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Updated November 18, 2025
These FAQs are based on the Biote® method as used at Svelte Medical Weight Loss Centers under the direction of Richard S. Bragg, MD.
What bioidentical hormones are, how pellets work, and why they’re different from other options.
Bioidentical hormones are compounds designed to closely match the hormones naturally produced by your body. When levels decline or become imbalanced, carefully prescribed bioidentical hormones can help restore balance, improve vitality and support overall well-being.
When prescribed and monitored by a qualified clinician, bioidentical hormones have been shown to safely improve symptoms such as low energy, poor sleep, mood changes and decreased libido. Many patients also report restored vitality and an overall feeling of youthfulness.
As with any medical therapy, your risks and benefits are evaluated individually based on your medical history, exam and lab results.
Creams, patches, vaginal inserts and tablets can sometimes provide inconsistent absorption, which may not effectively optimize testosterone or estrogen levels. That can result in “ups and downs” in how you feel from day to day.
Pellet therapy places tiny bioidentical hormone pellets under the skin, where they steadily release hormone into the bloodstream over several months. This helps support more stable levels and fewer daily fluctuations.
Pellet therapy:
Some patients do well on creams, patches or injections; others prefer pellets for the convenience and stability. Your provider will help you weigh the options for your situation.
Hormone pellet therapy is not new. Forms of pellet implantation have been used since the mid-1900s in Europe, Australia and the U.S. Biote® has standardized this approach with specific dosing algorithms and training to improve safety, consistency and patient experience.
Hormone levels change with age, stress, medical conditions and certain medications. In both men and women, low or imbalanced hormones can contribute to:
Lab testing plus a careful review of symptoms help determine whether hormone therapy is appropriate for you.
Hormone health is closely tied to metabolism, body composition, sleep, mood and vitality. Optimizing hormones can support weight-loss goals, make it easier to maintain results and help patients feel younger, more energized and more balanced overall.
Who may be a candidate and how we decide if pellets are appropriate for you.
Candidates are typically adults with symptoms of hormone imbalance. For women, this often means being peri-menopausal or menopausal. For men, symptoms can appear gradually with age.
Our providers evaluate your symptoms, medical history and lab results to determine eligibility. You can also start with our hormone quizzes to see if pellets may be an option:
Pellet therapy is generally recommended for women who are peri-menopausal or menopausal. Younger women are typically not candidates unless there is a medically confirmed hormone deficiency. Your provider will review your history, symptoms and labs to determine the safest, most appropriate options.
Pellets can offer a more consistent hormone level and reduce the need for frequent injections, which many men find more convenient. For some, this leads to steadier symptom control, better energy and improved quality of life.
Your provider will review your current regimen, labs and goals to decide whether it makes sense to switch to pellets.
Many women find pellets more effective because they maintain consistent hormone levels and eliminate the messiness, transfer risk or skin irritation that some creams and patches cause. That said, some women do well on non-pellet therapies. We’ll help you decide based on your response, preferences and labs.
If you are actively trying to conceive or planning pregnancy in the near future, supplemental testosterone (including pellet therapy) is generally not recommended, because it can interfere with normal fertility.
Your provider will review your family-planning goals and discuss alternative approaches that are better aligned with preserving fertility.
How pellet therapy is priced, how long pellets last and why many patients choose them even when insurance covers other forms.
Insurance may cover certain hormone therapies such as creams or patches. Many patients still choose pellets because they:
Because pellets last an average of about 3 months for women and 4-5 months for men, the month-to-month cost often compares closely with other options, while providing more consistent symptom relief for many patients.
Pricing varies for men and women and depends on your specific dosing needs. For current details and cost breakdowns, please visit our Biote pricing page:
Pellets are not a “weight loss procedure,” but by improving hormone balance they can support better energy, sleep, metabolism and body composition. Many patients find it easier to lose or maintain weight once hormones are optimized.
On their own, pellets do not cause fat gain. Weight changes are usually related to lifestyle, diet, other medications and underlying health conditions, which we address together as part of your plan.
On average, pellets last about:
The exact duration depends on your dose, activity level, metabolism and how quickly your body uses the hormone. Your provider will help set expectations based on your labs and follow-up visits.
