Bio-identical Hormones vs. Pharmaceutical Hormones Fox Valley Plastic Surgery

Designed for the Way You’re Meant to Feel

Hormone Replacement Therapy is approved for the relief of menopausal symptoms, and prevention of osteoporosis in at-risk women, and for andropause (low testosterone) in men. It also improves muscle function, reduces heart failure and heart attack risk, lowers mortality in younger postmenopausal women, protects against brain aneurysms, and preserves brain function.

Fox Valley Plastic Surgery helps men and women throughout Wisconsin recapture their wellness and vitality from the inside out with bioidentical hormone replacement therapy (BHRT) as opposed to traditional HRT, which uses synthetic ingredients. A blood test would not be able to distinguish BHRT hormones from the body’s own natural hormones.

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BHRT: Key Details

Procedure Time: Initial consultation, 30-60 minutes; insertion, 20 minutes
Anesthesia: Local anesthesia
Recovery: No downtime
Results: Some patients notice improvement within 2-4 days; full effects felt within 8 weeks
Duration: 3-6 months, depending on gender and cardiac output
Pricing: Consult $100, Blood test cost determined by chosen lab, female BHRT visit every 3-4 months $425 per insertion, male BHRT visit every 6 months $1100 per insertion

What Is BHRT?

Bioidentical hormone replacement therapy is a medically supervised approach to restoring hormone levels that have declined due to aging, menopause, andropause or other physiological changes.

Bioidentical hormones are chemically identical to the hormones your body naturally produces. They are usually derived from plant sources (e.g. wild yams, soy, or cactus) and then processed to match human estrogen (estradiol, estriol), progesterone, and testosterone. Traditional HRT uses synthetic or animal-derived hormones that are similar but not identical to human hormones.

At Fox Valley Plastic Surgery, we use pellet-based BHRT. Small pellets, roughly the size of a grain of rice, are inserted just beneath the skin and dissolve gradually over three to six months. These pellets release hormones at a rate your body naturally regulates based on activity levels and physiological demand. The result is consistent hormone levels throughout the day, without the peaks and dips that come with other delivery methods.

Pellet therapy is the preferred choice of patients because of its convenience as well as the fact that it most closely mimics the pathways of endogenous hormones. Pellet therapy reduces or eliminates unwanted risks and side effects that are commonly associated with other forms of hormone therapy.

Why We Use EvexiPEL Bioidentical Hormones

Not all bioidentical hormones are created equal. At Fox Valley Plastic Surgery, we use EvexiPEL by Evexias Health Solutions, the gold standard in bioidentical hormone replacement therapy. The EvexiPEL Method was created to reduce inflammation, promote comfort at the insertion site, deliver consistent dosing, and achieve hormone optimization.

EvexiPEL pellets are compounded using plant-based hormones that are indistinguishable from those your body naturally produces, providing steady and consistent hormone optimization for up to six months. For optimal results, Evexias makes dosing recommendations based on patients’ individual lab results.

Additionally, all EvexiPEL providers are required to complete rigorous training in the EvexiPEL Method, which means they understand the nuances of hormonal balance. This advanced protocol ensures your treatment is safe, effective and completely customized to your body.

What Can BHRT Address?

More than 60 percent of people suffer from signs and symptoms related to hormone imbalance. Early symptoms of hormone imbalance are commonly dismissed as signs of aging or stress.

For women, common concerns include:

Hot flashes and night sweats
Disrupted sleep and fatigue
Low libido and vaginal dryness
Brain fog and difficulty concentrating
Mood swings or instability
Weight gain, particularly around the midsection
Joint pain and reduced muscle tone

For men, pellet BHRT often helps with:

Low testosterone and reduced sex drive
Fatigue and diminished motivation
Loss of lean muscle mass
Mood changes and irritability
Brain fog and poor concentration

If you are experiencing the symptoms of hormonal imbalance, you know they are not just minor inconveniences. For many patients, they can affect work, relationships and overall quality of life. BHRT can help you reclaim your vitality and start feeling like yourself again.

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Who Is an Ideal Candidate?

Both men and women who are experiencing the symptoms of hormonal decline can be good candidates for pellet hormone replacement therapy. This treatment is most often sought by:

Women who start therapy before they are 60 years old, and within 10 years of menopause.
Men with low testosterone or androgen insufficiency syndrome (AIS)
Patients who have had unsatisfactory results with other hormone delivery methods
Both men and women with unexplained symptoms
Individuals in good overall health who are not currently managing certain hormone-sensitive cancers

You may also be a candidate if you’re experiencing symptoms like low libido or joint pain that your primary care provider hasn’t been able to connect to a specific cause. Hormonal changes are frequently overlooked, particularly in women under 50. At FVPS, a full assessment is completed before any treatment recommendation is made. That includes a review of your symptoms, health history and lab work to confirm hormone levels.

