Pellet hormone therapy has become increasingly popular as a form of bioidentical hormone replacement therapy (BHRT), offering a convenient, long-acting option for managing symptoms of perimenopause, menopause, and other hormone-related conditions. Tiny hormone pellets—usually containing estrogen, testosterone, or a combination—are inserted under the skin and slowly release hormones over several months.
For some individuals, pellet therapy can offer a “set it and forget it” experience with consistent symptom relief. However, others may struggle with either underdosing or overdosing, leading to frustrating side effects or return of symptoms before the next dose is due.
At Antigravity Wellness, we believe in personalized care and informed decision-making. While we do not offer pellet placement, we often care for women who come to us after trying this therapy. This article explores the pros and cons of pellet therapy, provides real-life case examples, and outlines alternatives we offer to help you decide what’s best for your body.
Real-Life Case Studies: When Pellets Work—and When They Don’t
Case 1: Overdosed on Testosterone
A 47-year-old woman came to us after several months on testosterone pellet therapy. While she initially hoped it would help with her fatigue and low libido, she soon began experiencing unwanted side effects: acne, oily skin, mood swings, and even facial hair growth. Her lab work showed her testosterone levels were well above the optimal range for women, contributing to symptoms of high androgenism.
Thankfully, she was in the final month of her dosing cycle. We supported her detoxification pathways while waiting for the excess hormone to wear off. Once her levels normalized, we transitioned her to a topical gel, which allowed for individualized dose adjustments based on her symptoms. Within weeks, she began to feel balanced again—without the side effects.
Case 2: Underdosed and Discouraged
Another patient came to us after a year on estrogen pellet therapy. She reported that the first month after insertion she felt better—more energy, fewer hot flashes, improved sleep. But by the third month, she was back to feeling irritable, exhausted, and symptomatic. The final few weeks before her next pellet felt like a rollercoaster.
She felt defeated—especially since close friends swore by pellet therapy. After reviewing her case, we explained that every woman metabolizes hormones differently and not every delivery method works for everyone. We transitioned her to a combination of oral and topical therapies, allowing her dose to be adjusted as needed. She now reports consistent symptom relief and feels more in control of her health.
What Is Pellet Hormone Therapy?
Pellet therapy involves inserting small, rice-sized bioidentical hormone pellets just beneath the skin—usually in the hip or gluteal area. These pellets dissolve slowly, releasing hormones steadily into the bloodstream over 3 to 6 months.
- Bioidentical means the hormones are structurally identical to those produced by the human body.
- Common hormones used include estradiol and testosterone.
- It is marketed as a convenient, no-hassle alternative to daily pills, creams, or patches.
Frequently Asked Questions
Is Pellet Therapy FDA-Approved?
Pellet therapy is not FDA-approved, as most pellets are compounded by specialized pharmacies. This means they are not subject to the same regulatory scrutiny or standardization as FDA-approved hormone formulations.
Reference: North American Menopause Society (NAMS). Compounded Bioidentical Hormone Therapy Position Statement
Who Can Place Hormone Pellets?
Only trained healthcare professionals—such as physicians, nurse practitioners, or physician assistants—can legally place hormone pellets. However, oversight and training vary, and patients should vet their provider’s experience and approach to hormone management.
Are Pellets Covered by Insurance?
In most cases, pellet insertion and the compounded pellets are not covered by insurance. Patients typically pay out-of-pocket, with costs ranging from $350 to $700 per treatment depending on the hormone(s) used and the provider.
Reference: American College of Obstetricians and Gynecologists (ACOG). Practice Bulletin No. 141 – Management of Menopausal Symptoms
What Are the Benefits?
- Convenience: no daily dosing required
- Steady hormone release (ideally)
- Symptom relief for some individuals
What Are the Risks and Side Effects?
- Overdosing or underdosing (no ability to titrate after insertion)
- Acne, hair growth/loss, irritability, weight gain, or insomnia
- Injection site complications (infection, extrusion)
- Long duration: can’t be removed once inserted
Reference: Mayo Clinic. Hormone therapy: Is it right for you?
How Long Do Pellets Last?
Pellets typically last 3 to 6 months, depending on the compound and the individual’s metabolism.
- However, once inserted, you cannot reverse the dose.
- If side effects occur, you must wait for the hormone to metabolize and wear off, which can take weeks to months.
Alternatives to Pellet Therapy at Antigravity Wellness
At Antigravity Wellness, we do not offer pellet placement or removal. Instead, we specialize in bioidentical hormone replacement therapy (BHRT) using options that are mostly FDA-approved. These include:
- Oral formulations
- Topical creams or gels
- Injections
The form of hormone therapy we recommend depends on each patient’s:
- Medical condition
- Personal preferences
- Lifestyle and goals
- Risk profile and benefit potential
We believe in using individualized, titratable therapies that can be adjusted as a woman’s hormones shift during perimenopause and beyond. Hormones don’t stay static—neither should your treatment.
In addition, many of these FDA-approved hormone formulations are covered by insurance, making them a more cost-effective and flexible option compared to pellets.
Thinking About Making a Change?
If you’re currently on pellet therapy and not getting the relief you hoped for—or if you’re experiencing concerning side effects—speak with your pellet provider first.
But if you feel unheard or unsure, we are happy to offer a second opinion.
Book a Brief Initial Consult Call—a 20-minute phone chat with Dr. Nicole Smith—to review your history, symptoms, current treatment, and what’s working (and what’s not). We’ll help you find a safe, personalized plan to move forward with confidence.
References
- The North American Menopause Society (2022). NAMS Position Statement on Bioidentical Hormone Therapy.
- American College of Obstetricians and Gynecologists (2014). Practice Bulletin No. 141 – Management of Menopausal Symptoms.
- Mayo Clinic (2022). Hormone therapy: Is it right for you?
- Faubion, S. S., et al. (2015). Compounded bioidentical hormone therapy: identifying use trends and knowledge gaps among U.S. gynecologists. Menopause, 22(9), 926–932.
- Files, J. A., et al. (2011). Hormone therapy for menopausal symptoms: a review of the evidence. JAMA, 305(24), 2555–2564.
