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 second to none. You may experience any or all of the following.

How often will I need them inserted?
It depends on the person, but anywhere from 4-6 months. Occasionally “booster” doses are given before then.

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 optional especially if a woman has relatively small breasts.

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 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. 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 bio-identical subdermal hormone therapy. 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 is the most important hormone for a woman to protect her against heart attack, fatal stroke, loss of teeth, as well as osteoporosis and Alzheimer's and maybe even Parkinson’s Disease. Synthetic estrogen taken orally does not offer the universal benefits.

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

Will I grow unwanted hair from the testosterone?
That can sometimes happen, but it is most often rather mild and can be minimized by adjusting the dose of the testosterone pellet.

Do I need other medications?
Unless the uterus has been removed, women will also need progesterone, to protect the uterine lining. This is given either as drops under the tongue or pills.

Does my insurance cover this?
Insurance sometimes pays for the insertion fee, and the pellets themselves are the patients’ responsibility as they are not on any insurance formularies. The cost of the pellets in women is approximately $10-30 per month, depending on the number of pellets needed and how long you can go before needing more.