top of page
Image by The Tonik

Pellet therapy


Scan QR code and follow the text prompt.  You will then receive a link to an informational video within 10 minutes. 

What is Bio-identical hormone therapy?

Bio-identical Hormone replacement therapy with pellets is a natural alternative to synthetic hormone replacement therapies. With bioidentical hormones, the structure of the hormone- testosterone, estrogen or both- is matched to the individual patient's needs. Bioidentical hormones are natural, plant-based substances that metabolize in our bodies the way nature intended. Synthetic hormones are massed-produced and artificially formulated in a lab. Artificial hormones are intentionally manufactured to be slightly different than natural human hormones, so the manufacturer can patent the formulation. Consequently, synthetic hormones may not provide a good fit or optimum outcome for the human body as bio-identical hormones do.

What are bio-identical hormone pellets, and how do they work?

Composed of either estradiol or testosterone, bio-identical hormone replacement pellets are larger than a grain of rice and smaller than a Tic Tac. EvexiPEL sources its pellets from FarmaKeio, a leading compounding pharmacy in the US. that presses the hormones into the tiny, solid cylinders. During the sterile procedure, the practitioner applies a local anesthetic, makes a small incision, then inserts the pellets into the fatty tissue under the skin- typically in the flank or upper buttocks. The incision is then closed without any need for stitches. The pellets release testosterone or estrogen into the bloodstream based on cardiac output, in other words, due to increased physical activity or emotional stress (good or bad). This steady stream of hormones helps keep symptoms such as mood and energy fluctuations at bay.

Who can benefit from bio-identical hormone replacement therapy via pellets and how?

As we age, testosterone, estrogen, and progesterone naturally decline over time. Around age 35, men experience a gradual reduction in testosterone, typically 2 to 10 percent per year. For women, pre-menopause may start as early as in the 30s. In fact, hormone imbalance kicks in long before hot flashes do-by 10 to 15 years! Patients need to listen to their bodies. Is the body saying, "I feel a bit off?" In other words, do they feel like many men and women in their 30s, 40s and beyond who lack motivation and feel more tired than usual, gain weight for no reason-especially belly fat, experience mood swings more frequently, feel anxious and depressed, struggle with brain fog and insomnia, wonder why their sexual desire and libido have tapered off. If these symptoms sound familiar, the patient may be an excellent candidate for hormone pellet implants.

What else should patient expect with bio-identical hormone replacement therapy with pellet implants?

On average, pellet implants last 5 to 6 months in men (two visits per year) and 4 to 5 months in women (three times per year). Since patients receive a topical anesthetic during the procedure, most can expect little to no discomfort during or after the procedure. Although most people experience substantial benefits after the first round of therapy, many patients experience a more pronounced benefit after the second round of pellet implants. Therefore, practitioners advise patients to have the procedure performed at least two times before expecting optimum results. Remember, people don't get out of balance overnight, so it often takes a few months to get back on track. We do ask patients to take it easy and avoid strenuous exercise for a few days following the procedure- 72 hours for women and 5-7 days for men. This helps ensure the incision heals and can prevent extrusion of the pellet from under the skin.

How soon will the patient feel the effects of bio-identical hormone replacement therapy via pellets?

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.

How long can patients expect to be on bio-identical hormone replacement therapy?

Patients of all ages- as young as the 20s and into the 90s- are treated with bio-identical hormone replacement therapy, so there is no firm answer. Instead, it's a matter of personal preference. The patient needs to decide how long he or she wants to look and feel their best and experience a higher quality of life. That's how long the patient should be on bio-identical hormone replacement therapy.

Do women who no longer have hot flashes, still need bio-identical hormone replacement therapy?

Research repeatedly links imbalance to an increased risk for cancer, osteoporosis, stroke, thyroid disorders, diabetes, heart disease, and other age-related disease processes. During pre-menopause, 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.

We hear about estrogen and progesterone, but do women need testosterone, too?

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.

Can bio-identical hormone replacement therapy help patients lose weight?

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 therapy 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). So, those stubborn 5 or 10 lbs. you've been battling? That's where the weight loss benefits of bio-identical hormone replacement therapy may shine through.

Can bio-identical hormone replacement therapy help patients get their sex life back on track?

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 patients have experienced a return of or significant improvement to their sexual libido and function.

Is there a risk or side effects from bio-identical hormone replacement therapy?

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.

Common symptoms of hormone imbalance in Men:

  • Fatigue, lethargy, and lack of motivation

  • Mood swings, anxiety, and depression

  • The decline in general well-being, feeling burned out

  • Inability to focus and remember things

  • Insomnia

  • Stubborn weight gain, belly fat and food cravings

  • Frequent illness

  • Hair loss

  • Saggy, dry, aging skin

  • Aches, joint pain, and longer recovery time from injuries

  • Loss of libido and inability to achieve or maintain an erection

Common symptoms of hormone imbalance in Women:

  • Fatigue, lethargy, and lack of motivation

  • Inability to focus and remember things

  • Mood swings, anxiety, and depression

  • Insomnia and night sweats

  • Stubborn weight gain, belly fat, and food cravings

  • Frequent illness

  • Muscle loss and weakness

  • Hair loss

  • Saggy, dry, aging skin

  • Aches, joint pain, and longer recovery time from injuries

  • Loss of libido, difficulty achieving arousal and orgasm

  • Painful intercourse

  • Frequent urinary tract infections (UTIs)

  • Hot flashes, vaginal dryness, and night sweats

  • Infrequent menstrual cycles- or lack of menstrual cycle- prior to menopause


We do not bill insurance for these services (except for labs). If you would like a Superbill to submit for reimbursement, please let us know. 


New Patient Consultation Fee with subsequent lab review: $150


Female Hormone Pellet Insertion Fee: $550

Male Hormone Pellet Insertion Fee: $650   

Male Hormone Pellet Insertion Fee (> 2000mg): $750

If you do not have insurance we have negotiated cash prices for labs.

Labs may be drawn in the office at time of consult or ordered through QUEST (balance bill costs may apply through Quest). 

Beach Deck

Want To Talk?

Every patient deserves quality, comprehensive and compassionate care.
bottom of page