Why Pellets Aren’t Always Ideal

Pellets dissolve slowly over 3–4 months. Once inserted, you can’t adjust the dose.

Common concerns include:

• Too much testosterone early
• Not enough testosterone later
• Facial hair
• Acne
• Mood swings
• Clitoral discomfort
• Voice fatigue
• No ability to lower or stop the dose

This is why many women look for alternatives.

Better Alternatives to Pellets

1. Testosterone Troches (Sublingual)

One of the most flexible options.

Pros:

• Easy to adjust
• Fast symptom response
• Lower risk of prolonged side effects
• Convenient dosing

Troches pair well with estrogen patches or creams, which we commonly use in menopausal women.

2. Topical Testosterone Cream

Applied to skin areas with consistent absorption.

Pros:

• Easy to titrate
• Gentle
• Steady absorption

This is helpful for patients with sensitive systems or those wanting gradual improvement.

3. Injectable Micro-Dosing (Off-Label)

Some patients benefit from very small doses of testosterone cypionate.

Pros:

• Extremely precise dosing
• Easy to adjust
• Predictable serum levels

This is different from male TRT dosing and is carefully monitored.

4. Combination Therapy With DHEA

Some women convert DHEA to testosterone more efficiently.

Pros:

• Mild support
• Gentle on the system
• Oral dosing

We often use DHEA in women with adrenal fatigue or chronic stress patterns, discussed more on our Stress Hormones page.

Why Personalized Hormone Therapy Matters

Every woman metabolizes hormones differently.
What worked for a friend or influencer online may not work for you.

That’s why our approach includes:

• Detailed hormone labs
• Symptom assessment
• Body composition evaluation
• Sleep, gut, and inflammation status
• Regular follow-up
• Safe, gradual dose changes

We take a functional medicine perspective, integrating hormones with:

• Thyroid health
• Insulin resistance
• Adrenal function
• Gut health

You can read more under Functional Medicine and Gut Health.

Bottom Line

Pellets are just one tool—and often not the most precise. There are safer, adjustable alternatives that allow women to feel their best without being locked into a fixed dose for months.

If you're in St. Louis and want a clinician-guided approach, our hormone team is here to help.

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