Insurance typically does not cover pellet insertion. Some blood work may be covered depending on your plan and where labs are drawn. We review your expected costs up front so there are no surprises.
How we think about cancer risk, side effects, evidence and long-term use for both women and men.
A family history of cancer does not automatically exclude you from hormone therapy, but it is an important part of your risk profile. Your provider will review your personal and family history, risk factors, recent imaging and lab work to determine whether pellet therapy is appropriate and, if so, how to use it as safely as possible.
In some cases, hormone therapy can be customized to support symptom relief while respecting clear oncologic recommendations. For breast cancer survivors, we proceed very carefully, often in coordination with your oncology team, and may use non-estrogen options where appropriate.
Decisions in this situation are highly individualized and made only after a thorough review of your history and current treatment plan.
Testosterone therapy can affect how your body regulates its own hormone production. As part of the Biote® approach, we use a daily supplement (DIM/Hormone Advantage) to help block the conversion of testosterone into estradiol. This:
Your dosing, monitoring and supplement plan are all designed to support both effectiveness and safety. If you have concerns about testicular size or function, we encourage you to discuss them openly with your provider.
Side effects are uncommon but can include:
Most effects are mild and short-lived. Your provider will review what to watch for and what to do if anything concerns you.
Not all clinicians use pellets in their practice, and some may be less familiar with this method. There is published literature and extensive real-world experience supporting pellet therapy when used appropriately and monitored correctly.
At our practice, we follow Biote® training and protocols, use standardized dosing algorithms, and have treated more than 1,000 pellet patients since 2017. We are happy to answer questions and share our approach so you can make an informed decision.
How to get started, how we determine your dose and what “optimized” really means.
The first step is a simple hormone panel performed by our medical team to assess your hormone levels. Once results are reviewed, you’ll meet with a provider for a consultation, discuss options and, if appropriate, schedule your pellet insertion.
We’ve been treating patients using the Biote® method since 2017 and are a Platinum-level Biote provider, meaning we have performed pellet therapy for more than 1,000 patients at our practice.
Yes. Your dosage is individualized based on:
We use Biote’s dosing algorithms as a starting point, then fine-tune based on your response and follow-up labs.
“Optimized” means your hormone levels are in a range where you feel your best—better energy, mood, sleep, libido, mental focus and overall vitality—while staying within safe boundaries based on your age, sex and medical history.
Supplements are personalized based on your labs and needs. Many patients benefit from:
Your provider will recommend a specific plan after reviewing your lab results.
What the pellet procedure feels like, how long it takes and what to do afterward.
Most patients experience minimal discomfort. Local anesthesia is used to numb the area, and you may feel pressure rather than sharp pain. The small incision is closed with a strip or stitch and typically heals quickly.
The pellet insertion itself usually takes only a few minutes. Your total visit time is longer to allow for preparation, consent and post-procedure instructions.
Downtime is minimal. Most patients resume light daily activity quickly while following their clinician’s instructions to protect the insertion site.
We provide specific aftercare instructions at your visit, but in general:
Most people can work and perform light activities right away. If you have a physically demanding job or unique medical considerations, we’ll tailor recommendations for you.
Many patients begin to notice improvements in energy, mood, sleep and libido within 1-2 weeks. Full benefits are often seen over 3-5 weeks as hormone levels stabilize and your body responds.
Yes. We can treat out-of-state patients during their visit to Florida, as long as appropriate consultation and lab work are completed ahead of time. Please contact our office in advance so we can coordinate your care and timing.
Questions men commonly ask, plus concerns about hair and whether pellets really work.
Many men notice meaningful improvements in energy, strength, mental clarity, mood and sexual function with properly monitored testosterone therapy, including pellets.
Safety depends on your starting health, cardiovascular risk factors, prostate history and how closely therapy is monitored. We screen carefully before starting treatment and follow evidence-based guidelines for ongoing care, especially in men in their 50s, 60s and older.
Hair thinning can have many causes, including genetics, stress, nutritional deficiencies and hormones. When hair loss is related to hormone imbalance, optimizing hormones may support healthier hair over time, but results vary from person to person.
Your provider can help you explore whether hormones, nutrition or other factors are likely contributing to your hair changes.
