Bioidentical Hormone Optimization Treatment (BHOT)

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Menopause is an endocrine condition, which involves the permanent loss of a women’s ability to produce meaningful quantities of estrogen or progesterone. Disruption in estrogen and progesterone affects all other hormone-producing glands in the body, resulting in a generally dysfunctional endocrine system. 

Andropause is the menopausal equivalent in men. For males, decline in testosterone production begins as early as age thirty, decreasing by approximately 1 percent each year. Typically, by age 60, testosterone decline in men becomes clinically significant. In men, declining testosterone levels are often further exacerbated by stress and excess body fat. Hormonal imbalance has also been associated with stress, inadequate sleep, lack of exercise, unhealthy diet, environmental exposures, and chronic health conditions. 

Hormone replacement therapy offers a solution to hormonal dysregulation in both men and women and has been shown to increase energy, improve sleep, improve mood, increase muscle mass, preserve bone density, improve the appearance of the skin, improve memory and concentration, and improve libido. Unlike synthetic hormones, bioidentical hormones have the exact same chemical and molecular structure as hormones produced by the human body. Bioidentical hormones are well metabolized, effective, customizable, and have fewer side effects. 


Bio-Identical Hormone Optimization Treatment (BHOT) is the therapeutic use of plant-based hormones that are identical on a molecular level with those created by the human body. Hormone pellets are often the preferred method of delivery and have benefits over other formulations, such as creams or orals. Sustained, consistent release of hormones from pellets over time is considered an advantage over the fluctuations that can occur with other formulations.


Pellet therapy is simple and easy! Pellets are inserted into patients 3-4 times per year. The procedure takes less than 15 minutes.

Patients don’t have to worry about applying creams or taking orals daily so compliance is not an issue.


The Pellecome Re3® Advanced Pellet Delivery System for Men & Women has been designed to make the pellet insertion procedure easier, safer & more reliable.


  • Insertion Tool Facilitates Effortless Preparation + Placement
  • Precision Scalpel Ensures Proper Depth + Size
  • Funnel Technology Secures Pellets For Safe + Efficient Use
  • Helps Achieve Better Clinical Results

What is BHRT?

BHRT stands for Bio-Identical Hormone Replacement Therapy. The “B” stands for Bio-Identical, not biosimilar. During the development of a therapeutic project, any modification in the manufacturing process can create slight changes in the structure of the resulting drug, thus creating a “biosimilar.” The term “Bio-Identical,” as defined by experts from The Endocrine Society, is a compound that has exactly the same chemical and molecular structure as the hormones that are produced in the human body.

Hormone Imbalance

A simple way to describe hormone imbalance is that it represents any combination of hormone levels that are not within the expected normal range. Because hormones are kept within a certain range to perform specific functions, hormone imbalance can be associated with a variety of symptoms and functional changes in the body.

Hormone imbalance in men and women differs because of the hormones involved and the function of the hormones that are not within the normal range or not functioning properly.

Hormone Imbalance in Men

Male Reproductive System

Changes in testosterone levels

Testosterone deficiency is present in a percentage of men age 50–69 years and in an even greater proportion of men 70 years of age and older. Unwanted consequences include decreases in:

  • Muscle mass and strength
  • Bone mass
  • Sexual interest and ability to function sexually
  • Cognitive function

They may also experience increases in fat mass. It is unknown, however, whether these changes can all be attributed to declines in testosterone levels or whether there are other contributing factors.

Hormone Imbalance in Women

Female Reproductive System

Decreased estrogen levels represent an important form of hormone imbalance in women. Although in many cases it is the result of a normal physiological change associated with aging, because up to a third of a woman’s life today may occur after menopause, there is a compelling reason to be concerned about its impact on physical, social, and emotional aspects of a woman’s life, including:

  • Physical symptoms, such as vasomotor symptoms (night sweats, hot flashes and flushes) and vaginal dryness
  • Structural changes such as bone loss, skin thinning, fatty replacement of the breast
  • Changes in blood lipids
  • Atrophy of the bladder and urethra

Hormone Optimization

Optimization in men

A common form of hormone optimization in men is testosterone replacement therapy. This type of therapy is approved for men who have low levels of testosterone related to certain medical conditions. Examples of these conditions include genetic problems, and chemotherapy or infections that have damaged the testicles.

Optimization in women

Hormone optimization in women usually involves some formulation of estrogen, either alone or with progesterone. As with testosterone therapy, estrogen therapy is guided by certain limitations and restrictions. Hormone therapy with estrogens (with or without progesterone) is indicated only for treatment of vasomotor symptoms and vaginal atrophy and for osteoporosis prevention or treatment.

Testosterone is also used in women and may be appropriate treatment for those with depression and fatigue after surgically induced menopause, or in women in whom estrogen therapy hasn’t relieved all symptoms and there is a need to benefit from the effects of testosterone on the endocrine system and sexual function. Testosterone therapy comes in many forms, such as creams, gels, patches or pills.

Types of BHRT

Hormone therapy using testosterone or estrogen + progesterone is available in a wide variety of formulations, including pellets, injections, oral forms, gels, solutions and patches. The available BHRT products in these categories represent a portion of the available treatments.

Program: Initial Baseline Bloodwork, Initial Consultation (Medical History and Lab Review), Pellet Insertion, Post-Insertion Follow-Up Labs, Follow-Up Consultation

Brief Overview




Anti-Aging, Muscle Mass, Lean Body Mass, Fatique, Sexual Function, Hot Flashes, Skin Thinning, Cognitive Function, Incontinence, Bone Loss

Suitable for:

Anyone over 35 years old looking for hormone optimization, improvement in lean body mass or anti-aging

Healing Time:



Initial Consult Complimentary


6-8 weeks for effect


Pellet Insertion Every 3-4 Months


  • Initial Baseline Bloodwork
  • Initial Consultation (Medical History and Lab Review)
  • Pellet Insertion
  • Post-Insertion Follow-Up Labs
  • Follow-Up Consultation

Treatment Options:

  • Pellecome Pellet
  • Testosterone Injection
  • Progesterone Capsule

Signature Combinations:

B12, MIC, Supplements, Emsella, Emsculpt NEO

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