Bioidentical hormone therapy pellets are custom-compounded estradiol or testosterone pressed into small, solid cylinders similar to a large grain of rice. Pellet production is highly regulated by the FDA.  

EvexiPEL Certified providers source pellets from FaramKeio, one of the leading 503B FDA-registered compounding pharmacies in the country. Each pellet is carefully compounded to the exact dose prescribed by your practitioner to meet your body’s unique needs and facilitate optimal absorption of your prescribed therapy. 

Treatment plans begin with laboratory testing. At your first consultation, your provider will review your lab results, medical history, symptoms, and discuss your current lifestyle and personal experiences since symptoms began. This information will allow your provider to develop a treatment plan for you that may include BHRT as well as other healthy lifestyle changes and therapies to achieve optimal health and wellness. 

Patients who seek hormone therapy are often seeking relief from uncomfortable symptoms of hormone imbalance including hot flashes, night sweats, hair loss, insomnia, weight gain, brain fog, low energy, moodiness, irritability, anxiety, fatigue, and more. With pellet therapy, patients experience relief of these symptoms as well as additional benefits, such as improved libido, mental focus, and reduced risk of disease. 

The primary goal of hormone therapy is to address the root cause of these symptoms—hormone imbalance—and reach a state of hormone optimization.

Bioidentical hormones are derived from natural sources, such as yams or soy, and designed to be structurally identical to the hormones produced by the human body. This feature ensures that when bioidentical hormones are supplemented to correct hormonal imbalance, the hormones react in the same manner as the hormones naturally produced by the body, therefore reducing side effects, supporting disease prevention, and alleviating uncomfortable symptoms. 

Compounded bioidentical hormones are not FDA-approved because each dose is tailored to the needs of each patient. The pharmacies and ingredients used to develop compounded bioidentical hormones are FDA-registered and approved.  

Some bioidentical hormones, such as Prometrium®, a bioidentical progesterone, and estriol, a bioidentical estrogen, are FDA-approved. 

There is no correlation to increased risk of breast or other cancer with the use of bioidentical hormones, as documented by countless peer-reviewed studies, analyses, and research. 

Some patients may experience temporary, undesirable side effects as their body adapts to the treatment. The most common side effects are increased hair growth and skin breakouts due to increased oil production. If you observe any side effects, tell your EvexiPEL certified provider so that he or she may adjust your treatment plan as needed. 

Bioidentical hormones are derived from natural sources, such as yams or soy, and designed to be structurally identical to the hormones produced by the human body. This feature ensures that when bioidentical hormones are supplemented to correct hormonal imbalance, the hormones react in the same manner as the hormones naturally produced by the body, therefore reducing side effects, supporting disease prevention, and alleviating uncomfortable symptoms. 

Compounded bioidentical hormones are not FDA-approved because each dose is tailored to the needs of each patient. The pharmacies and ingredients used to develop compounded bioidentical hormones are FDA-registered and approved.  

Some bioidentical hormones, such as Prometrium®, a bioidentical progesterone, and estriol, a bioidentical estrogen, are FDA-approved. 

There is no correlation to increased risk of breast or other cancer with the use of bioidentical hormones, as documented by countless peer-reviewed studies, analyses, and research. 

Pellets deliver consistent levels of hormone for 3 to 5 months in women and 4 to 6 months in men. Pellets mimic the slow, steady release of hormones naturally produced by the body, therefore reducing side effects commonly observed with other delivery methods and improving overall outcomes, including relieving symptoms of hormone imbalance.  

Unlike patches, pills, creams, or injections, pellets are highly convenient. Once inserted, the pellets begin to dissolve delivering a steady state of hormone to your body. With pills or creams, there is always the forgetting or applying too much or too little of the product. Injections often give higher doses at the beginning of each cycle and taper off sharply before the next injection. Patches are often unsightly or fall off before the cycle is complete. These features lead to drastic changes in your hormone levels that can impede relief or cause other side effects. With pellets, most patients experience hormone optimization within two insertions and enjoy complete symptom relief as well as other benefits. 

The steady rate of delivery is a key feature in supporting reduced risk of some diseases, while also optimizing overall health. When administered correctly, pellet therapy does not contribute to an increased risk of blood clots that are commonly experienced with other forms of hormone replacement therapy. 

Pellet therapy is a longstanding, effective form of hormone therapy, dating back to the early 1930s. Patients who have experienced negative side effects or poor outcomes with other forms of hormone therapy are often successful with pellet therapy. 

Bioidentical hormone pellet therapy is not shown to carry the same risks of certain cancers commonly affiliated with synthetic hormones, such as oral estrogen, chemical progestin, or hormone metabolites. These forms of synthetic hormones were cited in the well-known Women’s Health Initiative (WHI) and accurately linked to certain forms of cancer.  

