Bioidentical Hormones: Capsules, Creams, Pellets – Which is Best?
Bioidentical hormone therapy has become common today as both women and men are realizing its many benefits. They sleep better, have more energy and lose weight. Restoring and balancing hormones also improves mood and libido, and relieves PMS, hot flashes, depression and anxiety. It improves memory and helps get rid of brain fog.
Since more doctors are dabbling in bioidentical hormones and offering an array of options, we want to help give you the best information so that you can make an informed decision for your health. Many people ask “what’s the best dosage form for bioidentical hormones?” While pellet therapy has recently become popular with some doctors, is it really the best way to take bioidentical hormones? We don’t believe so, and here’s why.
Bioidentical Hormones
Bioidentical hormones have the exact molecular structure as hormones produced by your body, so when you restore them, your body knows what to do with them. Just as a key fits perfectly into the right keyhole, bioidentical hormones do the same in your cells. Research shows that hormonal decline is associated with loss of body function and increase in disease. Studies demonstrate that bioidentical hormone replacement therapy can improve sleep, fatigue, mood, cognitive function, bone mass, sexual function, muscle strength and body composition, and decrease inflammation. (1)
Methods of Bioidentical Hormone Delivery
While there are several methods of delivering bioidentical hormones to your body, today we will focus on three and explain why we believe capsules and creams are superior to pellet hormone therapy.
Capsules are able to deliver the exact dose that is prescribed by your doctor. You don’t have to rely on a “one size fits all” pill – you can take the dose that is needed for your particular health needs and symptoms. Capsules allow your doctor to individualize your dose and also make it easy to adjust your dose as you work with your doctor to find the right dose to alleviate your symptoms. With capsules, you can administer a higher dose than with creams.
Our doctors have experienced a lot of success with dispensing the bioidentical hormones in oral capsules. They have been pleased with the consistency of results and compliance that capsules allow, while our patients find them convenient and effective.
Creams, which deliver the hormones directly into your blood stream through your skin, may allow for lower absorption of hormones than capsules. Absorption depends upon time of year (humid or dry) and condition of your skin (hydrated, dry, irritated). All body sites are not as equally permeable. Application sites for the cream must be rotated, for instance, absorption could be different between the inner arm and inner thigh. The higher the dose you need, the more cream you have to apply to your body. So if you are needing a higher dose, then capsules may be the best fit for you.
Capsules vs. Creams
Choosing between capsules and creams depends on a few factors: a) the dose needed, b) the patient’s preference, and c) what works best. For those patients who have experience with bioidentical hormones in both capsules and creams, many have found better results by taking them orally. Conversely, some patients prefer creams.
With capsules and creams, if a woman still has symptoms of a hormone deficiency, then the doctor is able to increase the dose immediately so symptoms can be resolved in a matter of hours or days. If the dose is too high, then skipping a dose for a few days is usually all that is needed to eliminate symptoms.
Pellet Therapy
Pellet therapy involves implants that are placed under the skin that release hormones into your body. The pellets, which are a little larger than a grain of rice, contain hormones (either estradiol or testosterone) which are pressed or fused into very small cylinders. (Note that progesterone can’t be used in pellets because it dissolves too quickly.) Then pellets are inserted under the skin through a small incision (either lower abdomen or upper buttocks) with local anesthesia. The incision is then closed with sutures or sterile tape strips. The pellets are replaced approximately every 3 to 5 months. They do not need to be removed – they are dissolved by the body. Patients can begin to feel relief starting anywhere from 48 hours up to 2 weeks after the pellets are implanted.
Hormone Overdosing/Underdosing with Pellet Therapy
Pellet therapy has its limitations and is sub-optimal if the dose is delivered incorrectly. If too much is given, it cannot be removed. It requires frequent visits to the doctor and pellet placement.