Real Patients stories

“My moods have changed, I’m happy and even-keeled.”

- Annie

What to Expect During Your BHRT Journey

Consultation & Lab Work

Every treatment plan begins with a thorough consultation. We’ll review your symptoms, discuss your health history and order bloodwork to get a clear picture of your current hormone levels. At Fox Valley Plastic Surgery, BHRT is only administered to patients who need it. For your convenience, we offer BHRT consultations at both our Oshkosh and Appleton locations.

Pellet Insertion

Pellet insertion is a relatively simple in-office procedure. The skin is numbed with a local anesthetic, and a very small incision is made in either the lower back or the upper buttocks. With a small metal device called a trocar, the pellets are then inserted into the deep fat layer, where they won’t be felt during daily activities. The incision is then closed with a Steri-Strip, and you’re free to return home. Most patients find the procedure easy and experience little to no discomfort during insertion.

How Pellet Insertion Works

Ongoing Monitoring

At Fox Valley Plastic Surgery, we closely monitor every BHRT patient to ensure hormone levels remain in the appropriate range and to determine when it’s time for your next appointment. Follow up labs are required after the initial insertion. Pellets typically last three to six months, depending on how quickly your body metabolizes the hormones. More active patients tend to go through pellets more quickly. Patients soon learn how often they need their pellets replenished to keep feeling well.

BHRT Recovery & Results

Recovery

After pellet insertion, vigorous physical activity should be avoided for two to three days to allow the incision site to heal. Otherwise, you can return to your normal routine immediately. There are no lifestyle restrictions tied to the pellet itself. Some patients notice a difference within days. For others, the full benefit builds over three to four weeks as hormone levels stabilize.

Results

Results vary by individual, but the changes our patients describe are consistent. Better sleep is usually one of the first things noticed, followed by increased energy levels and enhanced mental clarity. Because the pellet delivers hormones steadily by reacting to the needs of your body, there are no “spikes” and “dips.” This consistency is one of the things our patients appreciate the most about pellet hormone therapy.

Long-Term Outcome

Patients who eat healthy and exercise regularly while on BHRT notice more positive changes in overall quality of life. Hormones help create optimal conditions for improvement, but they work best when the rest of your lifestyle is pulling in the same direction.

Frequently Asked Questions

How is pellet BHRT different from a patch or cream?

Patches and creams release hormones inconsistently and require daily or biweekly attention. They can also transfer to others through skin contact. Pellets bypass all of that by releasing hormones steadily and gradually, helping maintain consistent levels without daily dosing.

What's in the pellets?

The pellets contain either bioidentical estradiol, testosterone or both, depending on your individualized treatment plan. They are derived from plant-based compounds, most commonly soy or yams, and are compounded to match your specific dose by a licensed, FDA-registered 503B pharmacy. They dissolve completely and do not need to be removed.

How long before I feel results?

Some patients notice changes, particularly in sleep quality and energy, within two to four days of insertion. Full results are typically felt within three to four weeks as hormone levels stabilize. Individual timelines vary based on how depleted your starting levels were and how quickly your body metabolizes hormones.

Are there side effects?

The pellet insertion itself carries minimal procedural risks: minor bleeding, bruising, infection and, very rarely, pellet extrusion. These complications are uncommon. As hormone levels adjust in the first few weeks, some patients experience temporary changes in mood, acne or cycle irregularities. These typically resolve as levels stabilize. Your provider will walk through what to watch for at your consultation.

What is the FDA guidance on hormone therapy?

There is no direct causative link between bioidentical estrogen, progesterone, and breast cancer. In late 2025, the US Food and Drug Administration formally approved changing the drug labels for menopausal hormone therapy products, including estrogen therapies. The updates involve removing the long-standing “boxed warning” that highlighted risks such as cardiovascular disease, breast cancer and probable dementia. The change reflects newer research that paints a more nuanced picture of the risks and benefits of HRT for many women.

Because the FDA reversed the black box warning on hormone replacement therapy, there has been an immediate demand for HRT. As of the beginning of 2026, there is a nationwide shortage of estrogen patches as demand for menopause hormone therapy grows. The manufacturers of the patches do not expect to fully resolve the shortage until the end of the year. These patches are not bioidentical hormone replacement therapy, which is better absorbed by the body, but they are a form of relief for some patients. Therefore, many patients are looking at pellet therapy as their preferred method of dosing.

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Most of our BHRT patients tell us they wish they’d come in sooner. If you’ve been living with low energy, poor sleep, weight gain and other symptoms you can’t quite explain, a conversation with our experienced team is the first step to reclaiming your inner vitality. Call us at 920-233-1540 or request an appointment online to get started and find out if BHRT is right for you.

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