Hormone therapy
Biote Hormone Therapy in Salem, Oregon
Biote hormone therapy is a form of bioidentical hormone replacement that uses small pellets placed under the skin to release estradiol or testosterone over several months. At Functional Wellness & Aesthetics in Salem, Oregon, treatment starts with a blood panel and a consultation with Rick Meyers, FNP-BC. Pellets are recommended only when labs, symptoms, and health history all support them.
The basics
What Biote hormone therapy is
Biote is a method of bioidentical hormone replacement therapy (BHRT) that delivers hormones through pellets about the size of a grain of rice, inserted under the skin in a short office visit.
The pellets contain estradiol or testosterone with the same molecular structure as the hormones your body makes. A licensed compounding pharmacy prepares them, and they dissolve slowly over three to six months, so you don’t apply a cream every morning or remember a weekly shot.
Biote trains and certifies providers in this method. The company reports approximately 6 million pellet insertions across its network over more than a decade.
Rick completed Biote’s provider training in 2026 and offers hormone testing and pellet therapy at our Salem clinic.
Pellets are one way to deliver hormones, and they aren’t the right way for everyone. The table below shows how they compare with the other options you may have heard about.
How hormone pellets compare with other delivery methods
| Method | How often | Changing the dose | FDA-approved versions | Stopping treatment |
|---|---|---|---|---|
| Pellets (Biote) | Every 3 to 6 months | Only at the next insertion | Testopel testosterone pellets for men. Compounded pellets, including Biote, are not FDA-approved as finished products. | Slow. The pellet keeps releasing hormone until it dissolves. |
| Patches and gels | Daily to twice weekly | Any time | Yes, for estradiol and testosterone | Fast. Stop applying it. |
| Injections | Weekly to every few weeks | Each dose | Yes, for testosterone | Days to weeks |
| Pills | Daily | Any time | Yes, for estradiol and progesterone | Fast |
Steady release is the main reason patients choose pellets. The trade-off is flexibility. Once a pellet is in, the dose is set until it dissolves, which is why the testing and the conversation up front matter so much.
Symptoms
Symptoms that may point to a hormone imbalance
Low or shifting hormone levels can appear as changes in energy, sleep, mood, weight, and sex drive, and the pattern looks different in women and men.
For women
For women, the most common reasons to ask about hormone testing are hot flashes, night sweats, trouble sleeping, vaginal dryness, low libido, mood swings, and brain fog during perimenopause or after menopause.
For men
For men, it’s usually fatigue that rest doesn’t fix, loss of muscle despite training, weight gain around the middle, low motivation, irritability, and reduced sex drive or performance.
Testosterone in men declines gradually with age, and some men feel it more than others.
Thyroid problems, poor sleep, stress, certain medications, and untreated sleep apnea can cause many of the same symptoms. That’s why we test instead of guessing. If your labs point somewhere other than your sex hormones, we’ll say so.
Our approach
How Rick approaches hormone therapy
Rick Meyers, FNP-BC, reviews your symptoms, health history, lab results, and goals in person and builds a plan from those four things rather than from a protocol.
Rick is a board-certified family nurse practitioner with about 30 years in medicine and the founder of this clinic. In Oregon, nurse practitioners hold full practice authority, which means Rick orders your labs, interprets them, prescribes, and performs the insertion. The person who reads your results is the same person you talk to at every visit.
Some patients come in asking for pellets by name. Rick will still start with the labs and the history, and in some cases the recommendation will be a different form of hormone therapy, treatment for something else that’s causing the symptoms, or a referral.
Rick tells patients:
“I don’t start anyone on pellets at a first visit. We look at your labs, your history, and what you’re feeling, and then we decide together whether this is the right tool for you.”
Step by step
How the process works
Treatment follows five steps: a consultation with lab work, a results review, the pellet insertion, follow-up labs, and a maintenance schedule based on how your body responds.
01
Step 1: Consultation and lab work
Your first visit is a consultation with Rick. You’ll talk through your symptoms, medications, and medical history, and we’ll draw blood for a hormone panel. For women, that typically includes estradiol, FSH, and total testosterone. For men, it includes free and total testosterone and estradiol. Both panels usually add thyroid markers, a blood count, and a metabolic panel. Men over a certain age also have a PSA drawn.
