Pros and Cons of Hormone Pellets

Mood swings, restless nights, low energy, hot flashes, and brain fog are just a few challenges that often go hand-in-hand with hormonal changes. Whether due to menopause or medical conditions like PMOS (formerly known as PCOS) or thyroid dysfunction, hormonal issues can be difficult to deal with.

Chances are you’ve been searching high and low for ways to feel better – and you’ve come across hormone pellet therapy. This treatment replaces hormones that may be lacking with slow-release pellets full of hormones that are placed under the skin.

Since there are so many kinds of HRT (hormone replacement therapy), it’s important to understand the differences between them, which is what we’re discussing today. This article is a contrast-and-comparison-style article that puts hormone pellets up against other forms of HRT.

What Are HRT Pellets?

Hormone pellets are small, 3 mm by 9 mm, rice-like pellets that are implanted below the skin with a trocar after the area is numbed. They are usually placed on the hip, lower abdominal wall, or buttocks.

Each pellet contains a custom hormone preparation that is gradually metabolized by the body over three to six months. Commonly, hormone pellets contain estradiol, testosterone, progesterone, DHEA, or a combination of estradiol and testosterone. 

Hormone pellet therapy is one form of HRT that is available and relatively easy to access with help from a doctor.

How Do Hormone Pellets Work?

Hormone replacement pellets work on a round-the-clock basis, slowly releasing a steady amount of hormones for the duration of their lifespan. How often hormone pellets need to be replaced depends on the hormone type, the required dose, metabolism, and lifestyle factors like sleep, stress, and physical activity. Most often, though, you can expect hormone pellets to need replacing every few months.

Who Can Benefit from Hormone Pellets?

The presentation of hormone-related symptoms is a good indicator that you’ll benefit from HRT pellets. Some symptoms to watch out for include:

• Hot flashes

• Vaginal dryness

• Depression

• Excessive hair growth

• Increased thirst

• Insomnia

• Nausea

• Mood swings

• Unexplained weight changes

• Hair loss/thinning

• Heavy/painful or irregular periods

If you’ve noticed any of the symptoms mentioned above, we’d strongly recommend meeting with your physician to discuss treatment. Your treatment should be tailored to your needs to give it the best chance of being successful.

Additionally, Mira’s Panorama Lab Test is an excellent way to evaluate your unique hormonal health. Where symptoms are present, this easy at-home blood test can also provide valuable context and insights into your hormone health, testing five important hormones with personalized reports.

Go to the lab—without actually going

Test your 5 essential fertility biomarkers & get 5 personalized reports from home.

Try Now

Who Should Avoid Hormone Pellets?

While HRT pellets are a good option for some, they may not be right for everyone. There are some instances in which hormone pellets shouldn’t be used or should only be used with extreme caution and guidance from a doctor.

This includes anyone who has or is at high risk of blood clotting disorders, cancer, heart or cardiovascular disease, osteoporosis, or stroke. Liver disease can make HRT more complicated but not necessarily impossible, as the disease affects the way the body metabolizes hormones.

This fluctuation in metabolic rate can result in too much hormone building up within the body, or in the hormone being metabolized much faster than anticipated.

How Do Hormone Pellets Compare to Other HRT Options?

Pellet therapy differs from other HRT options on the market for a variety of reasons. Most notably, perhaps, is its rigidity. Once the pellets have been implanted, it is difficult to adjust the dosage should a change of course be necessary. Both oral and topical hormone therapy allow for easy adjustments, sometimes as often as daily or weekly, depending on symptoms and the body’s response to the treatment.

If your hormone pellets cause unpleasant symptoms or don’t seem to be doing the trick, you might be tempted to assume that the doctor can simply remove them. Unfortunately, you would be wrong.

Not only are hormone pellets hard to adjust, but they are also hard to reverse. Most of the time, the only reversal for pellet therapy is allowing the pellets to naturally metabolize and leave the system.

In terms of convenience, though, hormone pellets rank highly. They are widely considered one of the most convenient forms of HRT, since they require attention every few months. Other forms of HRT require daily or weekly maintenance, which can be bothersome and inconvenient.

Side effect management also differs between HRT methods. For topical and oral HRT, dosage can be adjusted to correct unwanted symptoms, or the method of therapy can be changed altogether. Where hormone pellets are concerned, symptom management is a lot more challenging due to the lack of reversibility and flexibility.

Symptom management varies between therapy methods, but many of the symptoms overlap. When using HRT, it’s important to track symptoms. Although it can be time-consuming, careful monitoring can ensure treatment effectiveness and prevent long-term health complications.

Tracking can be made easier using the Mira Hormone Monitor, Wands, and the official Mira App. This handy tool kit is designed to make monitoring and tracking symptoms stress-free, giving you clearer insight into how your hormone levels are changing over time.

Are Hormone Pellets Safe?

Hormone pellets fall into a grey area when it comes to safety. Many are compounded, which makes them more likely to be inaccurately dosed. In addition, they have not been studied as extensively as other forms of hormone therapy and are not FDA-approved, so it can be difficult to weigh the benefits against potential risks. ACOG advises against using hormone pellets as a first-line treatment, encouraging patients to instead opt for methods of treatment that have been better studied.

