Hormone pellet therapy delivers bio-identical hormones via small, solid implants inserted under the skin. These pellets, typically composed of compressed hormones like testosterone or estradiol, release a steady, consistent dose into the bloodstream over an extended period. This mechanism avoids the peaks and troughs associated with other delivery methods, offering a sustained effect for several months. The implantation process is a brief, minor surgical procedure performed in a clinician’s office.
Preparing for the Procedure
Preparation begins with a detailed medical consultation and comprehensive laboratory testing. Blood work measures current hormone levels, allowing the provider to determine the precise, individualized dosage required for the pellets. This customized approach ensures the therapy is tailored to the patient’s biological needs.
For the procedure, the patient is positioned comfortably, typically lying on their side, to provide the clinician easy access to the insertion site. The upper hip or outer gluteal area is the preferred location because it contains sufficient subcutaneous fat tissue to anchor the pellets and is a site with minimal movement. This selection helps minimize the risk of pellet migration or expulsion.
The selected area is meticulously cleaned and sterilized using an antiseptic solution to reduce the risk of infection. A local anesthetic, often a buffered lidocaine solution, is then injected directly into the skin and underlying fat layer. This injection creates a numbed pathway into the tissue, ensuring the patient experiences little to no discomfort during implantation.
Step-by-Step Insertion Process
After the local anesthetic has taken effect, the clinician confirms the numbness of the area before proceeding to the incision. Using a small surgical scalpel, a tiny incision (usually between three and five millimeters) is made through the skin. This small opening provides the entry point for the specialized insertion tool.
The clinician then uses a sterile, hollow instrument known as a trocar. The trocar is advanced through the incision at a shallow angle, typically around 30 to 45 degrees, into the subcutaneous fat layer beneath the skin. This action creates a precise pocket where the hormone pellets will reside and slowly dissolve.
Once the trocar is correctly positioned, the prescribed number of pellets are loaded into the instrument. A blunt obturator or plunger is then used to carefully advance the pellets from the trocar tube into the newly formed subcutaneous pocket. The pellets are placed deep enough to ensure consistent absorption and prevent them from being easily pushed out.
The trocar is smoothly withdrawn from the tissue, leaving the pellets securely in place within the fatty layer. Immediately after removal, the clinician applies firm pressure to the incision site for several minutes to achieve hemostasis and minimize bleeding or bruising. The entire implantation sequence is typically completed in less than 10 minutes.
To close the small opening, the skin edges are brought together and secured, most commonly with sterile adhesive strips called Steri-Strips. These strips hold the tissue taut, promoting healing without the need for traditional stitches, which helps minimize scarring. A sterile gauze pad and a compression dressing are then placed over the site to protect the wound and maintain pressure.
Managing the Recovery and Follow-up
Adherence to post-procedure instructions is important for ensuring the incision heals correctly and the pellets remain securely in place. Patients are advised to keep the insertion site completely dry for the first 24 hours to prevent moisture from compromising the dressing. After this initial period, showering is usually permitted, but the site should be gently patted dry.
To prevent the pellets from migrating or being expelled, patients must restrict activities that place strain on the insertion area for three to seven days. This involves avoiding strenuous exercise, heavy lifting, or activities that heavily engage the gluteal muscles (such as running or deep squatting). Patients should also avoid soaking the wound in water (baths, hot tubs, or swimming) for up to a week.
Mild swelling, bruising, and localized soreness at the insertion site are common and generally subside within a few days to a week. Patients must monitor the area for signs of complication, such as persistent pain, warmth, spreading redness, or yellowish discharge, which could indicate an infection. Contacting the provider immediately is necessary if these signs appear.
The hormones begin to release immediately, but it can take several weeks for the patient to feel the full effects as the body adjusts. The therapeutic effect typically lasts between three and six months, depending on the patient’s metabolism and activity level. Follow-up blood work is scheduled four to six weeks after the initial insertion to confirm the correct dosage.
The final step is scheduling the next insertion appointment when the effects of the current pellets begin to diminish. Subsequent lab work is performed a few weeks before the next procedure to ensure the hormone dosage remains accurately calibrated. The clinician alternates the insertion site, allowing the previously used area to completely heal before another pellet is implanted.