Written by Lauren Lund, APRN-CNP

Reviewed by Laurianne Scott, DO

Hormonal imbalances can significantly impact a woman’s quality of life—contributing to fatigue, mood swings, weight gain, sleep disturbances, and changes in libido. At MOBO Medical Spa, we often speak with women seeking safe, effective, and consistent hormone replacement options. One increasingly popular treatment is hormone pellet therapy, which delivers bioidentical hormones in a steady, physiologic manner. Let's explore the science behind hormone pellet therapy, how it works, and the benefits it can offer to women experiencing hormonal changes.

What is Hormone Replacement Therapy?

Hormone replacement therapy (HRT) for women using testosterone, estrogen, and/or progesterone aims to restore balanced hormone levels to alleviate symptoms such as hot flashes, mood swings, fatigue, decreased libido, vaginal dryness, bone density loss, and irregular menstrual cycles. MOBO Medical Spa's Hormone Therapy program may also be used for women undergoing menopause or those experiencing hormone deficiencies or imbalances.

Estrogen: Estrogen is a natural hormone that plays a critical role in regulating many bodily functions, including the menstrual cycle, bone health, and cardiovascular health. As you transition through menopause or experience hormone fluctuations, estrogen levels decline, leading to various symptoms. The goal of estrogen therapy is to alleviate symptoms such as hot flashes, night sweats, vaginal dryness, mood swings, and may help to prevent long-term health issues like osteoporosis. Estrogen therapy may be administered alone (for hysterectomy patients) or in combination with progesterone if you have an intact uterus, depending on your specific needs and risk factors.

Testosterone: Testosterone is an important hormone for women, contributing to various physiological functions such as muscle strength, bone density, mood, sexual desire, and cognitive function. In women, testosterone levels typically decline with age, especially during and after menopause. This decline can lead to symptoms such as reduced libido, fatigue, decreased muscle mass, and mood disturbances. Testosterone therapy in women may be considered as part of a treatment plan to help restore balance of hormones, address hormone-related symptoms, and improve overall quality of life. Testosterone therapy can be administered in several forms, including pellet implants, topical creams, and injectable formulations. Testosterone pellets have been used for hormone therapy in women since approximately 1940. There is no FDA approved Testosterone therapy for women. Testosterone pellets are ‘compounded’ and are used ‘off label’ in women. Off label use means testosterone is an approved drug legally prescribed by a provider but has not been specifically approved for use in women by the FDA.

Progesterone: Progesterone is a hormone that plays a critical role in regulating the menstrual cycle and supporting pregnancy. During menopause, progesterone levels decline, and some individuals may benefit from supplemental progesterone to manage symptoms, maintain hormonal balance, and/or to protect their uterus.  

What Is Hormone Pellet Therapy?

Hormone pellet therapy is a form of bioidentical hormone replacement therapy (BHRT) in which customized hormone pellets— containing estradiol and/or testosterone—are implanted subcutaneously, usually in the upper gluteal area. These pellets are derived from plant sources (such as yams) and are molecularly identical to the hormones naturally produced by the human body.

Once implanted, the pellets dissolve slowly over an average of 3 to 4 months in women, releasing a consistent dose of hormone into the bloodstream in response to cardiac output (blood flow). This method bypasses the gastrointestinal system and liver metabolism (as seen with oral formulations), offering stable hormone levels without the peaks and troughs associated with other forms of hormone replacement, such as creams, patches, or injections.

 
The Benefits of Hormone Pellets

Hormone pellet therapy has been studied for its potential benefits in various areas of women’s health, particularly during perimenopause, menopause, and postmenopause. Many people seek the use of hormone pellets due to it's benefit of consistent hormone levels. Pellet therapy provides a steady, physiologic dose of hormones, which reduces the fluctuations that can occur with oral or transdermal therapies. This stability is key in reducing symptoms and improving patient adherence. 

