Hormone Replacement Therapy: Pellet vs. Injection

Deciding between pellet and injection hormone replacement therapy is important because while they both can bring restorative balance to your hormonal levels, one might better satisfy your personal preferences. As we age, much like every other part of our body, our endocrine system gradually becomes less productive and more prone to imbalances. For men and women, this steady decline in available hormones can have adverse effects on our health and well-being. To refortify your endocrine system, Dr. Christopher Asandra employs hormone replacement therapy, a restorative treatment to bring renewed harmony to your hormonal levels. He does so through either pellets or injections. Understanding the differences and advantages between the two is crucial for maximizing your hormone replacement plan. 

If you would like to schedule a personal consultation, Dr. Asandra can check your hormone levels and then proceed with the best treatment route for you. To reach our offices directly please call (424) 542-8881.

Different Levels, Same Hormones

While it is commonly understood that testosterone is the dominant hormone in men as estrogen and progesterone are for women, both sexes share these same hormones – although their levels differ vastly. In fact, progesterone in men helps maintain natural testosterone levels, a healthy immune and cardiovascular system, and moderate a balanced weight,[1] whereas testosterone is often prescribed to postmenopausal women to raise their libido, mood, natural hair growth, and overall wellbeing.[2] Although one sex has a higher level of one hormone, all of these work congruently with each other to round out a person’s health and happiness. However, when one of these is out of sync with the others, the entire endocrine system can become disrupted.

Signs of Imbalanced Hormones


Low hormones in men can cause various physiological concerns that can harm their physical and mental well-being. Signs of low testosterone in men include:[1]

  • Decreased mobility
  • Low energy
  • Loss of muscle mass
  • Depressive moods
  • Erectile dysfunction
  • Low libido
  • Loss of focus


While a man’s hormones only naturally spike during puberty, a woman’s can spike multiple times throughout her life, mainly during puberty, pregnancy, and menopause. Signs of a hormone imbalance in women include:[2]

  • Decreased bone density 
  • Weight changes
  • Low energy
  • Restless sleep
  • Hot flashes
  • Mood swings
  • Brain fog
  • Decreased libido
  • Vaginial dryness

Rebalancing Your Hormone Levels

Hormones in men and women play pivotal roles in a person’s growth and development through the stages of life. From the onset of puberty to the latter part of our golden years, fluctuating hormonal levels can affect our body’s ability to keep up with the rigors of life. Resulting from natural aging, genetic makeup, or dietary and lifestyle choice, imbalanced hormone levels can lead to many health concerns. However, through hormone replacement therapy (HRT), Dr. Asandra can restore your body’s natural hormone supply and reverse the aforementioned symptoms. When you receive HRT at AsandraMD, Dr. Asandra will recommend either pellet or injection therapy. Understanding the difference between the two is important as you continue this journey to a more rejuvenated, vibrant you.


Hormone pellets are rice-sized capsules inserted under the skin in the hip area. Depending on your treatment plan, these pellets will secrete the right amount of your deficient hormones over the next 3-4 months to balance your hormone levels. Made up of naturally-occurring elements that are safely absorbed into the body, these pellets dissipate over the coming months. Once the pellet has been fully absorbed, you will see Dr. Asandra again for another session where he will reintroduce another round of pellets into the same area. Many patients choose pellets because of the ease of only having to come into our offices every few months.[3]


The alternative to subcutaneous pellets is intramuscular injections. When administered by a trained professional, these hormone injections raise the body’s hormone levels rapidly. Noticeable results occur in as little as 24 hours. As opposed to gel and creams, injections don’t require daily application, rather bi-monthly injections to sustain natural, elevated hormone levels.

The Deciding Difference

When choosing between injections or pellets, Dr. Asandra will walk you through which one would better suit your body’s requirements and satisfy your personal preferences. Many of our clients choose pellets because they require only a few sessions with Dr. Asandra a year – about three to four, whereas injections are required roughly every two weeks. However, pellets aren’t as fast-acting as injections and are absorbed gradually by the body – this makes injections favorable for some patients. 


From understanding your symptoms to checking your current hormone levels to choosing the right treatment route, the entire process can seem very overwhelming. However, with Dr. Asandra and his wonderful staff at AsandraMD, you are supported by an expert team through this process. Patients seeking hormone replacement therapy can range in age from as young as mid-30s to 60s and even 70s. Because everyone’s body is different and unique, individual hormonal levels will differ, even if they are the same age. 

For those curious about their hormone levels or those looking to treat existing hormone deficiencies, please schedule a personal consultation with Dr. Asandra at our Beverly Hills office. 

