To Pellet or Not to Pellet: Choosing the Better Path to Hormonal Health

By: Physicians Preference RX

At Physicians Preference Pharmacy, we’ve spent over 24 years helping guests achieve optimal health through bioidentical hormone replacement therapy (BHRT) in the form of oral capsules, topical and vaginal creams, and sublingual tablets. BHRT uses hormones that are molecularly identical to those produced by the body to restore balance and address symptoms caused by hormonal decline. While there are many approaches to hormone therapy, not all are created equal. In this blog, we’ll explore the differences between hormone pellets and our compounded BHRT capsules, creams, and sublingual tablets, and why our approach with BHRT prioritizes flexibility and customization, safety, and lasting results.  

What Are Hormone Pellets?  

Hormone pellets are small, solid cylinders, the size of which may vary depending upon the dose, containing bioidentical estrogen and testosterone (progesterone does not come in pellet form). They are inserted under the skin through a minor surgical procedure and release hormones steadily over time. In our experience, pellet therapy dosing is supra-physiologic dosing, which is an exceedingly high dose. While this delivery method may seem convenient, it can lead to extreme side effects that can continue until the pellet fully dissolves, which could take up to 3 months. Also of note, since progesterone is not contained in pellets, a separate daily progesterone prescription must also be taken by the patient in either capsule or cream dosage form.  

The Drawbacks of Hormone Pellets  

Surgical Procedure Risks:  

• Pellet insertion involves a minor surgical procedure requiring an incision.  
• Risks include pain, bleeding, bruising, infection, and potential scarring.  
• Physical activity may need to be restricted for several days post-procedure.  

Hormone pellets can cause a variety of side effects, including:  

• Mood swings  
• Weight fluctuations  
• Sleep disturbances  
• Breast tenderness or swelling  
• Fluid retention  
• Hair loss or excessive hair growth in both men and women  
  • Male-patterned baldness   
  • Chest hair growth in women  
  • Facial hair growth in men and women  
• Acne and irritability  

Inflexible Dosing:  

• Once inserted, the hormone dosage cannot be adjusted.  
• Guests must wait for the pellets to dissolve naturally, which can take months (typically 3 months minimum).  
• This rigidity can lead to prolonged discomfort if the dose is too high or too low.  
• Not all of the needed hormones can be given by pellet therapy; the dose of progesterone is too high for pellets, so an additional daily prescription of cream or capsules is added to the estrogen and testosterone pellet therapy

Why Our Bioidentical Hormone Replacement Therapy (BHRT) Dosage Forms Are a Better Option  

Unlike hormone pellets, compounded BHRT oral capsules, creams, and sublingual tablets offer a safer, more adaptable, and customized approach to restoring hormonal balance.   

Physicians Preference Pharmacy Compounded BHRT options offer:  

Customizable Solutions:  

• BHRT can be delivered in various forms, including compounded oral capsules, sublingual tablets, and topical and vaginal creams.  
• This variety allows us to tailor treatments to each guest’s preferences and absorption status  .

Flexible/Adjustable Dosing:  

• Our compounded BHRT capsules, creams, and sublingual tablets provide the ability to adjust hormone levels up or down based on how the guest feels. Our dosage forms provide physiologic dosing of hormones (following normal hormone patterns) with little to no side effects experienced.  
• This real-time titration ensures the “sweet spot” of optimal energy, mental clarity, and symptom resolution.  

Non-Surgical and Comfortable:  

• Compounded BHRT capsules, creams, and sublingual tablets eliminate the need for incisions, reducing risks of pain, infection, or recovery downtime.  
• Guests can return to their daily activities immediately.  

Long-Term Effectiveness:  

• With ongoing monitoring and adjustments, our compounded BHRT capsules, creams, and sublingual tablets provide sustainable results tailored to each individual’s changing needs.  

Signs of Hormone Decline in Women and Men  

In Women (includes but not limited to):  

• Fatigue and low energy  
• Weight gain, especially around the abdomen  
• Mood swings and irritability  
• Sleep disturbances or insomnia  
• Hot flashes and night sweats  
• Decreased libido   
• Vaginal dryness  
• Hair thinning or loss  
• Brittle Nails  
• Brain Fog  

In Men (includes but not limited to):  

• Decreased energy and motivation  
• Weight gain, particularly in the abdominal area  
• Loss of muscle mass  
• Mood changes, including depression or irritability  
• Sleep problems  
• Reduced libido / Romantic desire and erectile dysfunction  
• Hair thinning or loss  
• Difficulty concentrating or memory issues  
• Brain Fog  

Recognizing these signs early can help you take proactive steps toward restoring hormonal balance. For more on signs and symptoms, visit our hormonal health resource pages on Menopause, PMS, and Low T.  

Compounded Products

At Physicians Preference Pharmacy, we use the highest quality compounded products to treat hormone imbalance including: 

• Estriol and Estradiol: These are estrogens that are identical to the hormones that are produced in the human body primarily by the ovaries. Estrogen is a primary female sex hormone that regulates the menstrual cycle, supports reproductive health, and influences bone density, mood, and skin elasticity. It is mainly produced in the ovaries, with smaller amounts from the adrenal glands and fat cells, and its balance is essential for overall hormonal health. It is important to balance estrogen with progesterone.  
• Progesterone: Progesterone is a steroid hormone that regulates the menstrual cycle, supports pregnancy, balances estrogen, promotes sleep, and aids brain and bone health. It is produced in the ovaries, adrenal glands, and placenta during pregnancy. Low progesterone can cause irregular periods, PMS, infertility, mood swings, and sleep disturbances. 
• DHEA: DHEA is a precursor to androgens, testosterone, and estrogens, essential for protein repair and hormone balance. Produced in the adrenal glands, it declines with age and may support heart health, metabolism, immunity, and cognitive function. 
• Testosterone: Testosterone is a key hormone in both men and women, primarily responsible for muscle growth, bone density, energy levels, mood regulation, and libido. It is mainly produced in the testes in men and the ovaries and adrenal glands in women, with balanced levels essential for overall health and well-being.   

Take Charge of Your Health Today  

If you’re considering hormone therapy, it’s essential to choose a method that prioritizes your safety, comfort, and long-term success. At Physicians Preference Pharmacy, we’re here to guide you every step of the way. To speak to a pharmacist about our compounded BHRT dosage forms, call 281-828-9088 today!  

Your health is your greatest asset—and we’re here to help you protect it.