Frequently Asked Questions

What are hormone pellets made of?
They are derived from soybeans, and are biologically identical to human forms of estradiol and testosterone. There is also a small amount of magnesium stearate added to the prepelletized powder to help it flow better during the pellet making process. The pellets are specially manufactured by select compounding pharmacies using strict manufacturing standards. The pellets are completely biodegradable under the skin leaving no residue whatsoever.

What can I expect bioidentical subdermal hormones to do for me?
The quality of life given back to every man or woman is excellent. You may experience any or all of the following.

How often will I need them inserted?
It depends on the person, but the normal interval is 3-6 months. Occasionally “booster” pellets are inserted before then as necessary.

Does is matter what time of my cycle or day to have my blood tested?
For women, it’s best to have your hormone levels checked a week prior to, during, or after your period at any time of the day. For men, it’s best to have your testosterone levels checked early in the morning when they are highest.

How will I know when it’s time for more pellets? Do I need a blood test every time?
People can usually tell when it’s time for more by how they feel. If you feel they’ve worn off before a 3-month time period, your blood levels should be rechecked to see where you’re at. If it’s been longer than 4 months, you can get more pellets without another blood test. Between 3 and 4 months is on a case by case basis. All patients should have an office visit either with Dr. Epperly or their regular family doctor annually. Women with a uterus need an annual Pap if <65 years old. Men need their liver enzymes, PSA, blood count, and testosterone levels checked annually. Women should have their estradiol levels checked annually as well. Mammograms are suggested.

Are there any side effects and/or complications?
Unlike other forms of hormone therapy, there are very few side effects and they are usually transient. You could get some breast discomfort, nipple tenderness, bloating, and rarely a pellet site could get infected or the pellet could come out. As with hormone therapy in general, some women (who still have their uterus) get a return of menstrual type bleeding particularly if the progesterone is given cyclically rather than continuously. Usually, this bleeding is easily managed by adjusting the doses of the pellets or the progesterone. Rarely, the bleeding could become problematic to the point of requiring a D&C. With the testosterone pellets in women, there are occasional incidences of increased or darker hair growth or mild acne, but these issues are generally minor and easily managed.

I get horrible headaches, will this help me?
Yes! Subdermal estradiol pellet implants have had great success in dramatically reducing hormone-related migraine headaches.

Why doesn't my doctor suggest these as an option?
The great majority of physician training is on horse estrogens and/or synthetic hormones (e.g PremPro). More than likely they were never trained on the use of bioidentical subdermal hormone pellet implants. Also important is the fact there are no drug company sales representatives speaking to doctors on a regular basis about pellet therapy.

How long will it take for the pellets to get into my system and work?
Twenty-four to seventy-two hours. Results are almost always seen within a few days to weeks.

If I am a woman, do I still need estrogen after menopause?
Bioidentical estrogen (17-Beta Estradiol) is the most important hormone for a woman to protect her against osteoporosis and premature loss of teeth, and to possibly reduce her risk of heart disease and Alzheimer's dementia. It's Dr. Epperly's belief that women can stay on bioidentical estrogen replacement for as long as they want to. We believe the benefits will last for as long as hormone replacement continues.

I have no libido, what will this do for that if anything?
Good hormone balance will usually greatly improve your sexual desires.