Hormone Pellets

What are Hormone Pellets ?

Pellets are a delivery method of bioidentical hormone replacement. They are often the preferred method because they are convenient for patients and provide excellent results. Pellets deliver consistent healthy levels of hormones over a period of months. They avoid the daily or weekly fluctuations of hormone levels seen with other delivery methods that can result in unwanted side effects and symptoms.

Pellets are made up of either estradiol or testosterone. The hormones, estradiol or testosterone, are pressed or fused into very small solid cylinders. These pellets are larger than a grain of rice and smaller than a ‘Tic Tac’. Pellets are made by a licensed compounding pharmacist and delivered in sterile glass vials.

The History of Pellets

Pellets have been used in both men and women since the late 1930’s. In fact, there is more data to support the use of pellets than any other delivery method.

Pellets are not patented and not marketed in the United States, which is why many patients have never heard of them. Pellets were frequently used in the United States from about 1940 through the late 70’s, early 80’s when patented estrogens were marketed to the public.

They continued to be prescribed in Europe and Australia where pharmaceutical companies produce pellets.

Most of the research on pellets is out of England and Australia with some from Germany and the Netherlands. They made a resurgence in the United States over the past decade as the medical community has become more aware of the importance of bio-identical hormones. In fact, there is now even some exciting data on using hormone implants for treatment of breast cancer patients in the United States.

The Procedure

The insertion of pellets is a quick, simple, and painless procedure. The area of implantation is numbed using a local anesthetic, a tiny incision is made in the lateral buttock/hip, and the pellets are inserted. The incision is so small, it does not require sutures, only steri-strips (tape) which are removed at home after 7 days.

The pellets absorb over an average period of 3-5 months in women and 5-6 months in men and do not require removal. High levels of stress, smoking, physical activity, certain medications and lack of sleep may increase the body’s demand for hormones and may require that pellets be replaced sooner.

What can I expect after pellet insertion?

Some patients begin to feel better within 24-48 hours, but most will see gradual improvement over 2-3 weeks.

Complications from the insertion of pellets include minor bleeding, bruising, discoloration of the skin, infection, and possible extrusion of the pellet. Other than slight bruising these complications are very rare. Submersion in water, e.g. swimming, hot tubs, bath tubs, is avoided for 4 to 5 days, and vigorous physical activity is avoided for 48 hours in women and up to 5 to 7 days in men. Antibiotics may be given if a patient is diabetic or has recently had a joint replaced.

When a patient first starts hormone therapy there may be mild, temporary breast tenderness, which typically resolves after a few days. Hormone receptors may be very sensitive and take time to adjust. There may be a temporary water weight gain, which will also resolve on its own. The body will tone up, as bone density and muscle mass increase and fatty tissue decreases.