The safety of hormone pellets for women isn't black and white, as risk is thought to be based on a number of factors, including the type of hormone, medical history, dosage, and monitoring that will follow implantation.

Research from the British Journal of General Practice found good cause for monitoring the side effects of testosterone pellets in females. The pellets in question have the potential to push testosterone levels higher than the female body’s baseline, resulting in facial hair growth, acne, a deepening voice, and an enlarged clitoris, among other things.

HRT comes with additional risks for some women, including the development of gallbladder disease, blood clots, heart attacks, strokes, and breast cancer. According to the International Journal of Molecular Sciences, for women who take both estrogen and progesterone, the risk of breast cancer increases the longer the therapy is used.

If you’re considering trying hormone pellets to manage hormonal imbalances, it’s a good idea to educate yourself on the things happening within your body before starting treatment. Mira’s Panorama Perimenopause Lab Test is an at-home blood test that helps users better understand their hormone changes so they can make informed treatment decisions.

What Are the Benefits of Hormone Pellets?

The most enticing thing about hormone pellets is the convenience that they offer. Instead of requiring daily or weekly use, hormone pellets are placed once every few months and left to run their course. This eliminates the need to set reminders for users to take their oral hormones and the inconvenience of having to visit a doctor for an injection.

Some patients have also reported that hormone pellets helped improve the symptoms of hormonal imbalances that they were dealing with. For example, women may benefit from increased energy levels, improved sleep quality and libido, and the return of mental clarity. 

What Are the Downsides of Hormone Pellets for Women?

Due to the compounded nature of hormone pellets, there is a large margin of error where dosing is concerned. The Journal of the Menopause Society reports on a 2013 study in which the Missouri SPB assessed a selection of drugs compounded at Missouri pharmacies. The active pharmaceutical ingredient (API) levels of 13% of the 112 products tested ranged from 3% to 227% of the amount on the label.

Mixing multiple hormones into one pellet increases the risk of overdosing on one hormone and underdosing on another, which can cause symptoms like swelling, headaches, and mood swings. Inaccurate hormone dosing can also affect the cardiovascular system, blood pressure, and metabolism.

Hormone pellets are not easily removed if there is a problem, which is another major drawback of this form of HRT. Once implanted, they typically remain there until they run their course, despite any symptoms that may occur.

How Is the Hormone Pellet Procedure Done?

Before the procedure, patients are screened to ensure that they are good candidates for therapy. They are asked about their medical history, specifically if they use any anti-coagulants or supplements that act as blood thinners, and consent forms are signed.

The procedure can then begin. It’s done in the office and requires local anesthesia. It takes an average of 10–15 minutes, making it a quick appointment that is easy to schedule into a busy day.

The patient is positioned comfortably, and the instruments are laid out so the doctor can easily reach them. The implantation site is marked, thoroughly cleaned, and sectioned off to maintain sterility. The provider numbs the site before making a small incision.

The main surgical tool, the trocar, is introduced into the incision at a 45-degree angle until it bypasses the dermis (the skin) and enters the fatty layers below. The trocar is then laid horizontally and used to “tunnel” a track beneath the skin. The pellets are placed into the newly created track with a blunt obturator, and the trocar is removed.

What Are the Alternatives to Hormone Pellets?

If you’re not sold on the idea of hormone pellets, there are other options for HRT. Your choices include injections, creams/gels, patches, and pills.

To make the best choice when deciding on a method of HRT, take into consideration your lifestyle and preferences, and allow your provider to guide you through assessing your medical history and symptoms. Not all treatment methods are safe for everyone, and it is better to be safe than sorry.

For managing menopause-related hormonal changes, Mira offers a wide range of tools. The Hormone Monitor for Perimenopause and the Menopause Transition Mode setting in the Mira App work together to make tracking your cycle seamless and stress-free.

Key Takeaways on Pros and Cons of Hormone Pellets

Hormone pellets are convenient, relatively hands-off treatment options for hormonal imbalances. However, they haven’t been studied as much as other methods and, therefore, are not yet FDA-approved and pose a risk of inaccurate dosing.

If hormone pellets sound like an option for you, discuss the idea with a healthcare professional. Be sure to discuss the risks and weigh them against the benefits to determine if pellets are the right choice for your lifestyle and needs.

Frequently Asked Questions

What is pellet hormone therapy?

Hormone pellet therapy is a method of therapy for correcting hormone imbalances. It involves a small, pill-like pellet containing hormones being implanted under the skin.

Do hormone pellets help with weight loss?

Hormone pellets are not marketed as a weight loss solution. However, they can help correct symptoms of hormonal imbalances that cause metabolic issues.

Will I gain weight on hormone pellets?

They do not directly cause weight gain. Sometimes, though, they cause a temporary increase in water retention after being implanted.

Are hormone pellets FDA-approved?

No. They have not been approved by the FDA.

Will my insurance cover the cost of hormone pellets?

Because hormone pellets are not FDA-approved, insurance doesn’t usually cover them.

Are testosterone pellets for women safe?

Testosterone pellets have the potential to push testosterone levels higher than the female body’s baseline, resulting in facial hair growth, acne, a deepening voice, and an enlarged clitoris, among other things, which is why careful dosing and monitoring matter.