Personal Consultation 

We will begin your consultation at AsandraMD with a blood draw to test your current hormone levels. This test will provide us with the baseline for your personalized treatment plan. Once we have analyzed your sample, we will walk you through which course of treatment we recommend. By educating you on the differences and advantages of pellets and injections, we aim to give you the best knowledge possible so you’re confident, comfortable, and informed


Your HRT session will begin with you comfortably relaxing in our Beverly Hills offices. Here, we will be sure to inform you of what your session will entail. 


A small incision is made. Through this incision, we use a surgical instrument called a trocar to place 1-2 pellets in women and 2-10 in men subcutaneously in the hip area.  Over the next 90 days, these pellets will secrete the necessary hormones to bring your levels to desired scores. After they have been fully absorbed by your body, we will schedule another session with you to repeat this process.


Injections are simple procedures that will take place roughly every two weeks. We will first have you lie down and get comfortable. Then, we will insert the syringe intramuscularly. Over the next 24 hours, you will feel a noticeable shift in your energy levels and other symptoms. In two weeks, we schedule another session and repeat this process. 


After a few weeks of HRT, men will notice renewed energy levels, elevated mood, increased libido, a firmer grasp on weight control, and more muscle mass. Women will also As you continue your treatment plan, Dr. Asandra and his team will carefully monitor your hormone levels. We will make adjustments to your treatment when needed to ensure the best results possible. It is important to note that everyone’s body is different. Some patients may notice quicker results than others. This is completely normal and expected. Dr. Asandra will work closely with you to achieve your desired results. 

Complementary Procedures

After experiencing the level of care and expertise Dr. Asandra and his team are committed to, you may want to see what other conditions they help treat. Many HRT patients are on a quest to counteract the effects of aging. One common effect is hair loss. Both men and women gradually lose hair as they get older. Although common, hair loss can feel like a debilitatingly lonely experience with no viable solution in sight. However, with Dr. Asandra’s approach to hair restoration, you can witness real, natural hair growth in many balding spots around your head. Using advanced strategies, Dr. Asandra can help reactivate your dormant hair follicles, causing the natural regrowth of hair. If you would like to see how his hair restoration approach can revitalize your hairline, be sure to ask about it during your consultation or follow-up appointments.


The cost of your HRT plan will vary depending on the quantity and frequency of treatments you elect to undergo. The cost and financing options will be addressed during your consultation. If you have any questions about this matter please call our office at (424) 542-8881.


What is hormone replacement therapy?

Hormone replacement therapy is a personalized approach to restore your body’s hormone levels by introducing natural hormones to your body in the form of pellets or injections. This approach is used to combat signs of aging.

How do I know if I have a hormone imbalance?

There are many signs of a hormone imbalance. However, it is important to determine whether these are caused by a hormone imbalance or some other underlying cause as they are common to other ailments. Signs of a hormone imbalance include hot flashes, erectile dysfunction, weight gain, and fatigue. The only way to know for sure if these symptoms are related to hormone imbalances is to get your levels tested by a professional healthcare provider. 

What are the hormones found in men and women?

While the amounts differ between the two sexes, males and females have the same hormones. Testosterone is known to be found heavily in males while estrogen and progesterone are found predominantly in females. However, many other just as important hormones can cause changes in your health and well-being when levels are low. These hormones include insulin, serotonin, cortisol, adrenaline, and growth hormone. To fully understand your hormonal makeup, it is best to have an expert test your levels. 


  1. Oettel, M., & Mukhopadhyay, A. K. (2004). Progesterone: the forgotten hormone in men?. The aging male : the official journal of the International Society for the Study of the Aging Male, 7(3), 236–257. https://doi.org/10.1080/13685530400004199
  2. Snyder, P. J., Ellenberg, S. S., & Farrar, J. T. (2016). Testosterone Treatment in Older Men. The New England journal of medicine, 375(1), 90. https://doi.org/10.1056/NEJMc1603665
  3. Fait T. (2019). Menopause hormone therapy: latest developments and clinical practice. Drugs in context, 8, 212551. https://doi.org/10.7573/dic.212551
  4. Piecuch, M. J., Patel, B. G., Hakim, L., Wang, R., & Sadeghi-Nejad, H. (2017). Testosterone Pellet Implantation Practices: A Sexual Medicine Society of North America (SMSNA) Member Questionnaire. The journal of sexual medicine, 14(1), 47–49. https://doi.org/10.1016/j.jsxm.2016.11.305
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