Women’s Instructions After Hormone Pellets.
Channel: BioBalance Healthcast
Date: 2023-05-01

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog.
BioBalance Health® pellets are very safe and not painful to have inserted. They are also the easiest form of hormone replacement a woman can have because the dose is adapted every 4 months and our patients only have to think about their hormones three times a year.

BioBalance Pellet therapy is associated with fewer side effects than any other hormone replacement, and we have a 95% success rate for resolving the symptoms of menopause and testosterone loss. Women’s lives are drastically impaired at menopause.  BioBalance, and T pellets improve their quality of life to the level of quality they had before they were 40. 

Dosage and pellet side effects are specific to the individual and it may take us a few pellet insertions and blood tests to get the ideal result. Finding your perfect fit is like having a custom suit made: hormone balance requires patience and several fittings, before we determine your maintenance dose, which will direct your dose of E/T for follow up pellet insertions.

We give a handout to each patient when she checks out after her first pellet insertion. We ask patients to follow the instructions given to them verbally and in writing in our office. 
Risks of pellet insertion procedure, risk of taking estradiol and risk of taking testosterone are rare, but patients are given this handout, so they know what to expect.  These same risks are on their consent that they read and sign before they even come to the office the first time.

Here are the most important instructions for immediate care of the insertion site:

• Take the pressure dressing off in 3 HOURS
• Take the steri-strip off in 3 DAYS
• Don’t traumatize your incisional area
• If you are allergic to tape please tell us
• For three days don’t submerge in water—hot tubs, bathtubs, the lake, a stream, or the ocean.
• For three days don’t exercise
• Don’t take oral or IV steroids if it is not life-threatening

Please tell us if you are on steroids or take blood thinners so we can alter our treatment plan.

The risks of the pellet insertion procedure include:

• Infection
• Bleeding, 
• Bruising
• Allergic reactions
• Swelling
• Pain
• Reaction to the lidocaine with epinephrine :shakiness and anxiety, lasts a short period of time, and is not permanent.  Tell us if you have this side effect, and we will use lidocaine without epinephrine the next insertion.
• Keloid scarring


As is usual for medicine , individual patients have a higher risk based on their medical history. Patients who are at higher risk for complications secondary to the pellet insertion procedure in patients who are:

• Diabetic
• Have an autoimmune disease
• Take steroids
• Have a clotting/bleeding disorder
• Keloid former
• If you have many allergies
• If you have orthopedic implants that require antibiotics at the dentist, then you should tell us so we can give you antibiotics.


Risks of taking testosterone pellets with BioBalance Health® in the first few weeks or months and are transient. These side effects usually resolve on their own without treatment.

 The transient risks of testosterone treatment include:

• Over the top sex drive=Hypersexuality
• Vaginal itching from increased blood flow—it is not an infection
• Facial hair and acne (Prevented with Spironolactone preventive treatment)
• Weight gain from muscle mass and sometimes from conversion of testosterone into estrone which is a genetic risk.
• Increased muscle mass that is confused with weight gain.
• Lowered voice is only a problem when you are a singer.  Generally, those who think they have a lowered voice really have reflux and it has nothing to do with testosterone pellets. 
• Clitoral enlargement—this is a reaction to a new testosterone exposure, and generally will go away in the following few months.
• Thinning of hair at the temples and crown (Prevented with Spironolactone preventive treatment)

Women can take testosterone without estrogen before menopause, and after menopause if requested, however the symptoms of menopause will not be completely resolved with testosterone only pellets.

The risks of estradiol pellets are higher for patients with a uterus, than those women who have had a hysterectomy.

Those women with a uterus have the following risks:

• Uterine bleeding, growth of fibroids: Estradiol of any kind - pellets, pills, patches etc. - can stimulate the uterus to bleed. This can come from a thick lining, adenomyosis (spongy uterus), or fibroids. Prescribing progesterone, optimally sub-lingual progesterone or BLA progesterone from Belmar pharmacy, taken 1-2 times a day, counteracts this. Other treatments are surgical and offered by your Gyn. Your doctor will evaluate you for treatments: uterine wall ablation (80% effective), or a Mirena IUD.