Pellets, Injections, Creams, and Pills: Which Hormone Medium is Best for Me?

Hormone replacement therapy (HRT) is a type of medical treatment that helps rebalance and replenish one’s hormone levels. Hormones control and influence nearly all bodily functions, including growth, mood, energy levels, and even reproduction. When undergoing hormone replacement therapy, patients can address their symptoms through several different means. However, these options can be overwhelming and confusing for many. This comprehensive guide will help each patient learn more about hormone replacement therapy and each medium we offer, including pellets, injections, creams, and pills.

Dr. Amit Rajguru is board-certified in Internal Medicine and fellowship-trained in Anti-Aging, Regenerative, and Functional Medicine (A4M). He has more than 30 years of experience and knowledge in the newest techniques and technologies to help each patient improve their health effectively.

To schedule a personal consultation with Dr. Rajguru at our Walnut Creek office, please contact us by submitting our online contact form or calling (925) 433-8444.

About Hormone Replacement Therapy

Hormone replacement therapy focuses on restoring one’s hormonal balance by adjusting their estrogen, testosterone, or progesterone levels. When someone has a hormonal imbalance, it can diminish their daily comfort and lead to symptoms like weight gain, headaches, fatigue, and more. Dr. Rajguru offers many different types of treatments and application mediums for both HRT in men and HRT in women.

About Our Hormone Mediums

Hormone Pellets

Hormone pellets are small, rice-sized implants containing bioidentical testosterone or estrogen, der.ived from plant sources and compounded to match the molecular structure of hormones the body produces naturally. Inserted subcutaneously near the hip in a brief in-office procedure, pellets release hormones gradually over three to six months — eliminating the need for daily dosing or weekly injections. This delivery method is particularly well-suited for patients who want consistent hormone levels without the peaks and troughs associated with injections, or for those who find daily compliance with creams or pills difficult to maintain. Pellets are a common choice for women managing menopausal symptoms and for men on testosterone therapy who prefer a low-maintenance protocol.

Hormone Injections

Hormone injections deliver bioidentical hormones subcutaneously or intramuscularly, where they are gradually absorbed into systemic circulation. Injections produce higher overall hormone levels than topical methods and allow for precise dose adjustability — making them well-suited for testosterone therapy in men, patients who require more significant hormonal correction, or those who have not absorbed creams consistently. Most patients self-administer weekly at home after an initial training session at Evolved Medical. The tradeoff compared to pellets is a less noticeable fluctuation in hormone levels across the dosing cycle.

Hormone Creams

Hormone creams are applied directly to the skin — typically areas such as the shoulders, hips, inner wrist or inner arm — where hormones are absorbed transdermally into systemic circulation. Creams provide a gradual, steady hormone delivery and are a reasonable option for patients who prefer to avoid injections or procedures. Absorption can vary between individuals based on skin thickness, application site, and consistency of use, which is why follow-up lab monitoring is important to confirm adequate levels. Creams are most commonly used for estrogen and progesterone in women, and for patients who require lower or more finely titrated doses..

Hormone Pills

Oral hormone medications are taken daily and pass through the digestive tract and liver before entering systemic circulation — a process known as the first-pass effect. This hepatic metabolism means that oral hormones, particularly oral estrogen, can affect liver protein production and clotting factors in ways that other delivery methods do not. For this reason, oral estrogen is generally not the preferred option for patients with cardiovascular risk factors or clotting concerns. Oral progesterone, however, is commonly used and well-tolerated, and its mild sedative effect can be advantageous for patients with sleep difficulties. Pills are the simplest delivery method logistically but require daily adherence and carry route-specific considerations that are reviewed during consultation. ⁽²⁾

Benefits

Hormone replacement therapy can offer a multitude of benefits for patients experiencing hormonal imbalances, some of which include:

Candidates

Anyone interested in improving their overall energy levels, mood, libido, hair loss, or difficulties with sleep may be a suitable candidate for hormone replacement therapy. Women experiencing hot flashes, night sweats, and other symptoms of menopause may also make suitable candidates. Patients interested in lowering and maintaining a stable weight may also find our treatments beneficial. Interested candidates should be in good overall health and free from any estrogen-sensitive conditions. Dr. Rajguru will determine each patient’s candidacy for hormone replacement therapy during their consultation.

