Your first hormone pellet appointment involves two visits: an initial consultation with lab work to assess your hormone levels, followed by a brief in-office insertion procedure that takes approximately 2 minutes and requires no downtime. Most patients feel initial improvements within a week and return just once every 4–6 months for their next cycle.
If you’ve been considering BHRT but haven’t taken the step yet because you weren’t sure what to expect, this guide walks you through every stage, from your first phone call to how you’ll feel in the weeks after insertion. There are no surprises here.
Before Your Appointment: What to Know
Many patients come to BioHormone Center after months, sometimes years, of living with fatigue, brain fog, low libido, disrupted sleep, hot flashes, or mood changes they’ve been told are “just part of aging.” The consultation exists to determine whether hormonal imbalance is contributing to those symptoms, and if so, what the right treatment approach looks like for your body specifically.
Before your first visit, it helps to:
- Write down your symptoms, how long you’ve been experiencing them, and any patterns you’ve noticed
- Make a list of any medications, supplements, or prior hormone therapy you’ve tried
- Note any relevant personal or family health history (heart disease, breast or prostate cancer, blood clotting disorders)
- Be prepared to have blood drawn, lab work is completed either at your first visit or at a nearby lab before your appointment, depending on your situation
Visit 1: Consultation and Lab Work
Meeting with Dr. Augustino
Your first visit is a clinical consultation with Dr. Michael Augustino. This is a real conversation, not a checkbox intake. Dr. Augustino will review your symptoms in detail, ask about your health history, and take the time to understand what you’ve been experiencing and what your goals are. His 30+ years as a board-certified OB/GYN mean he approaches hormone health with the clinical depth of a physician, not the sales approach of a wellness center.
Your Lab Panel
Hormone therapy is never prescribed based on symptoms alone. According to the Endocrine Society, proper diagnosis of hormonal deficiency requires both symptom assessment and objective lab testing. Lab results are typically reviewed within a few days. Dana, BioHormone Center’s hormone coordinator with 14 years of experience, will walk you through your results and what they mean before your next visit.
Visit 2: Pellet Insertion — What Actually Happens
Once your labs are back and Dr. Augustino has determined your custom pellet dose, you’ll return for the insertion procedure. Here is exactly what to expect:
The Procedure Itself
The insertion is performed in a treatment room at the clinic. The entire procedure takes approximately 2–5 minutes. Here’s the step-by-step:
- Positioning: You’ll lie on your side on the treatment table. The insertion site is typically the upper buttocks or hip area, an area with good subcutaneous tissue and minimal nerve sensitivity.
- Numbing: A small amount of local anesthetic (lidocaine) is injected at the insertion site. You’ll feel a brief pinch, about the same as a standard blood draw. Within a minute, the area is numb.
- Incision: Dr. Augustino makes a very small incision, approximately 3–4 millimeters, just large enough for the pellet to be inserted. This is significantly smaller than a standard suture site.
- Pellet placement: Using a sterile trocar (a slender insertion tool), the custom-compounded hormone pellet, roughly the size of a grain of rice, is placed just beneath the skin in the subcutaneous fat layer.
- Closure: The small incision is closed with a sterile strip (like a steri-strip) and covered with a small bandage. No stitches are required.
Does It Hurt?
The most common description from patients is: “I barely felt anything.” The numbing injection is the most noticeable sensation, a brief sting at the surface. The insertion itself is not felt while the area is anesthetized. Some mild soreness at the insertion site over the following 2–3 days is normal, similar to soreness after a flu shot. This resolves on its own without treatment.
What to Avoid After Insertion
To allow the pellet to settle properly, patients are typically advised to:
- Avoid submerging the insertion site in water (pools, hot tubs, baths) for 3 days for women and 7 days for men; showers are fine
- Avoid intense lower-body exercise (such as squats, running, or cycling) for 3 days for women and 7 days for men; light walking is encouraged
- Keep the bandage dry for 24 hours.
These restrictions are brief and minor. Most patients return to desk work and light daily activity the same day.
After Your Appointment: What to Expect Week by Week
Days 1–7
Some patients notice early improvements in sleep and energy within the first week. Others may not feel significant changes yet, this is normal, as the pellet is just beginning to establish steady hormone delivery. Mild bruising or tenderness at the insertion site may be present and is expected.
Weeks 2–4
Most patients begin noticing meaningful changes during this window: improved sleep quality, more stable energy through the day, reduced hot flash frequency, better mood, and sharper mental clarity. The Cleveland Clinic notes that hormone therapy improvements in sleep and vasomotor symptoms typically become noticeable within the first few weeks of treatment.
Weeks 4–8
Full effects, including libido, body composition changes, and cognitive improvements, generally develop over the first 4–8 weeks. By this point, most patients are experiencing the full benefit of their dose.
Months 3–6
As the pellet is gradually absorbed, hormone levels taper naturally. Most patients begin to notice the end of their cycle as symptoms begin to return subtly, a signal that it’s time to schedule reinsertion. Your hormone coordinator will monitor your labs and keep you on track.
Frequently Asked Questions
How long does the actual insertion procedure take?
The procedure itself takes approximately 2–5 minutes. Including preparation and post-procedure care, most patients are in and out within 15–20 minutes for the insertion visit.
Will I need to take time off work after the procedure?
No. Most patients return to sedentary and light-activity work the same day. If your job involves heavy physical labor or intense lower-body exercise, you may want to schedule your appointment before a lighter work day or weekend.
How will I know my dose is right?
Dr. Augustino builds your dose based on your specific lab values and symptom profile. If your first cycle doesn’t fully resolve your symptoms, which can happen as the body establishes a new baseline, the dose is refined at your next insertion. Most patients find their ideal dose within the first two cycles. Visit our BHRT FAQ page for more.
What if I have questions between appointments?
BioHormone Center’s team is available by phone at 954-384-8668 Monday–Friday, 9AM–5PM. Dana, our hormone coordinator, is your primary point of contact for questions about your labs, symptoms, and next appointment timing.
Take the First Step Today
If you’ve been living with the symptoms of hormonal imbalance and wondering whether BHRT is right for you, the best next step is a consultation. There’s no obligation, no pressure, and no guesswork, just a thorough clinical evaluation with a physician who has been specializing in bioidentical hormone therapy for over 13 years.
BioHormone Center serves patients from Weston, Fort Lauderdale, Boca Raton, Pembroke Pines, Coral Springs, and across South Florida. Request your consultation online. We’re here Monday–Friday, 9AM–5PM.
Medical Disclaimer: This content is for informational purposes only and does not constitute medical advice. Consult a qualified healthcare provider before beginning any hormone therapy.
