Frequently Asked Questions

About BHRT with Pellets

If you have questions about bio-identical hormone replacement therapy with pellets, we’ve got answers. Check out our FAQs below, and feel free to contact us with additional questions.

Research consistently shows pellet implants offer a superior way to deliver hormones in women and men. Implanted in the fatty tissue under the skin, pellets release a constant stream of hormones into the body, 24/7/365, mimicking the way the body naturally releases hormones.

Convenience is also a key. With pellets, patients undergo the procedure two or three times a year and get on with life. Other modalities, like pills and messy creams, need to be used daily. Patches work a bit better, but the absorption of skin-based delivery methods is variable. People also lose sensitivity over time, which means patients will eventually need to find a new spot to apply the cream or adhere the patch

Pellet implants typically last 5 to 6 months in men (two visits per year) and 4 to 5 months in women (three visits per year).

A local anesthetic is injected to the site of the implant, which is placed in the fatty tissue under the skin. Patients experience little discomfort during, and minimal discomfort after the procedure.

Most female patients begin to “feel better” within 48 to 72 hours, though it may take a week or two for some women to notice a difference. Men can expect to experience the benefits of their pellet implants within 1 to 2 weeks. To achieve optimal health, living a healthy lifestyle – balanced diet and regular exercise – goes hand-in-hand with hormone balance.

While most people experience substantial benefits after the first round of therapy, many patients experience more pronounced benefits after the second round of pellet implants. Therefore, patients should expect to have the procedure performed at least twice before experiencing optimum results. People don’t get out of balance overnight, so it often takes a few months to get back on track.

Patients should take it easy and avoid strenuous exercise for a few days following the procedure – 72 hours for women and 5 to 7 days for men. This helps ensure the tiny incision heals properly and can prevent extrusion of the pellet from under the skin.

Many – but not all – insurance companies will reimburse patients for pellet therapy. EvexiPEL® practitioners can provide patients with the paperwork necessary to seek reimbursement.

EvexiPEL® practitioners treat patients of all ages – from the 20s to the 90s – so there is no firm answer. Instead, the patient needs to decide how long they want to look and feel better, while experiencing the protective benefits of balanced hormones, which are many. (See our Benefits of BHRT sections for men and women to learn more.)

During the initial consultation, the practitioner will inquire about the patient’s health and wellness goals and concerns. Then he or she will perform a thorough exam and lab tests to find the root cause of any health issues and whether hormone imbalance is to blame. If the patient is diagnosed with hormone imbalance, the practitioner will prescribe an integrated treatment plan based on the patient’s test results and information the patient provides (health and family history, symptoms, etc.).

Research repeatedly links hormone imbalance to an increased risk for cancer, osteoporosis, stroke, thyroid disorders, diabetes, heart disease and other age-related disease processes. During perimenopause, menopause and andropause (the male version of hormone depletion), declining health is considered the norm. But feeling poorly doesn’t need to be the norm, thanks to bio-identical hormone replacement therapy and other treatments EvexiPEL® practitioners may recommend.

Estrogen loss puts women at risk for premature ovary failure, osteoporosis, heart disease, colon cancer, Alzheimer’s disease, tooth loss, impaired vision, Parkinson’s disease and diabetes. These risks increase the longer a woman suffers from estrogen deficiency.

However, women also need testosterone! Imbalanced testosterone levels in women may compromise mental clarity, libido and muscle tone and mass. The brain needs testosterone in balance with estrogen – and a healthy gut – to produce serotonin, which supports emotional balance.

Bio-identical hormone replacement therapy is NOT a magic bullet for losing weight, however, when hormones are optimized, weight loss efforts typically begin to pay off. Patients still need to eat a balanced diet and exercise, and increased energy levels will help in that area. What bio-identical hormone replacement therapy may do is increase energy, improve quality of sleep, increase muscle mass and fat burning and decrease cortisol (which causes belly fat and type 2 diabetes). The stubborn 5 or 10 lbs. the patient has been battling is where the weight loss benefits of bio-identical hormone replacement therapy may shine through.

Hormone imbalance and “Low T” are by far the most common causes of sexual dysfunction in men and women. By balancing hormone levels with pellet therapy, most EvexiPEL® patients have experienced a return of or significant improvement to their sexual libido and function. EvexiPEL® practitioners treat men, women and relationships!

Testosterone contributes to healthy skin by aiding oil production, which allows skin to hold on to moisture. Skin can become dry, crêpey and dull when testosterone is low. In addition, testosterone is a natural blood vessel dilator, which facilitates blood flow to the skin. These two factors – moisture and blood flow – contribute to the dewy, rosy, vibrant complexion associated with youth.

For women, estrogen and collagen go hand-in-hand. Collagen naturally plumps the skin, so when estrogen declines, wrinkles and saggy skin result. Prevention is key, so optimizing hormones as early as possible is essential to maintaining healthy, younger-looking skin.

Testosterone and estrogen can be supplemented in the form of pellets, but other hormones may be out of whack, too. Many patients also benefit from progesterone and thyroid optimization. Depending on the patient’s individual needs, he or she may also benefit from an appropriate detox program, probiotics, nutritional support in the form of supplements or IV therapy, weight loss programs and other treatments.

Complications from the insertion of pellets may include: minor bleeding or bruising; discoloration of the skin; infection; and possible extrusion of the pellet. Other than slight bruising and skin discoloration, these complications are very rare.

The most common side effects are increased hair growth and possible skin breakouts with the first round of therapy, because the body is getting used to increased oil production in the skin. Patients may want to change their skin care regimen from heavy anti-aging products to lighter, oil-free skin care lines. Side effects may be avoided with decreasing doses on subsequent rounds of therapy.

There are currently no known health conditions that exclude a person from undergoing bio-identical hormone replacement therapy with pellet implants. The majority of people with hormone imbalance are great candidates for the therapy.

However, EvexiPEL® practitioners take an individualized approach based on the patient’s medical history. The approach to bio-identical hormone replacement therapy should be modified for patients who are estrogen-positive breast cancer survivors and prostate cancer survivors.

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