Specialty Care
Pellet therapy delivers hormones through a small implant placed under the skin, releasing steadily over several months. For the right patient it is genuinely convenient. It also has real trade-offs that deserve a straight explanation before you choose it, which is what this page is for.
A hormone pellet is a small, compressed implant, roughly the size of a grain of rice, placed just beneath the skin, usually in the upper buttock. The insertion is a brief in-office procedure done under local anesthetic through a very small incision. Once in place, the pellet dissolves slowly and releases hormone continuously.
The main advantage is consistency and convenience. There is no daily cream to apply, nothing to remember, no weekly injection, and no risk of transferring hormone to a partner or child through skin contact. Levels stay relatively steady rather than peaking and falling between doses.
The main trade-off is the flip side of the same feature: once a pellet is placed, the dose cannot be adjusted. If it turns out to be more than you need, or if you develop side effects, the pellet cannot simply be removed, and the effect has to be waited out. That is the single most important thing to understand before choosing pellets, and it is why we generally prefer to establish that you tolerate a hormone well in an adjustable form first.
A pellet typically lasts around three to four months, though this varies with the individual and with activity level. Symptoms usually return gradually as levels decline, which is often how patients know it is time to schedule the next insertion.
Pellet therapy is one delivery method among several, not a superior category of hormone therapy. Creams, capsules, patches, and injections all remain appropriate choices, and for many patients they are the better one. Which form suits you is a clinical decision made together, based on your goals, your history, and how much dose flexibility your situation calls for.
Women who have a uterus and receive estradiol pellets also require progesterone to protect the uterine lining. This is a necessary part of the plan rather than an optional addition.
Pellets suit some patients very well and others poorly. A consultation determines which you are. Pellets may be worth discussing if:
Worth a conversation if…
May not be appropriate if…
Candidacy is always determined during a confidential consultation.
The insertion itself is quick. The area over the upper buttock is cleaned and numbed with local anesthetic, a very small incision is made, the pellet is placed beneath the skin, and the incision is closed with adhesive strips. Most patients describe the numbing injection as the only uncomfortable part, and pain medication is not typically needed afterward.
You will be asked to keep the site dry for about two days, avoid swimming and baths for the same period, and skip vigorous exercise for roughly two days to reduce the chance of the pellet working its way out. Adhesive strips stay in place for about five to seven days. Some bruising or tenderness at the site is normal.
Larger pellets can sometimes be felt under the skin. That is expected and not a problem in itself.
Keep the insertion site clean and dry for about 48 hours. No swimming, baths, or hot tubs during that window.
Avoid vigorous exercise and heavy lifting for about two days. This meaningfully reduces the risk of the pellet extruding.
Leave the adhesive strips in place for roughly five to seven days and let them come off on their own.
Some tenderness, bruising, or firmness at the site is normal in the first several days.
Contact us if you develop increasing pain, redness, warmth, or drainage at the site, or if you notice the pellet coming out through the incision.
Pellet insertion is not typically covered by insurance and recurs roughly three to four times a year, so we present it as an annual cost rather than a single figure. Pricing depends on the hormone used and the number of pellets your plan requires. At consultation we also show you what the same therapy would cost in other delivery forms, because convenience is worth paying for only if you know what you are paying for it.
Why Randali
Every plan is overseen by our Medical Director: clinical judgment, never a questionnaire.
We weigh your full health picture to recommend the right treatment (or combination) for you.
Care delivered to medical standards and in line with state and federal regulations.
Two-plus decades of refined, natural results and lasting patient relationships.
Take the first step toward your goals with a personalized, physician-directed plan designed just for you.