Estrogen therapy may provide a range of benefits, including:

• Relief of menopausal symptoms such as hot flashes, night sweats, vaginal dryness, mood swings, and sleep disturbances.
• Improved vaginal health, including relief from dryness, irritation, and discomfort during intercourse.
• Prevention of bone loss and reduction in the risk of osteoporosis and fractures by helping to maintain bone density.
• Improved skin elasticity and hydration.
• Improved mood and quality of life for some individuals, including better cognitive function and mental clarity.
• Protection of cardiovascular health (when used early in menopause and under careful monitoring), though the benefits for heart disease prevention are still debated.

Testosterone therapy in women may offer a variety of potential benefits, including:

• Improved libido (sexual desire) and sexual function
• Increased energy levels and reduced fatigue
• Improved mood and emotional well-being
• Enhanced muscle mass and strength
• Improved bone density, reducing the risk of osteoporosis
• Better cognitive function, including mental clarity and focus
• Reduced body fat and improved body composition

Progesterone therapy in HRT may include the following benefits:

• Relief from menopausal symptoms such as hot flashes, night sweats, and mood swings.
• Reduction of the risk of endometrial hyperplasia (an overgrowth of the uterine lining), particularly in individuals who have an intact uterus.
• Improvement of sleep patterns
• Improvement of mood stabilization.
• Protection against bone density loss when used in combination with estrogen therapy.
• Support for overall hormonal balance and well-being.

Am I a Candidate for Hormone Pellet Therapy?

Comprehensive lab testing (including serum estradiol, free and total testosterone, progesterone, and thyroid function) is essential to determine candidacy and to tailor dosing appropriately. Women who may benefit from Hormone Pellet Therapy include those with:

• Perimenopausal or menopausal symptoms
• Surgical menopause (e.g., post-oophorectomy, a surgical procedure to remove one or both ovaries)
• Hormone deficiency symptoms (fatigue, brain fog, low libido)
• Other estrogen/testosterone imbalances

Hormone therapy may not be appropriate for individuals with certain medical conditions or risk factors. These include: 

• History of allergic reactions to estrogen, progesterone, testosterone or its components
• History of or current breast cancer, ovarian cancer, endometrial cancer, or hormone-sensitive cancers
• Active or History of blood clots (deep vein thrombosis, pulmonary embolism, stroke)
• Liver disease or impaired liver function
• Active or history of heart disease or stroke
• Uncontrolled high blood pressure
• Undiagnosed vaginal bleeding
• Pregnancy or breastfeeding or planning to become pregnant

If you have any of the above conditions, inform your healthcare provider to discuss risk/benefit profile and alternative treatment options. Family history of hormone sensitive cancer is not a complete contraindication; however, the benefits and risks must be discussed with your provider. 

What to Expect from the Pellet Procedure

1. Initial Consultation: A thorough review of your symptoms, health history, and lab work.

2. Pellet Insertion: A minor in-office procedure performed under local anesthesia to ease any discomfort. Pellets are placed via a small incision, typically in the hip or buttocks.

3. Pellet Aftercare: No vigorous physical activity for 48 hours following the procedure. No water immersion for 5 days. You may remove the dry dressing and shower the next day. Leave the steri-strips in place until they fall off on their own.

4. Notice Results: Most women notice results within 2 weeks.

5. Follow-up: Hormone levels and symptoms are re-evaluated after post-insertion, with ongoing monitoring and replacement with new pellets every 3–6 months.

A Personalized Approach to Hormone Health

Hormone pellet therapy is a science-based, long-acting, and individualized treatment option for women seeking relief from hormone-related symptoms. By restoring hormone levels in a physiologic and consistent manner, pellet therapy can improve quality of life across multiple domains—physical, emotional, cognitive, and sexual.

As with any medical treatment, a personalized approach is key. If you’re experiencing symptoms of hormonal imbalance, consult with your MOBO Medical Spa provider to explore whether hormone pellet therapy is appropriate for you.