At Fox Valley Plastic Surgery, we help men and women throughout Wisconsin recapture their wellness and vitality from the inside out with bioidentical hormone replacement therapy (BHRT). With a completely customized approach tailored to your body’s unique needs, we craft personalized treatment plans that can help you feel like yourself again.
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. Rather than approximating what your body once produced, BHRT uses hormones that are molecularly identical to your own, so you receive exactly what you’ve been missing.
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.
Technically speaking, all hormones are “natural,” but the distinction that matters clinically is molecular structure.
Bioidentical hormones are derived from plant compounds, often found in yams and soy, and processed to be structurally identical to human estradiol and testosterone. Because they are indistinguishable from your own natural hormones, bioidentical hormones act as precise molecular “keys” to receptor sites, and the body metabolizes them the way it was designed to.
Synthetic hormones, by comparison, are approximations. They can still bind to receptors and produce effects, but the fit isn’t the same, and neither are the results. Synthetic hormones are also significantly more potent, with a side effect profile that tends to be broader and harder for many patients to tolerate.
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. 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.
Hormonal imbalance doesn’t announce itself with a clear diagnosis. More often, it shows up in how poorly you’re sleeping, how slow your recovery is after exercise and how low your energy feels despite doing everything right. For many patients, the dots only connect in retrospect.
Pellet BHRT is appropriate for both women and men and can address a wide range of symptoms tied to declining hormone levels.
For women, common concerns include:
For men, pellet BHRT often helps with:
If you’re 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.
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:
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.
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 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.
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. 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.
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 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.
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. If you’re frustrated by weight gain, particularly around the midsection, our medical weight loss program can be a meaningful complement to your BHRT protocol, giving you a more complete foundation for lasting results.
For over 30 years, Fox Valley Plastic Surgery has served thousands of patients across Wisconsin, building a reputation grounded in thoughtful care and medically sound decision-making. We don’t bring in treatments because they’re trending. Every therapy we offer has been carefully evaluated for safety and effectiveness before it’s made available to our patients.
Our BHRT program uses the EvexiPEL Method, one of the most clinically established pellet delivery systems available. EvexiPEL uses the highest-quality hormones from a leading compounding pharmacy and FDA-registered 503B outsourcing facility. With individualized dosing and ongoing monitoring, your treatment plan can evolve as your needs change, so our protocols are never one-size-fits-all.
Our team includes practitioners with deep experience in hormone health, and we take time to actually listen during consultations. Patients frequently tell us that Fox Valley is the first place where someone connected the dots between the symptoms they’d been describing for years and an underlying hormonal issue.
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.
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.
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.
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.
There is no direct causative link between bioidentical estrogen, progesterone, and breast cancer. The Women’s Health Initiative (WHI) study in 2003 raised concerns about “hormones and breast cancer,” but a long-term follow-up study published in JAMA in 2017 by one of the original WHI authors found no increased mortality from breast cancer in the subjects over an 18-year period.
The number of patients receiving HRT five to 10 years after breast cancer treatment is increasing. However, hormone use in patients with a history of hormone-receptor-positive tumors is not yet considered standard care. The decision to use hormones in this situation is an informed one that the patient must make for herself.
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 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.
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.