For appropriately selected patients, pellet therapy can be a very effective way to improve symptoms of hormone imbalance. In our practice, many patients report:
No therapy works the same for everyone, but our experience with Biote® pellets since 2017 has been positive enough that they remain an important part of our hormone optimization toolkit.
You may have heard that it takes 7-10 for testosterone pellets to work.
So what is the truth about it?
It’s important to understand that each person’s body chemistry is a bit unique and can influence how the pellets are absorbed. Lifestyle and activity levels play a role as well. It also depends on which effects you are most interested in. So let’s split the effects into 2 categories.
Short Term and Long Term effects of bio-identical hormone optimization
These effects are usually noticed within the first 2 weeks and then are usually noticed fully at the 4-5 week mark.
These effects are usually noticed after maintaining a regimen of bio-identical hormones such as Biote over the course of a year or more
Saying the bio-identical hormones cause you to lose weight is a bit exaggerated. It is more that your body composition changes enable you to metabolize food and makes you more prone to exercise.
For Males and Females early perceived weight gain is typically related to transient water retention, and prolonged use of Biote (more than 5 months) often helps people experience a greater aptitude to lose weight. Yes, bioidentical hormones can help you lose weight. See this article for information on weight gain from testosterone pellets.
You may have heard 4-6 months, which we have found to be pretty accurate in our practice. It will depend on your level of activity. If you do a lot of exercise, you may find that you will need your pellets topped off to maintain a consistent testosterone level.
Many people get concerned that they are not familiar with pellets. While that may be true, they are commonly used throughout Australia and Europe. They are not marketed or patented at this time within the U.S. They were used in the United States in the 1940’s up through the 1970’s though. At the tail end of the 1970’s the use of pellets was supplanted by patented oral hormones.
These orally administered estrogen and testosterone hormones are chemically altered varieties that are heavily marketed within the United States. There are conventional pharmaceutical companies that manufacture pellets, with a good degree of research from Europe and Australia about pellet use.
Though, it turns out that the cannon of research on hormone pellets is seeing a steady increase in the United States. In particular, there is a new-found focus on pellet use for breast cancer patient populations. As of now, there are even clinics specializing in administering pellet hormone therapy.
Under local anesthesia, the doctor makes a tiny incision on the upper buttocks. Then they insert the hormone pellets and tape the incision shut. It is very important to locate a medical practitioner who has plenty of experience both determining the right dosages for clients as well as having a lot of pellet insertion experience as well.
The hormone pellets are manufactured from testosterone pressed and fused into cylinders. They are just a smidge larger than one single grain of rice, and small enough to fit inside a tiny incision. If you are wondering how doctors are able to provide hormone pellets in the United States, the answer is that compounding pharmacists create them. There are FDA-approved 75 milligram testosterone pellets also manufactured.
Through the use of the hormone pellets, there is no guessing or remembering to take any pills at the exact same time today as yesterday. The pellets, meanwhile, deliver the same dose for up to 5 months for the female population and up to 6 months for males.
This prevents spikes and drops in the necessary hormone levels that are typically experienced with other delivery methods. It’s an important matter to get the dosing just right to halt disease while creating an environment that fosters optimal health. Another excellent reason to consider pellets is that they do not run the risk of fostering the formation of blood clots that are seen in other hormone therapy delivery methods.
Studies that compare pellets to conventional hormone replacement prove pellets are superior in relieving the symptoms of menopause, while maintaining bone density. They are also second to none in the restoration of sleep, sex drive, libido, and sexual performance.
Testosterone through pellet implant treats PMS, menstrual headaches and even migraines. It improves incontinence vaginal dryness, urinary frequency and urgency, as well as may reduce hot flashes. Testosterone delivered through pellets has great effects for males and females to boost energy, remove depression, stop anxiety, increase concentration and memory, while delivering well being. Of course, the delivery of testosterone also increases lean body mass, while melting fat mass.
Testosterone makes mental and physical health possible while stalling the development of Alzheimer’s and Parkinson’s. Surprisingly to most people, low testosterone levels are associated with the development of Parkinson’s and Alzheimer’s disease.It’s been proven a great delivery method for those clients who had no success with other other hormone therapy.
