Get Well. Live Well.

Optimizing your hormones’ may help with sleep, energy, mood, brain fog and more.

Patients report improvement in many of these symptoms:

Mental fatigue and reduced focus


Lack of energy and motivation


Increased fat around mid-section


Muscle loss or inability to gain muscle


Depression, anxiety & mood swings


Irritated, snappy & on edge


Muscle and/or joint pain


Reduced sexual desire & performance

Bio-identical Hormone Replacement Therapy – An Integrative Approach to Hormone Optimization

Health practitioners have been performing bio-identical hormone replacement therapy (BHRT) with natural, plant-based pellet implants since the 1930s. Recently, there has been a resurgence in the number of practitioners offering pellet therapy, after studies revealed that natural hormones may be a safer, more effective alternative to synthetic hormone modalities that have been popular for decades.

One of the first practitioners to rediscover the benefits of BHRT with pellets was EvexiPEL® founder Terri DeNeui, MSN, APRN-BC. DeNeui launched EVEXIAS® Medical Centers in 2009 and has been helping patients heal ever since, by taking an integrative and functional approach to health and wellness.

Balancing hormones is only one part of the solution. We dig deeper to get to the root of the patient’s health issues before prescribing a pathway toward optimal health.”
– Terri DeNeui, MSN, APRN-BC

The EvexiPEL® difference

Thousands of practitioners around the world offer BHRT with pellets today – but most don’t take the integrated approach you’ll find with EvexiPEL® practitioners.

Consequently, while pellet therapy works beautifully in 60-70 percent of patients, an average of 30 percent of patients don’t feel better, even if their blood work looks good on paper. The EvexiPEL® approach is more effective for three reasons.


Commitment to digging deep. EvexiPEL® practitioners are trained to keep digging for the root cause of the patient’s health issues.


Integrated approach to treatment. Once the root cause is revealed, the practitioner creates a customized treatment plan for the patient. That plan may include pellet therapy, resolving leaky gut issues, detoxification (physical, environmental and emotional toxicity), nutrient supplementation and more.


EvexiPEL’s® superior pellet therapy method. Over time, DeNeui and her team of BHRT experts have fine-tuned their integrated approach to pellet therapy at EVEXIAS Medical Centers, becoming one of the largest hormone pellet therapy providers in the country.

This superior method has been shown to decrease inflammation at the insertion site, subsequently increasing healing and recovery times, as well as decreasing post insertion pain and pellet extrusion rates. Further, meticulous detail to the process has resulted in a superior method with better absorption rates and longer lasting results.

Frequently Asked Questions About BHRT with Pellets

If you have questions about bio-identical hormone replacement therapy with pellets, we’ve got answers. Check out our FAQs below, and feel free to contact us with additional questions.

So what exactly are bio-identical hormone pellets anyway?

Larger than a grain of rice and smaller than a Tic Tac, BHRT pellets are composed of either estradiol (an estrogen hormone) or testosterone. EvexiPEL® pellets are manufactured by FarmaKeio, a leading compounding pharmacy in the United States, where the hormones are pressed or fused into small, solid cylinders.

What happens during BHRT with pellets?

During BHRT with pellets, the practitioner makes a tiny incision – usually in the buttocks or flank – then inserts the pellets into the fatty tissue under the skin. The practitioner then closes the incision, without the need for stitches. To prevent patient discomfort, a local anesthetic is applied to the insertion site prior to the procedure.

How does BHRT with pellets work?

In response to physical activity or emotional stress (whether it’s good stress or bad), the pellets release estradiol and/or testosterone into the body. Thanks to the pellets, which are securely tucked away beneath the skin, the patient receives a steady stream of hormones, which keeps annoying mood and energy fluctuations at bay.

Is the EvexiPEL® method different than other forms of pellet therapy?

Yes! And the EvexiPEL® formulation has been shown to produce better outcomes for patients, too. After a decade treating thousands of patients, EvexiPEL® founder Terri DeNeui, MSN, APRN-BC worked diligently with a team of experts to develop a proprietary pellet formula.

Put into practice at one of the largest known hormone pellet therapy providers in the country – EVEXIAS® Medical Centers – the formulation yielded the following results:

  • Reduced scar tissue, resulting in far fewer pellet extrusions. Decreasing additional office visits dealing with complications and wasting valuable resources in practitioner clinics.
  • Far fewer boosts required in new patients. More effective and convenient for patients.
  • Quicker Absorption. Patients reported more comprehensive symptom relief sooner than with other compounded pellets.
  • More consistent absorption over time. Thus ensuring longer lasting therapeutic results.
  • Increased practitioner and patient satisfaction. Period.
How do pellets stack up against other BHRT options, like creams, patches, pills and injections?

Research consistently shows pellet implants offer a superior way to deliver hormones in women and men. Implanted in the fatty tissue under the skin, pellets release a constant stream of hormones into the body, 24/7/365, mimicking the way the body naturally releases hormones.

