Testosterone deficiency remains one of the most underdiagnosed and undertreated conditions affecting men, with millions experiencing symptoms that impact energy, sexual health, body composition, and well-being. As awareness continues to grow, more healthcare providers are looking for ways to integrate testosterone replacement therapy (TRT) into their practices.
Pellecome, based in Gladstone, New Jersey, offers bio-identical hormone replacement therapy (BHRT) through high-quality pellet implants and a proprietary delivery system designed for ease of use. Developed by Dr. Enrique G. Jacome, a board-certified Ob-Gyn with decades of experience in hormone therapy and more than 30,000 pellet procedures performed, this method supports predictable hormone delivery while simplifying the treatment process for providers. For patients, this means access to steady testosterone support through trained Pellecome providers nationwide.
What Is Testosterone?
Testosterone is the primary male sex hormone (androgen) and plays a central role in many aspects of male health. It supports the development of male physical characteristics, as well as muscle mass, bone density, red blood cell production, mood, and sexual function. Although often associated with men, testosterone is present in both men and women and contributes to overall hormonal balance.
Symptoms of Testosterone Deficiency
A diagnosis of testosterone deficiency may be more likely in men who present with lower than normal testosterone levels and all three of the following symptoms:
+ Erectile dysfunction
+ Decreased libido
+ Decreased frequency of morning erections
In addition to these primary symptoms, men with low testosterone may also experience:
+ Fatigue or low energy
+ Loss of muscle mass
+ Increased body fat
+ Mood changes
Hormone Imbalance Test
Evaluating testosterone levels begins with a simple blood test, typically drawn from a vein. Because testosterone levels follow a daily rhythm and are highest in the early morning, samples are usually collected between 7:00 and 10:00 AM for the most accurate assessment.
Initial testing often includes total testosterone. If levels are borderline or symptoms persist, additional testing may be recommended, such as free testosterone, sex hormone-binding globulin (SHBG), and other related markers to better understand hormone availability and balance. In some cases, repeat testing on a separate day is performed to confirm consistently low levels.
How Testosterone Levels Change With Age
Benefits of Testosterone Replacement Therapy
The desired effects of testosterone therapy in men include the following:
+ Increased lean body mass
+ Decreased fat mass
+ Increased bone mineral density
+ Increased sexual functioning
Several studies have reported on the use of testosterone replacement therapy in men with low testosterone levels. The treatments were administered either by injection or using a scrotal patch. Most studies have shown increases in lean body mass and bone mineral density and decreases in fat mass. In addition to an increase in muscle mass, testosterone has also been shown to increase strength in the upper or lower extremities.3
Bioidentical Hormone Replacement Therapy
Pellet Therapy: Restore, Regenerate, Renew
Pellet Therapy
Testosterone pellet therapy offers a long-acting approach to bio-identical hormone replacement. Small pellets are placed just beneath the skin, where they release testosterone gradually over time. This method is designed to maintain more consistent hormone levels without the frequent dosing required by other therapies.
Pellecome enhances this approach with a patented delivery system that supports precise pellet placement. This system helps reduce variability during insertion and is intended to improve both provider efficiency and patient experience.
Pellets can provide sustained testosterone levels for approximately 3 to 4 months, supporting steady improvements in energy, mood, and overall well-being. Subcutaneous implantation is a minor in-office procedure. As with any treatment, there are potential risks, including POME (pulmonary oil microembolism), infection, and pellet extrusion. 4,5,6
Other Testosterone Therapy Options
- Injectable testosterone esters, such as enanthate and cypionate, have been used for many years. While they are relatively inexpensive, they require frequent administration (every 1–3 weeks) due to their short duration in the body. These injections can cause hormone levels to rise above the normal physiologic range shortly after treatment and then decline before the next dose, which may lead to fluctuations in libido, mood, and energy.
- Transdermal testosterone formulations, including gels, creams, and solutions, are another commonly used option. These can help maintain more stable testosterone levels compared to injections, but they require daily application and may cause skin irritation. There is also a risk of transferring the medication to others through direct skin contact, which is why all topical preparations carry a warning about unintended exposure. 4,5,6
- Other delivery methods, such as testosterone patches, buccal tablets, and intranasal gels, are used less frequently and may be limited by convenience, absorption variability, or patient preference.5
Why Choose Pellecome for BHRT?
Pellecome provides healthcare professionals with a clinically grounded approach to bio-identical hormone replacement therapy. The combination of high-quality pellet formulations and a patented delivery system supports consistent placement and predictable hormone release.