Current research and data on bioidentical forms of estrogen and testosterone show a decreased risk of certain diseases. 

Clarity Wellness will complete a thorough examination, assess your lab work, and review your medical history before recommending treatment. There are currently no known health conditions that would prohibit BHRT, however for estrogen-positive breast cancer survivors or prostate cancer survivors, a modified treatment plan may be necessary. 

To prepare for your first pellet insertion, you should be up to date on routine screenings for your age and gender: 

• Mammogram 
• Pap Smear 
• PSA Test 

The appointment takes around 15 to 30 minutes and will involve a minor incision near the upper buttocks/hip area. The area may be sore for a few hours after the procedure. You will need to abstain from certain activities, such as strenuous exercise for several days post-procedure to ensure your incision heals properly. 

The insertion of pellets is a short, simple procedure that is often completed in a short 30-minute office visit. Pellets are usually inserted in the lower abdominal wall or the upper buttocks area. Local anesthesia is applied to the insertion site, where a small incision is made and the pellets are placed. The incision is closed up with a special medical tape.  

When selecting a pellet therapy provider, it is important to select an expert, highly trained in hormone therapy and effective insertion techniques that minimize pain, inflammation, bruising, and ensure optimal absorption and reduced risk of extrusion. 

The procedure requires a minor incision in the upper hip area. A numbing agent comprised of lidocaine and epinephrine with sodium bicarbonate is used to numb the area prior to the procedure. The procedure takes only a few minutes, and most patients report feeling little to no pain during the procedure. 

After insertion, you may experience soreness and light bruising at the incision site. Patients should refrain from strenuous activity for several days after insertion to facilitate healing and prevent the possibility of extrusion. 

The EvexiPEL method of insertion and the proprietary pellets sourced from Farmakeio, a 503B FDA-certified outsourcing pharmacy, reduce healing time, minimize bruising, and require less downtime.  

Patients may begin to notice symptom relief with bioidentical hormone replacement therapy within days to a few weeks after insertion. Most women experience improvement of at least one symptom within 72 hours of their first insertion, while men often see improvement of one or more symptoms within two weeks. The greatest improvements are most often observed in men and women after their second pellet insertion. 

Optimal results are best achieved when paired with a healthy lifestyle including a balanced diet and routine exercise. 

Hormone therapy begins with a complete lab evaluation to assess your health and hormone status. Using this information, your practitioner will develop a treatment plan. Your labs and symptoms will continue to be assessed prior to future insertions over the first several months of your treatment plan to evaluate outcomes and achieve optimization. 

During your treatment plan, men will need to maintain recommended routine PSA screenings with their primary care physician and women will need to continue with recommended routine screenings with their primary care physician, including mammograms and gynecological exams. 

Insertion schedules vary by individual. Various factors impact the rate at which the pellets dissolve. For most women, pellets will last 3 to 5 months, requiring approximately three to four visits per year. For most men, pellets will last 5 to 7 months, requiring two to three visits per year.  

Each treatment plan is individualized; therefore, the duration of each plan may vary. For patients seeking to maintain the benefits of hormone optimization, bioidentical hormone replacement therapy is the recommended treatment to help you feel your best every day. Discontinuing treatment may result in loss of hormone optimization and the return of uncomfortable symptoms of hormone imbalance. 

The cost of pellet therapy varies by individual, factoring in your personal prescription, gender, and how quickly your body metabolizes the pellet. On average, most patients will spend between $2 and $3 per day—less than most people pay for a daily cup of coffee.  

For most patients, labs and consultations are covered by your insurance. Coverage of pellets varies by insurance provider. To find out if pellet therapy is covered by your insurance provider, please contact your insurance provider directly.   

The short answer is yes, women need testosterone too. Women natural produce some testosterone in the ovaries. And much like the other female sex hormones, levels of testosterone can diminish with age, childbirth, or may never reach optimization. Women who have low levels of testosterone may experience low sex drive, decreased mental clarity, weight gain, poor muscle tone, as well as other unwanted side effects.  

Testosterone pellet therapy offers women an opportunity to relieve these symptoms and experience other valuable benefits, such as reduced risk of disease. 

The plant-based hormones used in bioidentical hormone replacement therapy (BHRT) have not been tied to an increased risk of cancer or blood clots, as is the case with some synthetic hormones.

Common side effects of standard hormone pellet insertions include minor bleeding or bruising at the insertion site, extrusion of the pellet, discoloration of the skin and infection. However, Dr. Terri DeNeui designed EvexiPEL pellets and the EvexiPEL Method to optimize the insertion process and heavily decrease the risk of those side effects that can sometimes occur at the pellet insertion site.

The most common side effects associated with BHRT pellets after the first insertion process include increased hair growth, acne, oily skin, fatigue and increased body fat as the body gets used to the therapy.