Personal Consultation

Every treatment at Evolved Medical begins with a personal consultation with Dr. Rajguru, where he will converse with each patient about their lifestyle, medical history, and any concerns they may have. He will also take a blood sample to analyze baseline hormone levels. Using this information, he will tailor a treatment plan to the patient’s health needs. Dr. Rajguru may also recommend additional treatments if he feels they will enhance treatment outcomes. We encourage each patient to prepare and ask any questions about their treatment or hormones in general, as this consultation is designed to be informative and collaborative.

To schedule a personal consultation at our office in Walnut Creek, please contact us online. To speak to a member of our team or schedule a consultation over the phone, please call (925) 433-8444.

Procedure

Upon arrival at our clinic, a team member will bring each patient to a private room for their treatment. Dr. Rajguru will then either guide patients on how to self-administer their treatment or administer the treatment directly.

Hormone Pellets

Hormone pellet therapy is one of the safest and most effective methods of hormone replacement available. Upon arrival at our office, each patient will receive local anesthesia at their pellet insertion site to enhance their comfort. Dr. Rajguru will make a small incision near each patient’s hip, then deposit the necessary amount of pellets for your dosage. Patients will not be able to feel these pellets, but they will begin releasing hormones into the bloodstream on their own.

Hormone Injections

Hormone injections balance hormone levels by injecting specially-formulated solutions directly into the bloodstream. Dr. Rajguru will teach each patient how to administer these shots either into the muscle or under the skin. Patients typically self-administer their hormone injections every week in the comfort of their home, reducing the need to return to the office.

Hormone Creams

Hormone creams deliver hormones through the skin. Patients self-apply these creams regularly, allowing them to address their concerns without injections or incisions.

Hormone Pills

Patients take hormone pills each day, providing an easy way to implement hormone replacement therapy into daily life.

Recovery & Results

Each patient’s recovery will vary, depending on the treatment received. Recovery is minimal, with many patients being able to return to their daily routine immediately after treatment. Patients who received hormonal pellets or injections may experience mild bruising or tenderness for the first several days of healing. However, these effects typically subside on their own. Those choosing to use a hormone cream or pills will not have any downtime or recovery, but they will need to consistently use their treatment for it to be effective. Dr. Rajguru will provide each patient with more detailed recovery instructions during their consultation.

After a prolonged period of regular use, patients will notice the effects of their treatment. Many experience an improvement in their energy levels, mood, and intimate lives, as well as an enhancement in their sleeping habits and patterns. Many women also report alleviated menopausal symptoms. Each of these benefits can lead to an improvement in each patient’s daily comfort, with results that can last for years. ⁽³⁾

Cost of Hormone Replacement Therapy in Walnut Creek

The pricing of each patient’s hormone replacement therapy will vary depending on the type of treatment. Dr. Rajguru will discuss the cost of each treatment during the personal consultation.

To schedule a personal consultation and learn more about the cost of your hormone replacement therapy, please contact Evolved Medical by filling in our online contact form or calling (925) 433-8444.

FAQ

References

1. Files JA, Ko MG, Pruthi S. Bioidentical Hormone Therapy. Mayo Clinic Proceedings. 2011;86(7):673-680. doi:https://doi.org/10.4065/mcp.2010.0714
2. Herman TF, Santos C. First Pass Effect. PubMed. Published November 3, 2023. https://www.ncbi.nlm.nih.gov/books/NBK551679/
3. Harper-Harrison G, Carlson K, Shanahan MM. Hormone Replacement Therapy. Nih.gov. Published October 6, 2024. https://www.ncbi.nlm.nih.gov/books/NBK493191/#article-22996.s6