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Trilogy Pellet Hormone Therapy

Conveniently located to serve San Antonio and surrounding communities.

This is not an FDA approved treatment . Pellets have been around since the 1940’s but they have been used extensively in Europe, Asia and multiple other countries. We have begun using the Pelleome system which reduces crushing of the pellets and facilitates insertion. Your start with us will be labs and screening questions

What are Hormone Pellet Implants?

This unique method of Hormone Replacement Therapy (HRT) uses an exact copy of hormones as produced by the ovaries. Pellets are placed under the skin, which assures absorption and adequate blood levels more consistently than creams, gels or patches. The pellets are compounded by a licensed pharmacy from FDA-approved hormones. However, subdermal placement of hormones for the uses described here does not have separate approval from the FDA.

Once implanted, the highly compressed pellet releases the hormone over many weeks, maintaining steady blood levels. This feature makes it desirable, as it minimizes fluctuation in hormone levels.

Hormone Pellet Implants Types

Four hormones are available for use in the pellet form.

  • Estrogen
  • Testosterone
  • DHEA
  • Progesterone

I would be happy to discuss the risks and benefits of non-oral HRTs as compared to oral forms and to answer any questions you may have.

Why are pellets recommended for supplementation?

  • Pellets provide consistent healthy doses of DHEA for three to four months in women.
  • With pellet supplementation, fluctuation of hormone levels, common with other forms of therapy, is avoided.
  • Pellet therapy does not increase blood-clotting risk.
  • Pellets provide better relief of menopausal symptoms than conventional hormone therapy.
  • Pellets help to maintain bone density, improve sleep and sexuality.
  • Patients who have experienced trouble with other forms of hormone therapy have had success with pellets.

DHEA Supplementation with pellets – side effects from pellet insertion?

With DHEA supplementation with pellets there may be some minor side effects from inserting the pellet under the skin. Patients should not do any vigorous activity for 48 hours after the pellet has been inserted. Also -No pool or water activities for 1 week. Side effects include:

Minor bleeding
Discolored skin at the area of insertion
In some cases infection or the pellet works its way back out(extrusion)

Bioidentical hormone pellets are tiny, rice-sized cylinders containing bioidentical hormones. When inserted under the skin, the pellets provide months of constant hormone levels.

Bioidentical Hormone Pellets

Bioidentical hormone pellets are tiny implants used to relieve the unpleasant side effects of falling hormone levels women experience during menopause.

Following blood tests to determine the precise amount of hormones needed to restore proper hormonal balance, a special compounding pharmacy will custom make the pellets using the dosage prescribed by your gynecologist.

The bioidentical hormone pellets will then be implanted under the skin of the buttock. This is done in your Plastic Surgeons office by Dr Jeneby or his NP/PA or other trained staff. office through a process taking only a few minutes.

First, local anesthesia will be used to numb the area. The hormone pellets are then inserted under the skin in the buttock through a tiny incision. Each pellet contains the precise balance of hormones your body needs.

The bioidentical hormone pellets remain under the skin for a period of 3-4 months, where they release a constant level of hormones. After the implants gradually dissolve and the uncomfortable side effects of menopause resume, you may return to your gynecologist for hormone pellet replacement.

Safety of Bioidentical Hormone Pellets

Bioidentical hormone pellets are formulated in a compounding pharmacy using elements extracted from natural plants like soy and wild yam. The molecular structure of these hormones is identical to the hormones produced by the body. This means the introduction of these hormones won’t be a shock to the body. Instead, the body will recognize the hormones as natural substances and respond accordingly.

Although bioidentical hormone pellet therapy has experienced limited availability in the U.S. for over 60 years, it is widely available throughout Europe where it is considered standard therapy.

If you are considering hormone replacement, make an appointment so we can discuss bioidentical hormone pellet therapy and whether or not it is right for you.

Female Menopausal Questionnaire

Male Low Androgen Questionnaire

Initial Labs :
Male CBC, BMP, Testosterone Free and Total, DHEA , SHBG PSA, Liver Enzymes,
Studies : Urology Consult if symptoms BPH

We aim to keep your Testosterone between 900-1200 (upper limit of Puberty levels ) but you may feel good at a lower level

Female CBC, BMP. Estradiol, Testosterone Free and Total, Estradiol, FSH, Progesterone
Studies: Recent Pelvic Ultrasound, Pap Smear within one year Results, Mammogram

We aim to keep your Estradiol between 50ng/dl – 150 ng / dl

Any breakthrough bleeding with a clear Pelvic ultrasound we will add Porgesterone oral tabs 200 mg/ day or consider a pellet on your next visit

Estrogen Replacement

Before using estradiol hormone replacement therapy:
Using estradiol hormone replacement therapy is a decision to be made with your Doctor . There are considerations to make with estradiol hormone replacement therapy, including:

Allergies – discuss any known allergies with your GYN.
Usage – it is important to use estradiol hormone replacement therapy as directed by your doctor .
What are the types of estradiol hormone replacement therapy?

Estradiol Hormone Replacement

Patch – applied to a clean, dry and hair-free area of the lower stomach or upper buttocks area. Wear the patch at all times until it is time to switch. Read all of the directions and make sure you understand them.