These implants are supposed to release small doses of hormones consistently, however this is not always the result. If the dose is too high, then that person is stuck with the negative symptoms for several months until the pellets dissolve. For instance, doctors have witnessed a man who became so irritable from an overdose of testosterone pellets that he couldn’t interact with his clients. Some people need to take a leave of absence from pellets for this reason. If the dose is too low, then they could take supplemental hormones, however it would be challenging for a physician to know how much to add and the dosing would be guesswork.
Restrictions After Pellet Insertion
To avoid the pellets from working their way out of the body, there are post-op instructions one must follow. After the insertion of the pellets, vigorous physical activity, bathing and swimming should be avoided for approximately 5 days. A shower may be taken as long as the incision isn’t scrubbed until it is well healed, after about a week.
Side Effects of Pellet Therapy
Discomfort at the injection site for the first week
Minor bleeding
Bruising
Swelling
Discoloration of the skin
Infection
Pellet extrusion
Redness and itching at the implant site
Hormones can be tricky for a doctor to dose, so they must be knowledgeable and experienced with prescribing bioidentical hormone therapy. While it may sound more convenient to have pellets inserted once every few months rather than take pills or apply creams, doctors still need to know what they are doing. Pellet therapy seems to be a fad right now, “everyone is doing it,” but are they doing it right?
Since 1989, we’ve had great success in treating over 30,000 people with bioidentical capsules and creams. If you are ready to feel better and get rid of your negative symptoms, then contact a wellness consultant today at 281-698-8698 so we can start you on the path to wellness.
Related Content
Bioidentical Hormones – The Common Sense Solution
Top 10 Benefits of Testosterone
What Every Woman Should Know About Menopause Treatment
Research
1. Point/Counterpoint: The Case for Bioidentical Hormones
AMQ
Thank you – this was a well presented and informative article. It has helped me make a choice for my hormone care.
Carolyn Hills
I need a good hormone doctor. I was usi,g cream for 20 years after hysterectomy. Doctor said I was not absorbing it. Gave me a pellet and for 4 months my
My estrogen went sky high and had diarrhea. Back on the cream now my testosterone is sky high.
Need good hormone doctor.
Hotze Team
Dear Carolyn,
We will be happy to help you. Please call our wellness consultants for a complimentary wellness consultation at 281-698-8698.
To your health,
Hotze Team
Jan
So do I! In Wichita Ks!!
Dr. Chris Riegel
Pellets are a good alternative but I’ve found other ways to help patients besides the pellets or other creams. Check out my blog below for more information.
Debbie Lake-Hinkle
I’m in the DC area, in search of a very informed and knowledgeable wellness doctor. Please tell me, if you can make a few recommendations.
Hotze Team
Dear Debbie,
Thank you for your question. We only have a wellness center in West Houston, however, you would only need to come here in person for your first visit with the doctor, which is very comprehensive. Then after that, your follow-up appointments can be done over the phone.
If we may be of service to you, please contact our wellness consultants for a complimentary wellness consultation at 281-698-8698.
To your health,
Hotze Team
Gina `
Live in Vero Beach, FL and looking for a wellness consultant that take insurance. Any recommendations would be appreciated.
Hotze Team
Dear Gina,
Thank you for your question. Most doctors who treat naturally do not take insurance. We do not contract with insurance companies because to do so would not allow us to treat you naturally.
If we may be of service to you, please do not hesitate to call our wellness consultants for a complimentary consultation at 281-698-8698. We see people from all over the world, and you would only need to come here in person for your first comprehensive visit with the doctor. Follow-ups can be done over the phone.
To your health,
Hotze Team
Tab17@sbcglobal.net
just curious…I recently (about 4 months ago) had pellet inserted. I never felt any different. Except for the vaginal dryness. Now I’m due for another pellet insert and at 350.00 every 4 months it’s getting really expensive. Now I’m looking at the patch. I feel like they really pushed me on the pellets and everyone around is talking about how great they are. I’m looking for something that works and is financially affordable. Patch/capsules. Would the capsules be cheaper? Plus after the pellet insert they have to do blood work to see where my levels are. With doctors visit payment, pellets and blood work, I’ve got to find something more affordable.
