Hormone implants and pellets: the honest picture

You may have heard of hormone pellets, sometimes called implants: small pellets of oestrogen, and sometimes testosterone, placed under the skin to release hormone slowly over several months. They are popular in some countries, particularly the United States, and women who have had them often speak highly of them. They are a genuine treatment with a long history in the UK. They also carry some specific caveats, and being honest about those matters more than the novelty.

What they are and how they work

A pellet is inserted under local anaesthetic into the fatty tissue, usually of the lower abdomen or buttock, in a few minutes. Over the following four to six months it releases hormone steadily, and then it is replaced. The appeal is obvious: nothing to apply or remember each day. For some women that convenience is a real advantage.

The caveats, plainly

There are three things an honest account has to include.

The first is supply. The pellets used in the UK are imported and unlicensed, and at present their supply is restricted and running down, so this is not something we can reliably start for new patients right now. That may change if a licensed product becomes available, and we will say so if it does.

The second is dosing. The version of pellets marketed heavily in the United States is often custom-compounded to high doses, well above the levels your body would naturally produce. UK menopause specialists and regulators advise against that approach. Very high hormone levels can cause side effects, and a particular problem is that symptoms can return before the next pellet is due, which tempts ever more frequent dosing. We do not offer compounded high-dose pellets.

The third is that a pellet cannot be removed. Once it is in, it releases its hormone until it is finished. If a side effect develops, you cannot simply stop, as you could by taking off a patch. That is why careful dosing and monitoring of hormone levels matter so much with this method.

Where this leaves pellets

None of this means pellets are bad. Properly sourced, sensibly dosed, and monitored with blood tests, they are a legitimate option, and we keep them on our menu for when reliable, appropriately dosed product is available. What we will not do is offer the high-dose compounded version, or imply that pellets are a shortcut to feeling permanently younger. They are one way of delivering hormones, with particular pros and cons, and they suit some women and not others.

The everyday alternative

For most women who like the idea of not thinking about HRT daily, a patch changed once or twice a week delivers oestrogen through the skin with the same safety advantages as a gel and none of the supply or irreversibility issues of a pellet. It is worth knowing that the convenience that draws people to pellets is largely available in a simpler form.

If you have had pellets abroad and want to continue care in the UK, a GP with specific menopause expertise can review what you were on, check your levels, and help you move to a sustainable plan.

Read next

• body identical hrt explained

• bioidentical hormones what the word means

• testosterone for women

Ready to start?

If you want to move from reading to acting, the next step is a short assessment with a GP who has specific menopause expertise. It takes about ten minutes and tells you what will help.

Begin your assessment at this link. Online or in person at Westfield London.