Hormone Therapy

After age 30, most of us experience a decline in hormone production that averages between 3% and 10% a year.

As we continue to age, the effect of this decrease in hormones becomes more profound. In short, as our bodies decrease the production of these hormones, our quality of life becomes greatly affected.

For both men and women, hormonal balance is necessary for good health and disease prevention. While there are several protocols used by the medical profession to address this issue, the introduction of bioidentical hormones using pellet therapy has had good results.

Symptoms of hormone decline frequently include:
  • Reduced mental clarity
  • Weight gain
  • Loss of muscle mass
  • Declining libido
  • Difficulty sleeping,
  • Muscle and joint pain
  • Depression
  • And other mood changes.
senior couple - what are bio-identical hormones

What are "bioidentical" hormones?

Bioidentical hormones have a biochemical structure that is perfectly matched to the hormones produced by the endocrine system in a man or woman’s body. At Duke City Healthcare, we use BioTE® Hormone Pellet Therapy, a plant-based hormone derived from natural plant sources that replicate the body’s normal hormonal levels.

Several drug companies on the market produce artificially formulated synthetic hormones, which are intentionally manufactured to be slightly different from human hormones so that they can be patented. Other companies use animal hormones, frequently from horses.

Because bioidentical hormones are natural substances, our bodies can metabolize them in the way they were designed to, minimizing side effects. These compounded bioidentical hormones can be matched to each man or woman’s unique needs, which is not impossible with mass-produced products.

happy couple with phone - why pellet therapy

Why pellet therapy?

Hormone pellets contain a natural plant source of estrogen or testosterone. The pellets, which are smaller than a grain of rice, are placed in the fatty tissue underneath the skin and most closely mimic the actions of healthy ovaries and testicles with regard to hormone release into the bloodstream. The hormone pellet therapy implantation procedure is performed in the office.

Unlike typical oral or topical cream therapies that can often produce roller coaster hormone levels that result in mood and energy fluctuations for the patient, pellet therapy can provide sustained hormone levels throughout the day for up to three to five months.

Comprehensive blood work is performed to analyze the patient’s hormone levels. Unique doses of hormones are prescribed based on the blood results. Pellets deliver pure, bioidentical hormones directly into the bloodstream for up to five months, providing a constant supply that the body recognizes as its own and significantly reducing the chance of adverse side effects.

Are you interested in ongoing pellet therapy treatment? Discover the ongoing benefits that a monthly membership in our Direct Primary Care program can have on your health.

improve overall health - mature couple with dog

Find out if you’re a candidate for Bioidentical Hormone Replacement Therapy. Take the Hormone Wellness Quiz.

General Questions about BHRT

How often do I need pellet therapy?

Women usually need bioidentical hormone pellet therapy (BHRT). also called “pellet therapy,” every 3 to 4 months, and men every 4 to 5 months.

Why are pellets a better delivery method than creams, patches, shots, or pills?

Pellets are a pure hormone that is not metabolized into byproducts as a result of being processed by the liver, stomach, or skin. This method of delivering hormones can help the body use the amount it needs as the blood flow surrounding the pellets “picks up” what is required.

How long will it take for my body to become leaner using BHRT?

That depends on age and activity level. Testosterone decreases fat and increases muscle and lean body mass. Testosterone also increases the body’s natural growth hormone production, thereby improving stamina and increasing muscle mass.

Are there any side effects or complications for pellet therapy?

Most side effects are temporary and treatable and occur less than 2 percent of the time when pelleted correctly.

How long will it take for the pellets to get into my system and start working?

Most patients recognize the effect of pellets within 24 to 72 hours. Optimal effects usually occur three weeks after insertion.

I have no libido—will hormone pellet therapy help?

Good hormone balance greatly improves libido. The addition of testosterone in pellet form can have a profound impact on how an individual feels and interacts with others.

BHRT FAQs – Women

I get horrible headaches. Will pellet therapy help me?

We have had great success with hormone pellet therapy, especially with women who have menstrual migraines and who have new migraines that appear after age 35.

Do I need to take other medications?

Women who still have their uterus will need to be on natural progesterone as well.

Why do I need estrogen?

Estrogen is the most important hormone for a woman. It can help protect women against heart attack, stroke, osteoporosis, and Alzheimer’s. It also helps keep women looking young and healthy.

Why do I need testosterone?

Testosterone is the third female hormone and is as essential as estrogen and progesterone. Women need testosterone to help keep their thought processes quick and libido healthy. It helps improve bone density, muscle mass, strength, and prevents some types of depression. Testosterone is also a source of energy and solid sleep.

Will I grow unwanted hair from testosterone?

Facial hair will grow with testosterone pellets, but normally no more than when you were in your thirties. There is less chance of excess hair growth with natural testosterone than with synthetic hormones.


Does testosterone cause prostate cancer?

Metabolites of testosterone, Dihydrotestosterone and estrone, can cause prostate enlargement and contribute to prostate cancer. Estrone increases and testosterone decreases as men age and gain belly fat. Testosterone pellets may help reverse that trend.

How do I take testosterone pellets and not convert them to Dihydrotestosterone and estrone?

The blood levels of estrone and DHT are checked after treatment to see if they are elevated. Some men still convert to these metabolites even on testosterone pellets. If they are converting, we troubleshoot with natural supplements such as DIM and Saw Palmetto, or an aromatase inhibitor prescription.

What if I have prostate enlargement already?

Testosterone pellets may make it better if it’s not converted to DHT. We will treat that if it happens.

Will my testicles shrink while on testosterone pellets?

Testicles are suppressed by taking any kind of testosterone and will not make as much testosterone while the pellets are working, so they may shrink. This is not permanent and the testicle retains its ability to produce testosterone.