Testosterone pellets (often marketed under the brand Testopel) are small crystalline implants inserted under the skin of the hip or buttock area during a brief in-office procedure. Each pellet is about the size of a grain of rice and slowly dissolves over 3-6 months, providing a steady release of testosterone without the need for daily or weekly dosing.
The insertion procedure involves a small incision under local anesthesia, through which 6-12 pellets are implanted into the subcutaneous fat layer. The incision is closed with adhesive strips, and normal activity can resume within a few days. The procedure takes about 10-15 minutes and is performed in the clinic.
The primary appeal of pellets is convenience: once implanted, there's nothing to do until the next insertion appointment. Testosterone levels rise over the first few weeks, plateau for 2-3 months, then gradually decline as the pellets dissolve. This creates a smoother hormone curve than infrequent injection protocols, though the decline phase can cause symptoms to return before the next insertion.
The downsides are significant. You can't easily adjust the dose once pellets are implanted. If you experience side effects or the dose is too high, you have to wait for the pellets to dissolve or have them surgically removed. Pellet extrusion (pellets pushing back through the skin) occurs in 5-10% of insertions. The cost is also substantially higher than injectable TRT.