Testosterone pellets are a form of testosterone replacement therapy (TRT) that slowly releases hormones over 3-6 months.
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Key Takeaways:
Testosterone pellets are a form of testosterone replacement therapy (TRT) that slowly releases hormones over 3-6 months.
They’re a convenient alternative to daily gels or weekly injections, offering steadier hormone levels with fewer treatments per year.
Pellet therapy can improve symptoms of low testosterone, like low sex drive, fatigue, and reduced muscle mass, but it may also lower fertility.
Testosterone pellets — sometimes called testosterone implants — are an FDA-approved, long-acting form of testosterone replacement therapy (TRT). Providers typically prescribe them to men with low testosterone levels (hypogonadism) to relieve symptoms of low T.
The pellets only need replacing a few times a year, making them one of the most convenient TRT options.
In this guide, we’ll cover how testosterone pellets work, who they’re right for, possible side effects, and what to expect if you’re thinking about trying this therapy.
Testosterone pellets like Testopel® are small crystalline implants that go just beneath the skin. A healthcare professional needs to insert them.
While they were first FDA-approved in 1972, they only became widely marketed in 2008, as more men began seeking long-acting options for testosterone deficiency.
These tiny implants go underneath your skin (usually in the hip or buttock area). As they dissolve, they steadily release a low dose of testosterone into your bloodstream.
The slow release keeps your hormone levels steady — no highs and lows like you get with short-acting injections or gels.
Testosterone levels usually peak about 2–3 weeks after the pellets go in. After that, levels gradually decline but stay within the normal range for about 4 to 6 months.
Most men get several pellets in one session. The exact number depends on:
Your starting testosterone
Body size
How you respond to treatment
While these pellets help reduce symptoms of low testosterone — like low energy, low sex drive, and muscle loss — they also lower certain hormones that control sperm production. So, while TRT can help you feel better, pellets can impact your fertility.
Men with low testosterone are good candidates for testosterone pellets.
The best way to find out if you have low testosterone levels is to schedule a consultation with a medical provider and get tested. You can also consider testing your testosterone at home with Hims at-home testing kits. No in-person visit needed. Results are reviewed by a licensed healthcare provider.
Common symptoms of low testosterone include:
Low sex drive
Low energy levels
Decreased muscle mass
Increased body fat
Reduced bone density
Depression
Less body hair
Brain fog
Reduced red blood cell count (anemia)
Gynecomastia (breast tissue development)
You may not be a good candidate for testosterone pellets if you’re planning on having kids, since testosterone therapy can lower your sperm count.
Your provider may also advise you against testosterone pellets or other forms of TRT if you have a history of prostate cancer or breast cancer, or if you’ve had a recent heart attack or stroke.
Testosterone pellet implantation is a quick, in-office procedure that usually takes around 10-15 minutes.
After you’re comfortably positioned on your side, your healthcare provider will numb a small area of skin near your hip or upper buttock. Once the area is numb, they make a tiny incision and insert the pellets into the fatty tissue beneath the skin.
After insertion, they’ll close the cut with a small adhesive strip (you probably won’t need stitches) and cover it with a bandage. Most men can return to normal daily activities right away, though your provider may suggest avoiding strenuous exercise for a few days.
Your provider will order follow-up bloodwork 4 to 6 weeks after insertion to check how you’re responding to the treatment.
You and your provider will work together to figure out the right implantation cadence for your pellet therapy.
According to Testopel dosage guidelines, testosterone pellets are inserted every 3 to 4 months, though the product can work for up to 6 months in some men.
Research shows that both brand-name Testopel and compounded testosterone pellets can successfully normalize testosterone levels.
One study found that testosterone pellets safely restored normal testosterone levels in participants with hypogonadism. Users also saw symptom relief for at least 3 months — and sometimes up to 6 months.
Testosterone pellets carry a small risk of infection at the insertion site. Pellet extrusion (when a pellet works its way out of the skin) happens in about 5-10 percent of users.
Because testosterone pellets go under the skin, it’s more difficult for your doctor to change your dose compared to oral medications or injectables. That means that if you need to stop treatment, you might need surgery.
Testosterone replacement therapy comes with other potential side effects and risks, including:
Acne
Low sperm count
Enlarged prostate
Gynecomastia
Testicular shrinkage
Mood changes
Worsened sleep apnea
Hair loss in genetically predisposed men
Pellets can also interact with other medications, including blood thinners, corticosteroids, and insulin, so it’s important for people to review their medication list with their doctor before starting treatment.
Regular check-ins with your provider are essential to make sure your testosterone therapy is working. With testosterone pellets, your provider will check your levels near the end of each cycle.
Based on your results, they can adjust the number of pellets or how often you get them to keep your testosterone within a healthy range for you.
Testosterone pellets offer a long-lasting way to increase testosterone. They go under the skin and release a steady dose for months — helping with sex drive, energy, muscle strength, and mood.
Unlike gels and injections, pellets mean fewer treatments and more stable hormone levels. But they do come with a small risk of infection or the pellet coming out. And they’re not a good option if you plan to have kids, you end up having bad side effects, or you need to stop suddenly.
Curious about testosterone pellets? Hims can connect you with a healthcare provider who can determine if TRT fits your needs via a discreet, convenient telehealth appointment.
Testosterone pellets are a form of testosterone replacement therapy. They consist of tiny implants (about the size of a grain of rice) that go under the skin. These pellets slowly release testosterone over several months.
Most men need new pellets every 3 to 4 months, though some see stable hormone levels for up to 6 months.
The number of pellets you need depends on your age, weight, baseline testosterone levels, and response to therapy. Most men receive 6–12 pellets during a single procedure.
Testosterone pellet treatment is generally safe when monitored by a healthcare provider. Risks include infection, pellet extrusion, and common TRT side effects like acne, low sperm count, or mood changes.
There’s no strong evidence that TRT causes prostate cancer. However, men with a history of prostate cancer or those at high risk should carefully discuss therapy pros, cons, and risks with their provider.
Pellets last longer and provide steadier testosterone levels, but they require a minor procedure for insertion. Gels are easy to apply daily, but can transfer to others. Injections are inexpensive but can cause hormone peaks and dips.
Yes. Testopel is the only FDA-approved testosterone pellet available in the U.S.
Yes. Like other forms of TRT, testosterone pellets suppress signals from the brain that tell the testicles to make sperm. This can lower sperm count and cause the testicles to shrink, which is a problem for men who want children.
If maintaining fertility is important, alternatives like enclomiphene citrate — a prescription medication that boosts natural testosterone production without shutting down sperm production — may be a better option. Talk to a provider about alternative testosterone treatments.
No. Testosterone pellets are a controlled prescription treatment and must be inserted by a trained healthcare provider.
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