Spray – estradiol hormone replacement therapy as a spray comes in an applicator with pre-measured estradiol that you spray on the area between the elbow and the wrist.

Gel – estradiol hormone replacement therapy as a gel comes in pre-measured applicator pump. This is applied to the inside and outside of your upper arm and shoulder.

Pellet implant – estradiol hormone replacement therapy as a subdermal implant. They are designed to maintain steady hormone levels over a 3 to 4 month period. (preferred)

Estradiol hormone replacement benefits:

Helps to relieve night sweats and hot flashes.
Helps to relieve vaginal dryness, itching and burning
Helps to relieve urinary symptoms
May help prevent osteoporosis

Estradiol hormone replacement therapy precautions?

While using estradiol hormone replacement therapy it is important to continue regular visits with your GYN. These visits may include routine pelvic and breast exams and mammograms.

Using estradiol hormone replacement therapy has risk factors:


It may increase the risk of blood clots, strokes and heart attacks.
The risk for the above problems is greater if you have high blood pressure, high cholesterol, diabetes, are overweight or smoke cigarettes.

Contact your Doctor immediately if you:
Feel confused
Have difficulty speaking
Have double vision
Have headaches
Can’t move your arms, legs or facial muscles

When used properly and with the supervision and management of a Dr Jeneby and Staff, estradiol replacement therapy can benefit female health.

Testosterone Replacement

What is Testosterone Replacement?

Discussion of testosterone replacement focuses on decreased sexual desire or libido. It should be noted that testosterone in women plays an important role in the metabolism of bones, muscles, skin and the function of the brain, just to mention a few. The goal of testosterone replacement in women is to reproduce steady physiologic levels over a period of time.

In women, testosterone is produced in the ovary and the adrenal gland. The blood level peaks between 20 and 30 years of age. Loss of ovarian function due to surgery, chemotherapy and radiation significantly reduces circulating testosterone. Menopause also results in diminishing testosterone. Oral contraceptives reduce testosterone levels as well. Oral contraceptives are metabolized in the liver. As a result, sex hormone binding globulin (SHBG) is produced. SHBG effectively binds free-testosterone, “the working fraction,” thereby reducing active levels. There is sufficient data suggesting testosterone replacement in women is beneficial. The following are a few benefits of bioidentical testosterone replacement…

Increased libido
Increased energy/stamina
Increasing lean muscle/reducing fat
Improved bone strength
Cognitive clarity
Improved mood and sense of well-being
Cardiovascular protection
Improved lipid profile (reduced cholesterol and triglycerides & improved HDL)

Again, monitoring is extremely important to assure appropriate blood levels and symptom relief. It is worth mentioning that many women will have low testosterone blood levels and be asymptomatic. This fact should imply that replacement of testosterone to normal levels does not guarantee results. For this reason, a trial may be very helpfu


How are progesterone supplements taken?

Progesterone supplementation can be achieved in the following ways: oral capsules, pellet implants, intrauterine device or creams. It is important to take them exactly as directed by your OB/GYN.

Progesterone Supplements

The possible benefits of progesterone supplements include:

Maintains the uterine lining and prevents excess tissue
Promotes normal sleep patterns
Increases metabolism and promotes weight loss
Balances blood sugar
Reduces blood clotting
Alleviates depression and reduces anxiety and stress
Prevents cyclic migraine headaches
Restores proper cell oxygen levels
Improves libido
Enhances thyroid hormones
Stimulates bone growth
Acts as a natural diuretic
Inhibits breast tissue overgrowth
Restores energy levels
Helps reduce hot flash symptoms of menopause

Most common side effects of progesterone supplements include:

Chest pain
Cold or flu-like symptoms
Cough or hoarseness
Problems with urination
Contact your OB/GYN if you have these symptoms after taking progesterone supplements.

What are the risk factors with progesterone supplements?

When using progesterone supplements you should have regular check ups with your OB/GYN to evaluate your progress. This check ups include regular pelvic exams, breast exams and mammograms.

Progesterone supplements come with the following precautions:

Progesterone supplements should never be taken when pregnant.
Progesterone supplements should be stopped if you have chest, groin or leg pain, difficulty breathing, shortness of breath, coordination loss or vision changes.
Progesterone supplements can slightly increase the risk of breast cancer and endometrial cancer.
Progesterone supplements in large doses, over a long period of time, and used with an estrogen supplement may increase the risk of heart attack, stroke, blood clots and dementia.
Progesterone supplements may increase your risk of heart disease or stroke if you smoke.
Proper use and proper management of progesterone supplements can result in better female health.

Bioidentical Hormone Pellets of North Texas

Dhea Men and Women

What are the potential benefits for using DHEA supplementation?

  • Bolster the adrenal gland to treat adrenal fatigue
  • Strengthen the immune system
  • Slow or reverse the aging process
  • Ease mild to moderate depression
  • Increase stamina/energy
  • Improve mood and memory
  • Improve muscle strength
  • Decrease body fat
  • Reduce fatigue
  • Improve fibromyalgia
  • Improve bone density
  • Improve sexual function/libido
  • Protect against Alzheimer’s disease
  • Soothe menopausal symptoms
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