Brenda Anderson
I get 50 mg. Estrogen, and 50 mg. Testosterone bio identical pellets, at 2 and half months my moods and headaches worsen! I read where progesterone could help , do they make a bio identical capsule of progestrone!?
Hotze Team
Dear Brenda,
Yes, bioidentical progesterone in capsule form is available. If the pellets don’t release the correct amount of hormones consistently, then you can have negative symptoms. It’s much more difficult to tweak your dose on pellets. Our doctors do not favor the pellet therapy. With capsules, our doctors can tweak your dose more quickly and adjust it so that you see relief of your symptoms.
Here is a good article on the many benefits of progesterone:
http://makeshift-worm.flywheelsites.com/2017/04/10-reasons-you-cant-live-without-progesterone/
If we may be of service to you, please contact our wellness consultants for a complimentary wellness consultation at 281-698-8698. Thank you for your question.
To your health,
Hotze Team
nancy
Hi Brenda, I read your situation about negative thinhgs with bioidenticos. I take progesterone 100mg pill and estrogen cream. one day I m stay sad other crying. I start one month ago. I don t know what to do…
Hotze Team
Dear Nancy,
100 mg is a large dose of progesterone. At Hotze Health & Wellness Center, our doctors individualize the dose according to each person’s needs. If that dose is too high for your body, it could cause symptoms. The fact that you are having symptoms tells us that you are not on the correct dose. Please contact our Wellness Consultants for a complimentary wellness consultation at 281-698-8698 and they will be happy to help you.
To your health,
Hotze Team
Sharon
I am currently on the Bio-Te pellet after full hysterectomy. I used the .075 patch successfully but thought a pellet would be more convenient. My prior testosterone level was 13. The Doctor told me the pellet was 300. At 6wks my follow up blood work showed my Testosterone level at 150. What is normal? I have no idea. I just know I’ve gained weight and feel swollen every day. Help!
Hotze Team
Dear Sharon,
Thank you for your question. The best way to tell if you are on the right dose of hormones is if your symptoms are resolved. The fact that you have gained weight and feel swollen is an indicator that you are not on the correct dose of hormones for you. The dose varies for each person’s individual needs.
The problem with the pellet therapy is that if they don’t release the correct amount of hormones consistently, then you can have negative symptoms. Also, if the amount of hormones that are being released are either too much or too little for what your body needs, then it is much more difficult to tweak your dose on pellets since you often have to wait weeks to remove the pellets. Our doctors do not favor the pellet therapy. With capsules, our doctors can tweak your dose more quickly and immediately and adjust it so that you see relief of your symptoms.
Please take our symptom checker to find out if you have other symptoms of hormone imbalance:
http://makeshift-worm.flywheelsites.com/symptom-checker/
If we may be of service to you, please contact our wellness consultants for a complimentary wellness consultation at 281-698-8698. We will be happy to help you!
To your health,
Hotze Team
Terri
I live in New Mexico and have taken bio-identical cream. Trial and error, I asked the doctor to separate the testosterone cream which I only add a tiny bit to my estrogen cream. I was loosing my hair with too much testosterone. Hope this helps.
Theresa Stewart
Hi my name is theresa I am of need of a bioidentical Dr in the nashville tn area.
Hotze Team
Dear Theresa,
Thank you for your question. We only have a center in Houston, yet we see people from all over the world. You only need to come here in person for your initial visit with the doctor for your comprehensive evaluation, and after that, your follow-up appointments may be done over the phone. If we may be of service to you, please call our wellness consultants for a complimentary consultation at 281-698-8698. Thank you!
To your health,
Hotze Team
Hotze Team
Dear Theresa,
We only have a wellness center in Houston, however we see patients from all over the world. You would only need to come here for your first visit with the doctor which is comprehensive. After that, follow ups may be done over the phone. If we may be of service to you, please contact our wellness consultants at 281-698-8698 for a complimentary consultation.
