What Biote pellet therapy is
Biote® is a hormone optimization method that uses tiny pellets of bioidentical estradiol and/or testosterone placed just under the skin. The pellets slowly release hormone over a period of months, so there is nothing to apply or remember each day. Biote pellets are compounded by outside pharmacies rather than sold as FDA-approved products for women, and dosing is individualized from your symptoms and lab results.
JennWell Women's Health offers Biote hormone pellet therapy with Jennifer Neilan, WHNP, as part of a broader menopause and hormone practice. That means pellets are one option on the table — discussed alongside patches, gels, pills and vaginal therapy — so the plan you choose fits your body, your history and your preferences.
Who may consider pellets
Women who explore Biote are often in perimenopause or menopause, or have hormone-related symptoms such as:
- Hot flashes and night sweats
- Poor sleep, low energy or brain fog
- Low libido
- Mood changes or irritability
- A preference for steady, low-maintenance dosing instead of daily products
Your consultation and labs
Every Biote plan starts with a visit to review your symptoms, cycle and menopause history, medications, and personal and family history of breast cancer, blood clots, stroke, heart disease and liver disease. Baseline labs check hormone levels and overall health. Jennifer explains what pellets can and can't do, the alternatives, and how your dose is chosen, so you can decide with clear information. Women who still have a uterus and use estrogen also need progesterone to protect the uterine lining, which is prescribed separately.
The insertion visit
Pellet insertion is a short in-office procedure. The skin of the upper hip is numbed, a very small opening is made, the pellets are placed under the skin and the site is closed with a small adhesive strip. Most women return to normal daily activities the same day. You will be asked to avoid soaking in baths, hot tubs or pools and to skip strenuous lower-body exercise for a few days while the site heals.
Follow-up and re-insertion
Follow-up labs a few weeks after your first insertion help confirm the dose is right for you. Many women notice improvement within a few weeks. Because pellets dissolve gradually, re-insertion is typically needed every few months, timed to when symptoms begin to return and guided by labs. Your plan is adjusted at each visit based on how you feel.
Side effects and what the guidelines say
Possible side effects include tenderness or bruising at the insertion site, and rarely infection or a pellet working its way out. Testosterone can cause acne, oily skin, unwanted hair growth or scalp hair thinning, and estrogen can cause breast tenderness or spotting. Unlike a patch or pill, a pellet cannot be removed or the dose lowered once placed, so side effects may last until it dissolves.
It is important to know that major professional bodies — including ACOG, The Menopause Society, the National Academies and the 2019 Global Consensus Position Statement on testosterone for women — recommend FDA-approved hormone products over compounded preparations, including pellets, for most women, citing dose consistency and the risk of hormone levels above the normal range. Jennifer walks through this evidence openly and uses lab monitoring to guide dosing, so you can make an informed choice that feels right for you.
Preparing for your visit
Coming prepared helps you get the most from an appointment about Biote pellet therapy. List your symptoms and how long you've had them, your period history, and any personal or family history of breast cancer, blood clots or stroke. Bring recent hormone labs and the names and doses of any hormones you've used before.
JennWell Women's Health is located at 11844 Standing Stone Dr., Suite 200 in Gretna, inside Skilled Touch Health and Healing, and welcomes women from Elkhorn, West Omaha, Millard, Papillion, La Vista, Bennington, Lincoln and across Eastern Nebraska. To schedule, call (402) 800-8595 or request an appointment online. If you are unsure whether this service is right for you, a consultation is a no-pressure place to start the conversation and learn your options.
Frequently asked questions
Clinical guidelines & references
This guide is informed by published consensus statements from these professional organizations. It is educational and not a substitute for individual medical advice.
- The Menopause Society (formerly NAMS). The 2022 Hormone Therapy Position Statement of The North American Menopause Society. Menopause. 2022;29(7):767–794.
- American College of Obstetricians and Gynecologists (ACOG). Compounded Bioidentical Menopausal Hormone Therapy (Clinical Consensus No. 6). Obstet Gynecol. 2023.
- National Academies of Sciences, Engineering, and Medicine. The Clinical Utility of Compounded Bioidentical Hormone Therapy. National Academies Press, 2020.
- International Menopause Society, Endocrine Society, ACOG & others (co-endorsed). Global Consensus Position Statement on the Use of Testosterone Therapy for Women. J Clin Endocrinol Metab. 2019;104(10):4660–4666.