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Are Hormone Pellets Better Than Creams?

Are Hormone Pellets Better Than Creams?

By Dr. Patrick Lovegrove Medically Reviewed by Lindsay Langley, BSN, RN, CHT
Posted Wednesday, December 13th, 2023
Are Hormone Pellets Better Than Creams

Hormone replacement therapy (HRT) forms a key part of many health regimens, particularly in managing symptoms of menopause and andropause. Many forms of HRT exist, including hormone pellets and creams. Deciding which method of administration suits you best requires understanding what each method entails and how they compare.

Understanding Hormone Replacement Therapy (HRT)

Hormone Replacement Therapy (HRT), also known as menopausal hormone therapy, can help relieve sweating, hot flashes, and other menopause symptoms. It also helps stop osteoporosis, a disease that makes bones weak and brittle. Individual hormonal needs are unique. As such, hormone doses are rarely a one-size-fits-all solution. It is where customization becomes important, and forms like pellets and creams come into play. They offer better customization options compared to other forms like pills and patches.

Explanation of hormone pellets and creams

Hormone Pellets: Hormone pellets are tiny, compact cylinders containing bioidentical hormones. A healthcare provider inserts the pellets subcutaneously (under the skin), typically in the hip region, during an outpatient procedure. The pellets release hormones into the bloodstream slowly and consistently, maintaining a balanced hormone level for 3-6 months, depending on a person’s metabolism and body chemistry.

Hormone Creams: Hormone creams are topical applications of bioidentical hormones. The body absorbs these hormones through the skin. Users typically apply these creams once or twice daily to maintain balanced hormone levels. The dosage and frequency can be adjusted, providing flexibility.

When comparing pellets versus creams, one should consider several factors:

• Consistency: Pellets provide more consistent hormone levels due to their slow and sustained release, while creams might experience peak and trough effects due to twice-daily application.

• Convenience: Pellets, lasting for several months, are less of a hassle than applying creams daily.

• Bioavailability: Pellets ensure 100% absorption since they are inserted directly under the skin, while creams’ absorption rates vary.• Personal Preference: Some might prefer the minimally invasive procedure of pellets. In contrast, others might prefer the non-invasive nature of creams.

Ultimately, the choice between hormone pellets and creams depends largely on individual preference, lifestyle, and the recommendation of healthcare providers. As such, it is vital to consult with a healthcare practitioner about the best form of HRT for your unique needs.

Hormone Pellets

Hormone pellet therapy has been around for over 70 years. It is slowly gaining popularity as a convenient, long-lasting hormone replacement therapy (HRT) option.

Benefits of Hormone Pellet Therapy

Consistent Hormone Delivery: One of the significant benefits is the consistency they offer. Unlike creams, gels, or injections, hormone pellets deliver a steady and controlled hormone dose throughout the day, eliminating the hormonal peaks and valleys associated with other methods.

Proven Efficacy: Hormone pellet therapy has been proven to help with various conditions like menopause symptoms, bone density loss, sexual dysfunction, mood disorders, and other conditions related to hormone deficiency.

Long-lasting: When testosterone or estrogen pellets are inserted, they gradually dissolve into the body throughout 3 to 6 months, rarely requiring a re-dose within this period, unlike daily applications or weekly injections of creams or gels.

Efficacy and Absorption of Hormone Pellets

The use of hormone pellets has been shown to provide effective hormonal balance. Because of their small size and placement under the skin, pellets allow hormones to be easily absorbed into the bloodstream over an extended period. With pellets, the body works in a way that it utilizes hormones at its pace and as needed. On the other hand, in the case of creams and gels, the absorbed concentration of hormones can fluctuate depending on factors like skin absorption levels, daily activities, and whether the patient remembers to apply it regularly. 