To your health,
Hotze Team
Hotze Team
Dear Theresa,
We only have a wellness center in Houston, however we see patients from all over the world. You would only need to come here for your first visit with the doctor which is comprehensive. After that, follow ups may be done over the phone. If we may be of service to you, please contact our wellness consultants at 281-698-8698 for a complimentary consultation.
To your health,
Hotze Team
karen
I just had my testosterone level checked and it is a 7. Im a 53 year old woman and had a partial hysterectomy at 40. Isn’t that a pretty low level? I have depression, no libido, and mood swings
Hotze Team
Dear Karen,
Thank you for your question. Our doctors focus primarily on symptoms to determine what is going on with your hormones. If you are still having depression, no libido and mood swings, then your hormones are still not at their optimal levels for you – which could possibly include your testosterone, estrogen, progesterone and thyroid hormones. Your symptoms are telling you that something is still not in balance. Here is a good article to help explain this: http://makeshift-worm.flywheelsites.com/2017/07/what-happens-to-your-hormones-after-a-hysterectomy/
Please take our symptom checker quiz to help determine what could be the cause of your symptoms: http://makeshift-worm.flywheelsites.com/symptom-checker/
If we may be of service to you, please contact a wellness consultant for a complimentary wellness consultation at 281-698-8698. We will be happy to help you.
To your health,
Hotze Team
Marie
I had a full hysterectomy 1 year and half ago. I opted out of HRT due to family history of cancer. Now I am experiencing severe bladder incontinence, it happened 2 months after my year anniversary of hysterectomy. My doctor prescribe vaginal estrogren to help. I am concerned of cancer if I take this. He also suggested estrogren oral for my hair, skin, and bone concerns. I am at a loss of what to do.
Susan
Please help i am from South Africa my dr. put me on Premarin 0.625 i have severe cramps in my calves. I am 62 at 59 they removed my uterus and overasies i complain about the cramps he described magnesuim and potasuim that did not help. I just read your article and there i saw my problem with the premarin. How long must i use hormones ? now for the rest of my life. Please send me a name for that biiodentical capsule. Thanks for your help
Hotze Team
Dear Susan,
We are so sorry to hear about your cramps. Magnesium can help with cramps. It comes in capsule, tablet, liquid or transdermal gel form (www.HotzeVitamins.com) You are also correct that Premarin can cause leg cramps. Our doctors do not recommend Premarin, which is horse estrogen. They recommend bioidentical hormones that are identical to your human hormones. We would recommend working with your doctor to switch to bioidentical estrogen. Here is an article that may be helpful: http://makeshift-worm.flywheelsites.com/2017/07/what-you-need-to-know-about-hormone-replacement-therapy-for-menopause/
For your consideration, we do see patients from all over the world. You would only need to come here in person for your first comprehensive visit with the doctor, then you follow-up appointments may be done over the phone. If you would like a complimentary wellness consultation, please call us at 281-698-8698 and we will be happy to help.
To your health,
Hotze Team
Renee
I’m considering pellets and am currently on 100mg Progesterone at bedtime, BioTe cream once a day 3Est/4Test, plus all the recommended supplements….mag, K2, D3, etc . I’m 43 and postmenopause. Prior to cream/prog pill, Testosterone was a 6 as well as pretty much non existent estrogen. This has cured night sweats and creepy skin as well as given me some energy. However, I’m still lacking in libido. I’m not having any bad side effects from the cream or progesterone bioTe pills. Any suggestions on the libido piece while using the cream?
Hotze Team
Dear Renee,
Thank you for your question. It may be possible that your hormones are not at their optimal levels or balance yet, however you would need to be evaluated by a doctor. The best way to know is to evaluate your symptoms: http://makeshift-worm.flywheelsites.com/symptom-checker/
Here is an article that may be helpful, as well: http://makeshift-worm.flywheelsites.com/2018/02/how-womens-hormones-affect-libido/
If we may be of service to you, please call our Wellness Consultants for a complimentary wellness consultation at 281-698-8698. We will be happy to help you.