In addition to product innovation, Pellecome offers support to help practices integrate and grow BHRT services. With no procedural fees or long-term contracts, providers have the flexibility to adopt pellet therapy on their own terms. Access to training, clinical resources, and practice support tools enables providers to expand their offerings and improve patient satisfaction.
Frequently Asked Questions
Can Low Testosterone Affect Your Sleep?
Low testosterone can cause irregular sleep patterns, insomnia, and changes in your sleep pattern.
How Long Does It Take to Feel Results From Testosterone Pellet Therapy?
It's possible to notice improvements in energy, mood, and libido within a few weeks after pellet insertion. Full benefits, including changes in body composition and strength, may develop over several weeks to a few months as hormone levels stabilize.
How Often Do Testosterone Pellets Need to Be Replaced?
Testosterone pellets typically last between three and four months. The exact timing can vary based on individual metabolism, activity level, and treatment goals, so providers adjust timing as needed.
Can Testosterone Therapy Affect Fertility in Men?
Yes, testosterone replacement therapy can reduce sperm production by suppressing natural testosterone production in the body. Men who are actively trying to conceive should discuss alternative treatment options with their provider.7
Are There Any Lifestyle Changes That Can Support Testosterone Levels During BHRT?
Healthy lifestyle habits can help support hormone balance during treatment. Regular exercise, strength training, adequate sleep, stress management, and a balanced diet all play a role in maintaining overall hormone health.
How Is Bio-Identical Testosterone Different From Synthetic Testosterone?
Bio-identical testosterone is chemically identical to the hormone naturally produced by the body, allowing it to be recognized and used more efficiently. Synthetic versions may differ in structure, which can affect how they are metabolized and tolerated.
Who Should Not Receive Testosterone Replacement Therapy?
Testosterone therapy may not be appropriate for men with certain medical conditions, such as untreated prostate or breast cancer, elevated red blood cell counts, or uncontrolled heart conditions. A thorough evaluation is necessary to determine if treatment is appropriate.
Schedule a Hormone Pellet Therapy Consultation
Pellecome supports providers in offering bio-identical hormone replacement therapy through high-quality pellets and a patented delivery system. Providers can connect with the Pellecome team to learn more about integrating BHRT into their practice by calling 888-773-9969.
Or, if you’re a patient experiencing symptoms of low testosterone, use the provider locator to find a Pellecome-trained provider near you.
1. Kelsey TW, Li LQ, Mitchell RT, Whelan A, Anderson RA, Wallace WHB. A validated age-related normative model for male total testosterone shows increasing variance but no decline after age 40 years. PLoS One [Internet]. 2014;9(10):e109346. Available from: http://dx.doi.org/10.1371/journal.pone.0109346
2. Araujo AB, O’Donnell AB, Brambilla DJ, Simpson WB, Longcope C, Matsumoto AM, et al. Prevalence and incidence of androgen deficiency in middle-aged and older men: estimates from the Massachusetts Male Aging Study. J Clin Endocrinol Metab [Internet]. 2004;89(12):5920–6. Available from: http://dx.doi.org/10.1210/jc.2003-031719
3. Katznelson L, Finkelstein JS, Schoenfeld DA, Rosenthal DI, Anderson EJ, Klibanski A. Increase in bone density and lean body mass during testosterone administration in men with acquired hypogonadism. J Clin Endocrinol Metab [Internet]. 1996;81(12):4358–65. Available from: http://dx.doi.org/10.1210/jcem.81.12.8954042
4. Alukal JP. Hypogonadism, an issue of urologic clinics of North America. Philadelphia, PA: Elsevier - Health Sciences Division; 2016.
5. Aversa A, Morgentaler A. The practical management of testosterone deficiency in men. Nat Rev Urol [Internet]. 2015 [cited 2026 Mar 20];12(11):641–50. Available from: https://www.nature.com/articles/nrurol.2015.238
6. Thirumalai A, Berkseth KE, Amory JK. Treatment of hypogonadism: Current and future therapies. F1000Res [Internet]. 2017 [cited 2026 Mar 20];6(68):68. Available from: https://f1000research.com/articles/6-68/pdf
7. Naelitz BD, Momtazi-Mar L, Vallabhaneni S, Cannarella R, Vij SC, Parekh NV, et al. Testosterone replacement therapy and spermatogenesis in reproductive age men. Nat Rev Urol [Internet]. 2025 [cited 2026 Mar 20];22(10):703–19. Available from: https://www.nature.com/articles/s41585-025-01032-8
