Testosterone Pellets for Women

by Dr. William Epperly of Forum Health, Bloomingdale

I haven’t written much lately about testosterone pellets, but I was recently reminded by a female patient and friend of mine how powerful these little pellets are. She absolutely loves her pellets and so do a lot of my other patients, and for good reason. Testosterone pellets have many potential benefits for both men and women. It makes obvious sense that they would help men, but most people don’t realize that women need testosterone, too.

A woman’s normal total testosterone blood level is about 1/20 the level of an average male. But even at that low level, good things happen. Testosterone maintains libido and healthy sexual response, including raising the intensity of orgasms. But it also helps maintain energy, drive, good mood, strong bones, mental clarity, and healthy skin. The prevalence of sexual dysfunction among all women is estimated to be between 25% and 63%, and the prevalence in postmenopausal women is even higher, with rates between 68% and 86%. Testosterone depletion plays a major role in these percentages.

Testosterone levels in women decline steadily after their 20’s. A woman’s average level in her 40’s is about half of what it is in her early 20’s. As a woman ages, she has three strikes against her in her efforts to maintain robust levels of testosterone. Half of her testosterone comes from her ovaries, and half is from conversion of hormone precursors which take place elsewhere in the body. But that changes in menopause so that most comes from conversion of precursors like DHEA, which leads to less total testosterone. Also, as a woman ages, she produces more SHBG which is a protein in the blood that ties up testosterone, making it unusable. And the third thing that causes this hormone to decline with aging is the gradual steady decline in the blood of precursor hormones like DHEA. 

Someone once said that your hormones don’t go down because you’re aging, but you age because your hormones go down. Actually, I think both are true. It’s like a vicious cycle.

So if you or your doctor measures your testosterone level, and it’s low, what can you do? You have three options, but only two options I commonly recommend:

  1. Testosterone pellet implants – These pellets are the size of a cooked long grain of rice. One or two pellets are painlessly inserted under the skin of the lateral buttocks every 3-6 months. They slowly release testosterone hormone, and even can release more hormone when it’s needed (as in when exercising). Scars are minimal and hidden beneath the location of a bikini. You can stay on pellets for many years without a problem. I usually have women stop pellets when they turn 90.  
  2. Testosterone gel or cream – Compounding pharmacies are all over these days, compounding pharmacists will make your gel or cream according to your pharmacist’s exact specifications. You just smear it on every day after you shower or before bed.
  3. Testosterone pills – There are testosterone pills, but I do not recommend using them.

I am amazed and delighted at how much patients love their testosterone therapy, and actually often drive long distances to get their pellets! Maybe you know someone who could benefit, too.