Convenience is also a key. With pellets, patients undergo the procedure two or three times a year and get on with life. Other modalities, like pills and messy creams, need to be used daily. Patches work a bit better, but the absorption of skin-based delivery methods is variable. People also lose sensitivity over time, which means patients will eventually need to find a new spot to apply the cream or adhere the patch.

How often do patients need to get pellet implants?

Pellet implants typically last 5 to 6 months in men (two visits per year) and 4 to 5 months in women (three visits per year).

Is the BHRT pellet implant procedure painful?

A topical anesthetic is applied to the site of the implant, which is placed in the fatty tissue under the skin. Patients experience little to no discomfort during or after the procedure.

How soon can patients expect to experience results following the BHRT pellet procedure?

Most female patients begin to “feel better” within 48 to 72 hours, though it may take a week or two for some women to notice a difference. Men can expect to experience the benefits of their pellet implants within 1 to 2 weeks. To achieve optimal health, living a healthy lifestyle – balanced diet and regular exercise – goes hand-in-hand with hormone balance.


While most people experience substantial benefits after the first round of therapy, many patients experience more pronounced benefits after the second round of pellet implants. Therefore, patients should expect to have the procedure performed at least twice before experiencing optimum results. People don’t get out of balance overnight, so it often takes a few months to get back on track.

Should patients plan for any downtime following EvexiPEL® pellet therapy?

Patients should take it easy and avoid strenuous exercise for a few days following the procedure – 72 hours for women and 5 to 7 days for men. This helps ensure the tiny incision heals properly and can prevent extrusion of the pellet from under the skin.

Does insurance cover bio-identical hormone replacement therapy with pellets?

Many – but not all – insurance companies will reimburse patients for EvexiPEL® pellet therapy. EvexiPEL® practitioners can provide patients with the paperwork necessary to seek reimbursement.

How long can patients expect to continue undergoing EvexiPEL® pellet therapy?

EvexiPEL® practitioners treat patients of all ages – from the 20s to the 90s – so there is no firm answer. Instead, the patient needs to decide how long they want to look and feel better, while experiencing the protective benefits of balanced hormones, which are many. (See our Benefits of BHRT sections for men and women to learn more.)

How do EvexiPEL® practitioners determine whether or not a patient is a good candidate for pellet therapy?

During the initial consultation, the practitioner will inquire about the patient’s health and wellness goals and concerns. Then he or she will perform a thorough exam and lab tests to find the root cause of any health issues and whether hormone imbalance is to blame. If the patient is diagnosed with hormone imbalance, the practitioner will prescribe an integrated treatment plan based on the patient’s test results and information the patient provides (health and family history, symptoms, etc.).

EvexiPEL® doesn’t limit treatment to pellets: Why DNA, toxicity and gut health matter

Unlike other BHRT providers, EvexiPEL® practitioners take a functional approach to treating patients with hormone imbalance. After years of treating thousands of patients and digging deep to find the root cause of patient health concerns, DeNeui, found that some patients don’t respond to BHRT with subcutaneous pellets alone.

“Today we take a much more integrated approach to treating patients than in the past. Experts in hormone optimization, functional medicine, nutrition and mental health work as a team so patients experience optimum results.”

– Terri DeNeui, MSN, APRN-BC

Over the years, DeNeui and her team of practitioners have discovered that hormone imbalance is but one factor that contributes to patients’ health struggles. The mind, body and spirit all need to be addressed in order for the patient to heal fully. Key insights include:

DNA: Recent research has revealed that how we metabolize hormones is hardwired in our DNA. Practitioners need to be aware that some patients have more difficulty metabolizing hormones, so treatment plans need to be modified accordingly.

Toxicity: Practitioners need to talk with patients about the toxins they’re exposed to in their day-to-day lives, then counsel them on steps to take to remove them. Toxicity goes beyond the food, fluids, chemicals and pollution we consume or breath in – toxic relationships and jobs lead to unnecessary stress and anxiety that makes people vulnerable to illness and chronic disease.

Gut health. Research has revealed there is a direct connection between gut health and inflammation, autoimmune disorders, mental health and more. It’s also essential to have a healthy gut in order to metabolize hormones efficiently. Thus, while uncovering the root cause of the patient’s health issues, practitioners must closely analyze the patient’s gut health and prescribe the appropriate detox program, probiotics, nutrients and supplements to restore gut health.

Partners in health: The patient-practitioner connection

Since many patients don’t see the results they seek with pellet therapy alone, both patient and practitioner need to commit to communicating openly – and often – about what’s working and what isn’t. EvexiPEL® practitioners know that regular and consistent patient follow up is key, because follow-up protocols are a fundamental part of the training EvexiPEL® provides.

Patients – especially the 30 percent noted above – also need to commit to the follow-up visits, tests and conversations needed to get well. The Band-Aid mindset – treating symptoms instead of the root cause – doesn’t work, so patient commitment to communication and follow through is essential for long-term health and wellness.

Get In Touch

Give Us A Call

(972) 668-2636


Monday – Wednesday: 9:00am to 5:00pm
Thursday: Closed
Friday: 9:00am to 5:00pm
Saturday & Sunday: Closed

Located at

9555 Lebanon Rd, Ste. 701
Frisco, TX 75035