02
Step 2: Results review and plan
When your results are back, you’ll meet with Rick to go over them line by line. If the labs and your symptoms support hormone therapy, Rick will recommend a dose and explain the risks and benefits. If they don’t, you’ll leave with a clear answer about what to look at instead.
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Step 3: Pellet insertion
Insertion takes a few minutes. Rick numbs a small area of the upper hip or buttock, makes a tiny incision, places the pellets under the skin, and covers the site with a bandage. There are no stitches, and you can drive yourself home.
04
Step 4: Follow-up labs
About four to six weeks after your first insertion, we draw blood again to see how your levels responded. This is how Rick fine-tunes the dose for your next round.
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Step 5: Maintenance
Pellets last about three to five months in women and four to six months in men, depending on dose and metabolism. Many patients return two to four times a year. You’ll know it’s time when symptoms begin to return, and we’ll schedule your next visit around that pattern.
What to expect: women and men
| Topic | Women | Men |
|---|---|---|
| Hormones in the pellets | Estradiol and/or testosterone | Testosterone |
| How long a pellet lasts | About 3 to 5 months | About 4 to 6 months |
| Progesterone | Prescribed alongside estradiol if you still have a uterus | Not applicable |
| Follow-up labs | 4 to 6 weeks after first insertion | 4 to 6 weeks after first insertion |
| Activity after insertion | Avoid strenuous lower-body exercise, baths, and hot tubs for about 3 days. Showers are fine the next day. | Avoid strenuous lower-body exercise, baths, and hot tubs for about 7 days. Showers are fine the next day. |
| When patients notice changes | Some within 2 to 4 weeks. Full effect can take up to 6 months. | Some within 2 to 4 weeks. Full effect can take up to 6 months. |
Candidacy
Who may be a candidate
Candidates for Biote pellet therapy are adults whose symptoms match a hormone deficiency confirmed on blood work and who have no condition that makes hormone therapy unsafe.
You may be a candidate if you’re a woman in perimenopause or past menopause with symptoms affecting daily life, or a man with low testosterone on labs and symptoms to match. Patients who have struggled to stay consistent with creams or injections sometimes do better with pellets.
Hormone therapy may not be appropriate if you have:
- a history of breast, uterine, or prostate cancer
- a history of blood clots or stroke
- uncontrolled high blood pressure
- if you’re pregnant, breastfeeding, or trying to conceive
Men with an elevated PSA will need a urology workup first. Rick reviews every one of these with you at the consultation.
The evidence
What the research says about pellets
Major medical groups recommend FDA-approved hormone therapy as the first choice, and compounded pellets have less safety data behind them than approved patches, gels, pills, and injections.
The American College of Obstetricians and Gynecologists states in its 2023 clinical consensus that compounded bioidentical hormone therapy should not be prescribed routinely when FDA-approved formulations exist.
Patients who choose it should understand the lack of FDA approval and the risks specific to compounding.
Pellets also deliver a fixed dose. Research presented at ACOG’s 2021 meeting found women on pellets had higher peak estradiol and testosterone levels and more side effects, including abnormal uterine bleeding, than women on FDA-approved therapy.
Many patients feel better on pellets, and the steady release suits some lifestyles. The decision still deserves real lab work, clear counseling, and follow-up, which is what you’ll get here.
Safety
Side effects and risks
The risks of Biote pellet therapy fall into two groups: procedure risks at the insertion site and hormone-related side effects that depend on the dose.
At the insertion site
At the insertion site, you may have bruising, tenderness, or swelling for a few days. Less often, the site can bleed or become infected, or a pellet can work its way back out through the skin. Following the activity restrictions lowers that risk.
Hormone-related side effects
Hormone-related side effects in women can include acne, facial hair growth, breast tenderness, mood changes, and irregular bleeding. Women with a uterus who receive estradiol need progesterone to protect the uterine lining. In men, testosterone can raise red blood cell count, cause acne or breast tenderness, and lower sperm count while on treatment.