To your health,
Hotze Team
Linda
I am 74 years old and had a full historectomy 20 years ago. I never took any hormones. Gradually over the years I have have major problems with bladder muscle control, energy and sleep problems. I have finally realized it may be due to lack of hormones. Where do I start to get help. I really would not be able to go too far to have an appointment.
Gradually over th
Jennifer Johnson
Dear Linda,
Thank you for your comment. A hysterectomy puts you into menopause and you have a drop in your hormones, which can cause your symptoms. Here is an article that may be helpful: http://makeshift-worm.flywheelsites.com/2016/07/what-your-doctor-wont-tell-you-about-having-a-hysterectomy/
Please take our symptom checker to help identify what symptoms could be caused by hormone imbalance: http://makeshift-worm.flywheelsites.com/symptom-checker/
If we may be of service to you, please contact our Wellness Consultants for a complimentary wellness consultation at 281-698-8698. You would only need to come here in person to Houston for your first comprehensive visit with the doctor, then after that your follow-up visits may be done over the phone. It would be our privilege to serve you.
To your health,
Hotze Team
Hotze Team
Dear Linda,
Thank you for your comment. A hysterectomy puts you into menopause and you have a drop in your hormones, which can cause your symptoms. Here is an article that may be helpful: http://makeshift-worm.flywheelsites.com/2016/07/what-your-doctor-wont-tell-you-about-having-a-hysterectomy/
Please take our symptom checker to help identify what symptoms could be caused by hormone imbalance: http://makeshift-worm.flywheelsites.com/symptom-checker/
If we may be of service to you, please contact our Wellness Consultants for a complimentary wellness consultation at 281-698-8698. You would only need to come here in person to Houston for your first comprehensive visit with the doctor, then after that your follow-up visits may be done over the phone. It would be our privilege to serve you.
To your health,
Hotze Team
hormone pellet insertion
This is the most honest information that has been published on this topic so far!
Sue
Hi I have been getting biote pellets for about 6 months now. 2 weeks after my last insertion I developed numbness to my extremities. Sometimes my entire arm or leg will be numb. Even my face /tongue at times goes numb. No deficits thankfully just numb/burning. I have gone through extensive testing and it is nothing neurological or autoimmune related. Do yo I think could be the hormones? The doctor that I got them from kept insisting it is not a side effect. She even told me at a level of 197 that I should need a boost …
Pamela Karasy
Consider Vitamin B12 injections for peripheral neuropathy. Estrogen depletes B12.
bb73034
50 yr old, menopausal since 1998, never took birth control or hormone replacement, great health, hypothyroid.
On 3/5/2018 Sottopelle inserted. Testosterone 20 ng/dl on 3/2/2018. Testosterone 242 ng/dl on 4/18/2018. I rendered a release of medical records on 5/22/2018 of which my doctor will not release to me or another doctor. The gyno’s I have conacted require the medical records for me to set an appointment. More than half the hair on my head has fallen out and the edema in both legs, one arm and stomach does not decrease overnight any longer. 3/2018 115lbs, 5/22/2018 130lbs, never hungry-just a couple bites fill me up. Suggestions would be helpful as what to do.
Hotze Team
Thank you for reaching out to us. Your symptoms are an indication that you are not getting the right dose of hormones for your body’s needs. Our doctors would recommend switching to capsules and creams so that the dose can be specifically formulated for your needs. The pellet therapy is not recommended by our doctors. Take our symptoms checker to see what could be going on: http://makeshift-worm.flywheelsites.com/symptom-checker/
Please contact our Wellness Consultants for a complimentary wellness consultation at 281-698-8698. We will be happy to serve you.
To your health,
Hotze Team
Lisa
Do the pellets last longer than the capsules? I know that the pellets are inserted every 3-4 months…How long do the capsules last?
