Pellets

This is a rare solution, mainly used in Australia. It consists of a pellet implanted under the skin, delivering estrogens steadily and regularly. This route is also used as a contraceptive method, with a different estrogen. The implantation can leave a little scar, and considering the pellet has to be changed after a few months, it is not ideal to have this route as a long term solution - especially if you started HRT early in your life. That is why it is mostly proposed to post-menopausal women.

Pros

• Delivers steady levels of estrogens, and once in place, you’re good to go for a few months, without having to remember to take your medication

Cons

• Can leave scars, accumulating with years
• You need to see a doctor everytime you change it
• Can sometimes (though rarely) “detach” and circulate in the body (and is sometimes lost)
• You can’t be sure the dosage will be optimal before you put it, and then have to wait a while before correcting it if it is not.