Because a pellet can’t be removed easily once it’s placed, a dose that turns out to be too high stays in your system until the pellet dissolves. This is the main reason Rick starts conservatively and rechecks labs after the first round.
Transparent planning
Cost and insurance
Most insurance plans don’t cover compounded hormone pellets, though many cover the consultation and the lab work.
We’ll give you the price of the insertion and any follow-up labs at your consultation so there are no surprises. Men typically need more pellets than women, so the cost differs. If you plan to use an HSA or FSA, ask us at your visit.
Why patients choose us
Why patients choose Functional Wellness & Aesthetics
Patients choose us for hormone therapy in Salem because one experienced provider handles every step, from the first lab draw to each follow-up.
Rick founded the clinic in 2020 after decades in medicine and treats every patient personally. Hormone therapy here sits alongside medical weight management and peptide therapy, so if your labs or goals call for a broader plan, you won’t be sent somewhere else to build it.
Every first consultation is free. Bring your questions, and bring any recent lab results you have.
Do you have a question?
Frequently asked questions
How does hormone testing work?
Hormone testing at our clinic is a blood draw. For women, Rick typically checks estradiol, FSH, total testosterone, and thyroid markers. For men, free and total testosterone, estradiol, a blood count, and PSA when age-appropriate. Results usually come back within a week, and you’ll review them with Rick in person.
How often do I need pellets?
Pellets typically last three to five months in women and four to six months in men, so most patients come in two to four times a year. The timing depends on your dose, your metabolism, and when your symptoms return.
How soon will I feel a difference?
Some patients notice changes within two to four weeks of the first insertion. Full effect can take up to six months, and some people feel the most benefit after their second round once the dose has been adjusted from follow-up labs.
Is Biote hormone therapy safe?
Hormone therapy carries risks, and compounded pellets have less long-term safety data than FDA-approved options. Safety depends on screening out people who shouldn’t take hormones, starting at an appropriate dose, and rechecking labs. Rick walks through your personal risk factors at the consultation and will tell you if hormone therapy isn’t a good idea for you.
Are Biote pellets FDA-approved?
No. Biote pellets are compounded by licensed pharmacies, and compounded medications aren’t reviewed or approved by the FDA as finished products. The hormones inside them, estradiol and testosterone, are the same molecules found in FDA-approved products. Testopel is an FDA-approved testosterone pellet for men.
What does the consultation involve?
Your first visit is free and takes about 30 to 45 minutes. You’ll go over your symptoms, medications, and history with Rick, and we’ll draw blood for your hormone panel. You’ll come back for a second visit to review results and decide on a plan together.
Can pellets be removed if I have side effects?
Removal is difficult and often unsuccessful. Once placed, a pellet dissolves on its own over several months. This is why Rick starts with a conservative dose and checks labs four to six weeks later.
Do I need progesterone with pellets?
If you still have a uterus and receive estradiol, yes. Progesterone protects the uterine lining from the effects of estrogen. Women receiving testosterone alone generally don’t need it.
Can I exercise after a pellet insertion?
Walking is fine right away. Avoid strenuous lower-body exercise, baths, swimming, and hot tubs for about three days if you’re a woman and about seven days if you’re a man. Showers are fine the next day.
I’m already on testosterone injections. Can I switch to pellets?
Often, yes. Rick will time your lab draw around your current injection schedule, review the results, and plan the transition so your levels stay steady.
Does insurance cover Biote hormone therapy?
Insurance usually doesn’t cover compounded pellets. Many plans do cover the consultation and lab work. We’ll give you the full cost of the pellet insertion at your visit.
Is hormone therapy right for perimenopause?
It can be, depending on your symptoms and labs. Women who still have cycles make estrogen and progesterone on their own, so the approach differs from treatment after menopause. Rick will talk through what makes sense for your stage.
Book a hormone consultation in Salem
Functional Wellness & Aesthetics is at 180 Ramsgate Square SE, Salem, OR 97302. We’re open Monday to Friday, 8:30 am to 5:30 pm, and you can reach us at 503-991-8549. Your first consultation is free, and it starts with a conversation about what you’re feeling.
About the provider
About Rick Meyers, FNP-BC
Begin here
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