Jennifer Johnson
Dear Lisa,
Thank you for your question. It’s not a matter of one method lasting longer than the other. With the pellets, you are basically inserting 3-4 months worth of hormones into your body that are supposed to be released appropriately over that time. With capsules, you most likely would take a capsule everyday with exactly the correct dose your doctor prescribed you. With pellets, there is no guarantee that the right amount of hormones will be released. Often too much is released and women have horrible symptoms such as hair loss, hair growth on the chest, and more. Our doctors highly recommend the capsules and creams over the pellets.
If we may be of service to you, please call our Wellness Consultants for a complimentary consultation at 281-698-8698. It would be our privilege to serve you.
To your health,
Hotze Team
Hotze Team
Dear Lisa,
Thank you for your question. It’s not a matter of one method lasting longer than the other. With the pellets, you are basically inserting 3-4 months worth of hormones into your body that are supposed to be released appropriately over that time. With capsules, you most likely would take a capsule everyday with exactly the correct dose your doctor prescribed you. With pellets, there is no guarantee that the right amount of hormones will be released. Often too much is released and women have horrible symptoms such as hair loss, hair growth on the chest, and more. Our doctors highly recommend the capsules and creams over the pellets.
If we may be of service to you, please call our Wellness Consultants for a complimentary consultation at 281-698-8698. It would be our privilege to serve you.
To your health,
Hotze Team
Suzanne B.
I’m currently on BIOTE Therapy pellets, 2 yrs. After the second round it has been impossible to get them regulated. I have blood drawn every 6mos. The last round My testosterone and estrogens levels were high, also Thyroid was high. I have hypothyroid issues and was taking 120mg of Nature Throid daily. They reduced it and now have me alternating 120mg and 90mg to bring levels back down. I’m due for Bloodwork on Thyroid to check levels. I have not had a round of pellets that made me feel as good as my second round. The Third round I started having issues having a orgasm, either it took too long or my clitoris started to hurt, this continues still. . I get them every 5-6mos. Starting to get frustrated.. My next insertion is due Jan. Or Feb. The cost is starting to get unreachable. Should I continue these? What would a consultation cost me?
Hotze Team
Dear Suzanne,
Thank you for your question. Our doctors do not believe that the pellets are the best method of bioidentical hormone therapy. You cannot control how much hormones are released into your system over time – and if you get too much or too little for your body’s needs, you will have negative symptoms. Our doctor rely heavily on the symptoms a person is experiencing, not on bloodwork levels alone. Our doctors are able to prescribe the exact dose for your needs, and it can be adjusted easily each day – you don’t have to wait 5 months to try again.
Please take our symptom checker quiz here: http://makeshift-worm.flywheelsites.com/symptom-checker/
If we may be of service to you, please call our Wellness Consultants for a complimentary wellness consultation at 281-698-8698. Thank you!
To your health,
Hotze Team
Kim
I have been on pellets (AZ and now HI) and creams while living in Toronto. For me the pellets were superior… just my 2 cents.
Lee Williams
I’m interested in bioidentical therapy but can a man get capsules?
Hotze Team
Dear Lee,
Yes, our pharmacy does compound testosterone capsules. If you would like a complimentary consultation, please call us at 281-698-8698 and we will be happy to tell you about our treatment program. Thank you for reaching out to us!
To your health,
Hotze Team
April
Hello! I’m 37 and have had 2 rounds of the Biote pellets. My testosterone was super low when my blood work was done, so that was the main focus..boosting my testosterone. I loved the idea of the pellets and couldn’t wait to try them out. My biggest complaints prior to getting them was my non existent sex drive and lack of energy. The first insertion I felt no difference. I was hesitant about a second round but my dr assured me that it sometimes takes a couple insertions before you feel the benefits. So in December I had my 2nd pellet insertion. I know she boosted my testosterone even more on that 2nd one. The first month was horrible. I was moody and irritable constantly. That has subsided but I have not felt any different. Still no sex drive. I am disappointed and will not get another pellet. However, I still have a fairly large lump at the insertion site. Its starting to worry me because it’s been over 3 months since the insertion and I would’ve thought the lump would go away as it did the first time. It has not reduced in size at all. Has anyone else had this issue?