Pellet therapy for hormones is not recommended by the North American Menopause Society (Menopause.org) for several reasons. It is not regulated, which means there is no oversight or quality assurance or a way to confirm exactly what the dosage is. When pellets are implanted under the skin, they are permanent and can not be removed. I have had patients and there are numerous reports of women receiving 10 times the recommended amount of hormones in pellet therapy leading to serious side effects.

If a woman has side effects, she must wait for all of the hormones to be released, which can take months and can lead to serious side effects that range from breast tenderness and abnormal bleeding to headaches, voice changes, and hair loss. 

For those reasons, I do not recommend pellet therapy for hormones. In addition, there are FDA-approved hormone options with validated safety data that can be stopped at any time if a woman has side effects.