Hormone pellet therapy inserts small subcutaneous pellets (typically containing estradiol and/or testosterone) into the upper buttock. The pellets release hormone over 3-6 months before being reabsorbed.
Why we flag pellets as a guideline-concern treatment
The Menopause Society, ACOG, and the Endocrine Society have all issued statements cautioning against compounded hormone pellets. Their specific concerns:
- Dose variability. Compounded pellets are not subject to FDA potency testing. Measured hormone release from nominally identical pellets varies.
- Supraphysiologic levels. Serum estradiol and testosterone routinely spike above physiologic postmenopausal targets, sometimes into premenopausal or male ranges.
- Inability to stop therapy. Once inserted, the pellet cannot be removed without surgery. Adverse reactions cannot be discontinued by simply stopping the dose.
- Lack of FDA oversight. No pellet formulation is FDA-approved for women.
Why providers still use them
Many patients and providers report strong symptom control and high satisfaction with pellets. Convenience (one insertion every 3-6 months) is real. If you choose pellet therapy, providers recommend:
- Baseline and follow-up serum hormone testing.
- A provider who will dose conservatively rather than to supraphysiologic targets.
- Clarity on what happens if adverse effects develop.
What we show on this directory
Providers who offer pellet therapy appear normally on this directory — it is a legal, commonly prescribed option. We tag the modality so patients can search for it or avoid it per their own judgment, and we link here so the guideline context is visible.