Testosterone pellets are small, rice-sized implants containing crystalline testosterone, designed to deliver hormone replacement therapy. This method provides a steady release of the hormone, avoiding the daily application or weekly injection schedules required by other forms of therapy. The implantation process is a minor, in-office procedure that typically takes only a few minutes. This long-acting delivery system is primarily used to treat hypogonadism, a condition characterized by low testosterone levels.
Preparing for Pellet Insertion
The process begins with a medical assessment to confirm the need for treatment. An initial consultation involves reviewing the patient’s symptoms and medical history. This is followed by blood tests to measure current testosterone levels and other hormone markers.
These lab results determine the correct dosage and number of pellets needed. Patients are advised to temporarily stop taking certain medications before the procedure to minimize bleeding risk. This often includes nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, blood thinners, or supplements that prolong clotting time.
The Insertion Procedure
The implantation site is typically the upper buttock or the hip area. This location contains subcutaneous fat tissue to cradle the pellets and is less likely to be subjected to significant movement or pressure. The patient is positioned on their side or stomach.
The insertion site is cleaned and sterilized to reduce the risk of infection. A local anesthetic, such as lidocaine, is injected into the skin and the deeper fatty layer. Once the area is numb, the provider makes a small incision, usually three to five millimeters long, using a scalpel.
A specialized hollow instrument, called a trocar or a cannula, is inserted through the incision into the subcutaneous fat layer. The testosterone pellets are loaded into this device and pushed into place beneath the skin using a blunt plunger. The provider fans out the pellets into the fat tissue to prevent clumping and ensures they are positioned away from the incision site. The instrument is removed, and the incision is closed, typically using sterile adhesive strips or a single suture, followed by a protective dressing. The entire process is usually completed in less than 15 minutes.
Post-Procedure Recovery
Following the insertion, patients can expect mild side effects at the site, including bruising, swelling, or tenderness. Applying an ice pack intermittently for the first 12 to 24 hours helps reduce swelling and manage discomfort. Acetaminophen may be used for soreness, though anti-inflammatory medications are discouraged immediately afterward because they can increase bruising.
Wound care prevents infection and pellet extrusion, the rare complication of a pellet being pushed out of the incision. Patients must keep the insertion site clean and dry for 24 to 48 hours. Avoid full immersion in water, such as baths, swimming pools, or hot tubs, for up to a week until the incision is fully healed.
Strenuous exercise, heavy lifting, or activities that cause excessive movement or direct pressure on the insertion site should be avoided for five to seven days. This restriction includes intense workouts like running or deep squatting. Patients should contact their provider if they notice signs of complications:
- Increasing redness or warmth
- Persistent pain
- Pus or excessive bleeding from the incision
Duration of Treatment Effects
Testosterone pellets provide a sustained, consistent release of the hormone. Once implanted, the crystalline testosterone slowly dissolves and enters the bloodstream.
The effects of a single pellet insertion typically last between three and six months. This duration can vary based on individual metabolism, physical activity levels, and the dosage used. A typical re-implantation interval is around five to six months to maintain stable hormone levels and prevent the return of low testosterone symptoms. This predictable timeline allows for a convenient treatment schedule that avoids the peaks and troughs seen with other hormone delivery methods.