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Pellet Therapy 101

So what exactly are bio-identical hormone pellets anyway?

Larger than a grain of rice and smaller than a Tic Tac, BHRT pellets are composed of either estradiol (an estrogen hormone) or testosterone. The pellets used for the EvexiPEL hormone pellet therapy are manufactured by FarmaKeio, a leading compounding pharmacy in the United States, where the hormones are pressed or fused into small, solid cylinders.

What happens during BHRT with pellets?
How does BHRT with pellets work?
Are EvexiPEL pellets different than other BHRT pellets?

During BHRT with pellets, the practitioner makes a tiny incision – usually in the buttocks or flank – then inserts the pellets into the fatty tissue under the skin. The practitioner then closes the incision, without the need for stitches. To prevent patient discomfort, a local anesthetic is applied to the insertion site prior to the procedure. 

In response to physical activity or emotional stress (whether it’s good stress or bad), the pellets release estradiol and/or testosterone into the body. Thanks to the pellets, which are securely tucked away beneath the skin, the patient receives a steady stream of hormones, which keeps annoying mood and energy fluctuations at bay.

Yes! And the EvexiPEL formulation has been shown to produce better outcomes for patients, too. After a decade treating thousands of patients, EvexiPEL founder Terri DeNeui, MSN, APRN-BC worked diligently with a team of experts to develop a proprietary pellet formula.

Put into practice at one of the largest known hormone pellet therapy providers in the country –EVEXIAS Medical Centers – the formulation yielded the following results:

  • Reduced scar tissue, resulting in far fewer pellet extrusions. Decreasing additional office visits dealing with complications and wasting valuable resources in practitioner clinics.
  • Far fewer boosts required in new patients. More effective and convenient for patients.
  • Quicker Absorption. Patients reported more comprehensive symptom relief sooner than with other compounded pellets.
  • More consistent absorption over time. Thus ensuring longer lasting therapeutic results.

Increased practitioner and patient satisfaction. Period.

EvexiPEL doesn’t limit treatment to pellets:
Why DNA, toxicity and gut health matter

Unlike other BHRT providers, EvexiPEL practitioners take a functional approach to treating patients with hormone imbalance. After years of treating thousands of patients and digging deep to find the root cause of patient health concerns and intensive research, DeNeui, found that some patients don’t respond to BHRT with subcutaneous pellets alone.

Over the years, DeNeui and her team of practitioners have discovered that hormone imbalance is but one factor that may contribute to patients’ health struggles. The mind, body and spirit all need to be addressed in order for the patient to heal fully. Key insights include:


Recent research has revealed that how we metabolize hormones is hardwired in our DNA. Practitioners need to be aware that some patients have more difficulty metabolizing hormones, so treatment plans need to be modified accordingly.


Practitioners need to talk with patients about the toxins they’re exposed to in their day-to-day lives, then counsel them on steps to take to remove them. Toxicity goes beyond the food, fluids, chemicals and pollution we consume or breath in – toxic relationships and jobs lead to unnecessary stress and anxiety that makes people vulnerable to illness and chronic disease.

Gut health

Research has revealed there is a direct connection between gut health and inflammation, autoimmune disorders, mental health and more. It’s also essential to have a healthy gut in order to metabolize hormones efficiently. Thus, while uncovering the root cause of the patient’s health issues, practitioners must closely analyze the patient’s gut health and prescribe the appropriate detox program, probiotics, nutrients and supplements to restore gut health.

“Today we take a much more integrated approach to treating patients than in the past. Experts in hormone optimization, functional medicine, nutrition and mental health work as a team so patients experience optimum results.”

Terri DeNeui, DNP, ACNP, APRN-BC
EvexiPEL founder

Is BHRT right for you?

Benefits of BHRT

BHRT with pellets has been shown to be a superior method to optimize hormones and address health conditions and symptoms associated with unbalanced hormones in women and men.

Signs & Symptoms

Hormone imbalance may occur as early as our 20s. Symptoms vary but may include fatigue, depression, insomnia, weight gain, muscle aches and weakness, sexual dysfunction and more.

What is BHRT?

With bio-identical hormone replacement therapy, synthetic hormones are replaced with natural, plant-based testosterone and estrogen pellets, providing superior results for the patient. 

Pellet Therapy 101

Tiny hormone pellets are inserted into the fatty tissue under the skin. Hormones are released in response to physical activity or emotional stress, keeping mood and energy fluctuations at bay.

Recommend a Provider

If you can’t find your healthcare practitioner on our provider list, let us know. We’ll contact them to see if they would like to learn more about EvexiPEL.

Become a Provider

Would you like to learn how to give patients the gift of health by becoming a certified EvexiPEL provider? We’d be delighted to speak with you.