Side Effects: It’s worth noting that, like all other forms of hormone therapy, pellet therapy may come with its risks. Though considered safe, slight bruising and swelling can occur where the Pellet is inserted. Some may experience increased hair growth or acne. Blood clots and breast cancer are rare but more dangerous side effects. It is always advisable to consult with a healthcare professional before starting any hormone replacement therapy.

In conclusion, while both hormone pellets and creams have advantages, pellets have an edge regarding predictable and sustained hormone delivery. However, individual preferences, health status, and thorough consultation with a doctor would determine the best choice for each person.

Whether you opt for pellets or creams, hormone therapy is highly individual, and what works best for one person might not work for another. Lean on your healthcare provider’s expertise to guide you through this decision-making process.

Hormone Creams

Often referred to as topical hormones, hormone creams are used regularly to manage the symptoms of hormone imbalance.

Benefits of Hormone Creams

Hormone creams provide a significant number of benefits that include:

  • Easy to Use: Hormone creams can be applied directly on the skin, making their usage straightforward.
  • Flexibility: The dosage of hormone creams can easily be adjusted.
  • Bioidentical: Bioidentical hormones are found in a lot of hormone creams. These hormones are very close to the hormones that the body makes on its own.

Efficacy and Absorption of Hormone Creams

The efficacy of hormone creams relies on their absorption into the body. Cream must be absorbed effectively to provide the expected benefit, leading to consistent results.

Proper absorption plays a crucial role in the effectiveness of the cream. The absorption can be affected by several factors:

  • Skin Thickness: The level at which skin can absorb a hormone cream varies, depending on its thickness and overall health.
  • Formulation: The type of hormone, its concentration, and the other ingredients in the cream influence its absorption.
  • Placement: Application on different body areas can also affect hormone absorption.

Here is a simplified comparison between hormone pellets and creams:

Treatment Type




Hormone Pellets

Insertion under skin

Steady release


Hormone Creams

Topical application



While hormone creams provide a more flexible and easily adjustable solution for hormone replacement therapy, their absorption and, consequently, their efficacy can be unpredictable. On the other hand, hormone pellets offer a steady release of hormones but lack the flexibility of dosage adjustment.

In conclusion, whether hormone pellets are better than creams depends largely on the individual’s specific requirements and their body’s response to the treatment method. Always consult a healthcare provider before deciding on the best method. Stay informed about hormone treatment options and updated on the latest developments.

Comparing Hormone Pellets and Creams

When it comes to hormone replacement therapy, two popular forms of treatment are hormone pellets and creams. After consulting with your healthcare provider, it’s essential to consider each method’s effectiveness, absorption rates, symptom relief, convenience, ease of use, safety, and side effects.

Comparison of Effectiveness and Absorption Rates

Hormone Pellets: These small slow-release tablets, implanted under your skin, are known for consistently delivering hormones like estrogen, testosterone, and progesterone. They offer steady hormone levels and provide a more predictable absorption rate.

Hormone Creams: Transdermal applications such as hormone creams can be similarly effective but may present more variation regarding hormone absorption. It could be due to the application location, skin thickness, and fat tissue amount.

Effectiveness in Symptom Relief

Hormone Pellets: Many patients report adequate symptom relief, including improved mood, increased energy levels, weight loss, and improved sexual drive when using pellets.

Hormone Creams: Some people find creams to give rapid symptom relief. However, consistency in relief might occur if applications are not included.

Convenience and Ease of Use

Hormone Pellets: Pellets must only be inserted every three to six months. After insertion, their invisible and intangible nature contributes to continuous, worry-free hormone delivery.

Hormone Creams: Creams, however, require daily application, which could become tedious.

Safety and Side Effects

Both methods are considered relatively safe when administered under expert care.


Hormone Pellet’s side effects might include minor surgical risks like infection or pellets coming out.

Hormone Cream’s common side effects include skin irritation or discoloration at the application site.

