HRT Pellets

HRT replaces or supplements hormones that decline with age—primarily estrogen and progesterone for women, testosterone for both women and men. The goal is restoring hormone levels to optimize energy, mood, sleep, cognition, libido, body composition, and overall well-being. At The Spa we use bioidentical hormones via pellet insertion, the most consistent delivery method.

Bioidentical hormones are structurally identical to the hormones your body produces naturally. They're derived from plant sources (typically yams or soy) and processed to match human hormones molecule-for-molecule. This is different from synthetic hormones (like Premarin) which have a slightly different molecular structure and different effects on the body.

Bioidentical hormone pellets are rice-sized hormone implants placed under the skin during a quick in-office procedure. They release a consistent dose over 3–5 months for women and 4–6 months for men. Pellets avoid the absorption variability and daily compliance issues of creams and oral medications—you get steady levels around the clock.

We numb the insertion site with local anesthetic before placing the pellets, making the procedure virtually painless. Most patients describe slight pressure. The site is sore for about 7 days. Avoid swimming, hot tubs, and strenuous exercise for 5–7 days.

Patients with symptoms of hormone imbalance and lab confirmation: fatigue, weight gain despite consistent effort, hot flashes, low libido, mood changes, brain fog, sleep disruption, loss of muscle mass. We start with a complete hormone panel. HRT isn't appropriate for everyone—we screen for contraindications including history of certain hormone-sensitive cancers, blood clot disorders, and active cardiovascular disease.

Most patients notice improvement in energy and mood within 2–4 weeks. Sleep and libido often improve in 4–8 weeks. Body composition changes (fat loss, muscle gain with consistent training) develop over 3–6 months. Full optimization is usually realized after 1–2 pellet cycles as we fine-tune dosing.

When properly screened and monitored, yes. We screen for contraindications before starting, monitor lab work regularly, and adjust dosing based on response. Bioidentical hormones at physiologic doses have a strong safety profile in patients without contraindications. We work within evidence-based protocols, not 'megadoses' that can cause issues.

Men receive testosterone pellets, re-inserted every 5 months on average. Women may receive estradiol and/or testosterone pellets, re-inserted every 4 months on average. Both pathways are designed around individual labs and symptoms.

HRT starts with a $150 consultation. Pellet insertion pricing is set after labs because the right dose depends on your individual hormone levels. We'll go over exact pricing at your consult.

Comprehensive hormone panel including total and free testosterone, estradiol, progesterone (for women), SHBG, DHEA-S, cortisol, thyroid panel (TSH, free T3, free T4), and a complete metabolic panel including lipids and CBC. We may add additional markers based on your symptoms.

Initial: blood work 4 weeks after first pellet, lab review at 5 weeks. Then labs every 3–6 months timed with pellet insertions. Pellet placement appointments every 4 months for women, 5 months for men on average. We're available between visits for symptom-related questions.

Book a wellness consultation. We'll review your symptoms, order baseline labs, and design a treatment plan based on results. If you have recent labs from another provider, bring them—we may not need to repeat all of them. Call (806) 701-5840 or book online.