.

When developing individual treatment plans for BHRT patients, delivery methods can make a big difference in the overall effectiveness. In some cases health practitioners may combine different delivery methods — for instance, progesterone should be administered orally or topically with an estradiol pellet.

Practitioners interested in offering this type of therapy should make sure they’re well-informed, and understand the implications of delivery methods, dosages, combinations, testing methods, and so on.

To learn more about the benefits of BHRT, schedule a free strategy call with us.

Enjoyed this article? Here are three more to help you:

How To Treat Low Androgens With BHRT
Menopause and BHRT: What’s the Best Type of Treatment?
How BHRT Can Help Patients Ease the Symptoms of Aging


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