Pellet recipients may experience bruising, minor bleeding or even some discoloration at the insertion site. Even these complications are rare, though, as it is inserted in a nice, meaty area of the buttock. Women may experience some facial hair growth as their testosterone levels are increased.
Testosterone is the key to the body’s signalling to make bone marrow and more red blood cells. For men in late middle age, low testosterone causes anemia. Testosterone delivery increases red blood cells and lowers anemia. After the onset of Andropause there are significant benefits to using bioidentical testosterone/hormones to increase vitality.
Actually, let’s focus on what should be avoided. For the first 2 days after insertion of the pellets, avoid exercise. In men, do not exercise for one week afterward. Otherwise, the pellet may get pushed out of the body. Then you would have to go through the process again.
For diabetics and former joint replacement patients, antibiotics may be prescribed as a prophylactic. It’s usually considered a clean and non-harmful procedure, so in most cases there may be no antibiotic prescribed before hand.
Here’s the truth. Sometimes a doctor saves face; meaning, if you catch them off guard with information that they are unfamiliar with they may assume there is no data to support pellets. That’s not really the case, of course. Pellets are more effective without having the risk of blood clots and stroke.
If you are particularly concerned about effectiveness and relief from low testosterone without risks of stroke, be more insistent. If you receive too much flak, you will want to go elsewhere, or get a referral to a physician who specializes in insertion of pellets. You do not want to go to the doctor who does not do the procedure. If they are not familiar with pellets, it is a flag to look at finding a doctor who understands what is called the efficacy and evidence for use of pellets. After all, we are talking about a simple procedure that can save lives (and sanity) in the process.
People feel like themselves after the insertion of pellets. They actually get sleep, have energy, and just experience a sense of well being, relief and happiness. They look better too, as their lean muscle mass and bone density return, while fat tissue falls. Even skin and hair improve as well.
Testosterone pellets are safer without the risk of breast cancer that oral estrogen poses. Evidence suggests that it actually may prevent breast cancer, and therefore be considered breast protective.
In fact, back in the 1940’s testosterone implants (and today in some circles) were considered a way to treat breast cancer. Androgens enhance Tamoxifenâ therapy for breast cancer patients.
We are unaware of any circumstances in which Biote hormone pellets cause cancer.
As it turns out, the answer is yes. Here’s why. First off, you do not want to wait until your testosterone is too low to get help. It feels like getting mowed down by a truck. Though, know this, a guy’s testosterone levels start their decline in their early 30’s. They may not start to “feel it” or experience the effects of low testosterone, though, until they are well into middle age (mid-40’s to mid-50’s).
Others do not feel it until their 60’s through even their 80’s It’s important to be tested to find out if there is a testosterone deficiency because it can cause serious illness. Without proper testosterone, it causes moodiness, depression, bone loss, exhaustion, erectile dysfunction, trouble sleeping and mental deficiency. The great news is that going to the doctor only can help in this situation. Get tested and get testosterone treatment through pellet insertion to turn the testosterone issue around to feel better pretty quickly.
Hair loss is a sign of low hormones for women. Pellet therapy may turn around the issue, creating hair growth.
Imagine undergoing a life-altering treatment that is simple and experiencing drastic results within 1 to 2 days. That’s often the case, though for many women it can take up to 2 weeks to experience a turnaround in how they feel.
Usually, insurance will NOT cover Biote hormone pellets, however at times, we may be able to get the labs covered.
Further considerations:
If you have tried natural replacement therapy or supplement based hormone replacement therapy from health food stores, you may not have experienced the high level of benefits biodentical medicine offers. Common cited studies have demonstrated the efficacy of bio-identical hormone optimization over synthetic hormone replacement therapy. While the studies have taken on various forms and have taken years for researchers to produce, the administration has taken into account control results for individuals dealing with fatigue, mood swings, heart conditions, menopausal treatments, and aging. Research policy has demonstrated positive results for otherwise healthy individuals based on doses treated with, existing conditions, and type of human hormone testing.
If you have questions pertaining to moving a lower testosterone level to normal levels through bioidentical treatment and live in the Orlando area, please use our form to contact us. Don’t forget to mention a good contact number and email. Our privacy policy is regulated by Hipaa. We keep your information safe.
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