These hormones are inserted in a simple, nearly painless procedure that takes less than 5 minutes right in the office. The advantage of pellets over pills, patches, creams, gels, and injections is that they are more convenient (they are inserted only 3-4 times a year) and they provide a much more even, consistent level of hormone in the blood. In addition, because unlike oral estrogen, the pellets do not pass through the liver and have no effect on blood clotting factors.
Major side effects of pellet implants are minimal from bio-equivalent hormone replacement. Minor side effects are not common however are reported from time to time. An example would be tender breasts or nipples or unwanted hair growth. But these occur in a very small percentage of women and can be remedied.