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Hormone Replacement Therapy

For Women in North Carolina



From metabolism to heart rate, sleep cycles, reproductive cycles, body temperature, and mood, hormones play an important role in the body as “messengers” that trigger essential functions.

Because of this, hormonal imbalance in women can manifest in different ways, making it difficult to identify. Onset can occur as a result of aging, menopause, lifestyle, disease, and environmental factors.

How it works: Delivering the Right Method

Our priority is to offer you the best solutions for your specific body and goals. This may require using more traditional hormone therapy options such as pills, patches, creams, and injections, or more modern and effective solutions like hormone pellet therapy.


Bioidentical hormones are identical in molecular structure to human hormones, which means your body effectively cannot tell the difference. Plus, the pellet delivery method we use in at Blue Sky MD ensures a consistent dosage over time.

Once every several months, we painlessly insert the pellet under the skin, and over time, the pellet consistently and evenly releases small doses of hormones.

We find that even patients who have failed to get results with other types of hormone replacement therapy see a high level of success with this bioidentical hormone replacement therapy method.



The first step in the hormone therapy process is to get some blood work done so we may analyze your current hormone levels. This helps us understand your symptoms and formulate your hormone prescription dosage.



Once we’ve established your baseline hormone levels, we can begin treatments with the appropriate delivery method.

If pellets are your delivery method, your Blue Sky MD providers will perform a quick procedure to insert the pellet under the skin.



You’ll meet with your Blue Sky MD provider periodically to get more bloodwork done, assess hormone levels, and verify symptoms are improving.

Patients receiving pellet therapy will need a new pellet inserted every 3-6 months.

Ready to get started? Schedule your first lab appointment.


Hormone therapy increases your chance of successful weight loss by 10% in both men and women.

HRT improves lean muscle mass, which increases metabolism and supports weight loss efforts.

On average, male patients using hormone therapy lose 20-25% more weight with combination hormone therapy and nutrition program. Women lose 10% more weight than just with nutrition programs.

In short, it depends. In some cases hormone replacement therapy is considered an elective procedure and isn’t covered by insurance. 

For other patients hormone therapy is a medical necessity. 

Contact us to find out if we can bill your insurance!

There are several types of hormone therapy available. The type prescribed a physician will depend on a patient’s symptoms and particular needs. Some common types of hormone therapy include:

  1. Estrogen Therapy
    This is the most commonly prescribed type of HT and is used to relieve symptoms of menopause such as hot flashes and vaginal dryness. It can be taken in the form of pills, patches, gels, or creams.

  2. Progestin Therapy
    This type of therapy is often prescribed in combination with estrogen therapy. Progestin is a synthetic form of progesterone, a hormone that helps balance the effects of estrogen.

  3. Testosterone Therapy
    This type of therapy is typically prescribed for men who have low levels of testosterone, a condition known as hypogonadism. Testosterone therapy can be administered in the form of gels, patches, or injections.

  4. Thyroid Hormone Replacement Therapy
    This type of therapy is used to treat low thyroid hormone levels, a condition known as hypothyroidism. Thyroid hormone replacement therapy can be taken in the form of pills.

  5. Bioidentical Hormone Therapy
    This type of therapy uses hormones that are chemically identical to those naturally produced by the body. They are usually customized to the individual patient based on their hormone levels and symptoms.

It depends. If we’re able to bill insurance, out of pocket costs may vary. 

During menopause women may experience insomnia, low energy, anxiety and depression, mood swings, sudden weight gain, and low libido.

As if these frustrating symptoms weren’t bad enough, imbalanced hormones in women may increase the risk of osteoporosis, cancer, heart disease, Alzheimer’s, and many other diseases and conditions.

Hormone therapy helps reduce these symptoms and protect our bodies against the more serious side effects of aging.

Pellets are made up of either estradiol or testosterone. The hormones are pressed or fused into very small solid cylinders. These pellets are larger than a grain of rice and smaller than a ‘Tic Tac’.

In the United States, the majority of pellets are made by compounding pharmacists and delivered in sterile glass vials. There is an ‘FDA approved’ 75 mg testosterone pellet.

Data supports that hormone replacement therapy with pellet implants is the most effective and the most bio-identical method to deliver hormones in both men and women.

Implants, placed under the skin, consistently release small, physiologic doses of hormones providing optimal therapy.

Pellets deliver consistent, healthy levels of hormones for 3-4 months in women and 4-5 months in men. They avoid the fluctuations, or ups and downs, of hormone levels seen with every other method of delivery. In studies, pellets have been shown to be superior for relief of menopausal symptoms, maintenance of bone density, restoration of sleep patterns, and improvement in sex drive, libido, sexual response and performance.

The insertion of pellets is a simple, relatively painless procedure done under local anesthesia. The pellets are usually inserted in the lower abdominal wall or upper buttocks through a small incision, which is then taped, closed.


Complications from the insertion of pellets include; minor bleeding or bruising, discoloration of the skin, infection, and the possible extrusion of the pellet. Other than slight bruising, or discoloration of the skin, these complications are very rare. Testosterone may cause a slight increase in facial hair in some women. Testosterone stimulates the bone marrow and increases the production of red blood cells.


Some patients begin to ‘feel better’ within 24-48 hours while others may take a week or two to notice a difference. Diet and lifestyle, along with hormone balance are critical for optimal health. Stress is a major contributor to hormone imbalance and illness. Weight loss is often helpful to optimize the effectiveness of pellet therapy.


The pellets usually last between 3 to 4 months in women and 4-5 months in men. The pellets do not need to be removed. They completely dissolve on their own.


If you have insurance, we are happy to file for your office visit and the procedure (which will require a co-pay). Self pay options are available if you do not have insurance or a have a high deductible.

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Aren’t able to make it in for an appointment in person? We get it. Life happens! Schedule a telehealth visit and meet with your provider virtually.

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Your unique biology determines your path to success for both weight loss and hormone balance. Start today with our short online Health Assessment that helps us understand your needs.

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