Hormone Pellets

Hormone Creams


More Predictable


Symptom Relief


Possibly Variable


Every 3-6 months



Minor surgical risks

Skin irritation

In conclusion, the decision to use hormone pellets or creams ultimately depends on an individual’s needs, lifestyle, and personal preferences. Discussing these aspects with your healthcare provider to find the best option for you is essential.

Patient Preferences and Considerations

When deciding on hormone replacement therapy (HRT), every individual has unique needs, preferences, and factors to consider. That’s why discussing all HRT options with a qualified healthcare provider is critical. Generally, patients consider factors like ease of use, cost, and possible side effects when deciding on the best HRT method. Let’s look at some of these considerations as we compare hormone pellets and creams.

Factors to Consider When Deciding on Hormone Replacement Method

Easiness of Use:

HRT methods like creams require daily application, sometimes time-consuming and inconvenient. On the contrary, hormone pellets must only be inserted once every few months via a minor in-office procedure.


The cost can be an influential factor when deciding on HRT. Bio-identical hormone replacement therapy (BHRT) creams are usually less expensive than pellets; however, it’s essential to consider that pellets provide a more sustained hormone release, making them cost-effective in the long run.

Potential Side Effects: While hormone pellets and creams can effectively manage hormonal imbalance symptoms, their potential for side effects can vary. For instance, some patients may experience skin irritation from creams. At the same time, pellets can sometimes lead to minor bruising or discomfort at the insertion site.

Here is a quick comparison to summarize these considerations:




Easiness of Use

Requires daily application and can be time-consuming

Need to be inserted only once every few months


Generally less expensive upfront but requires the frequent purchase

More expensive upfront but provides sustained hormone release

Potential Side Effects

Some people may get skin discomfort from it.

It can lead to minor bruising or discomfort at the insertion site.

In conclusion, both hormone pellets and creams have their pros and cons. It all comes down to individual needs, lifestyles, and preferences. One should discuss their symptoms, medical history, and personal comfort with these options with a healthcare provider to determine the best course of hormone replacement therapy suitable for them. Remember that taking control of one’s health is an important and highly personal decision. Take the time needed to make the best decision for your circumstances.


There is no one-size-fits-all answer for hormone replacement therapy (HRT). Both hormone pellets and creams have their strengths and drawbacks. Making an informed decision between pellets and creams requires a detailed understanding of an individual’s needs, lifestyle, and the unique advantages each method brings.

Key Points to Consider When Choosing Between Hormone Pellets and Creams

The choice between hormone pellets and creams typically depends on a variety of factors, such as:

• Consistency:  One edge that pellets may have over creams is ensuring a constant supply of hormones. Since pellets are implanted under the skin, they continuously release hormones, ensuring a steady level without the daily fluctuations that might come with creams.

• Convenience:  Creams are applied daily, which might not be as convenient for some individuals. On the other hand, pellets only need to be implanted every 3-6 months.

• Sensitivity:  Creams may not be best for people with certain skin conditions or sensitivities, as they might experience irritation. For such individuals, pellets might be the more suitable option.

• Cost:  The initial cost of pellets can be higher than creams since the procedure needs to be carried out by a healthcare provider. However, creams may be a more economical upfront choice but might increase in cost over time due to daily use.

Finding the Right Hormone Replacement Method for You

Determining the ‘best’ method of hormone replacement therapy is ultimately a personal decision that should be made in consultation with a healthcare professional. Remember, what works best for one person may not be the right choice for another.

Getting a full medical checkup, learning about all the possible risks and benefits, and having a detailed conversation with your doctor can help you choose the best way to replace your hormones.

Whether that’s a pellet or a cream, the crucial aspect is that it should align with your lifestyle and overall health condition and balance your hormones effectively. After all, hormone replacement therapy’s primary goal is to help you lead a healthier and more comfortable life.

Finally, monitor your symptoms and how you feel throughout the treatment. Don’t hesitate to address any concerns with your healthcare provider. Remember, hormone replacement therapy is personal, and finding the right method for you is essential to that journey.

About the author

Dr. Patrick Lovegrove