WOMEN POST-INSERTION INSTRUCTIONS
Bandage Removal
Your insertion site has been covered with two layers of bandages
- Outer pressure bandage: Remove 2–3 days after procedure.
- Allow steri-strips to fall off on their own, preferably after 6–7 days.
Site Care
- Apply an ice pack over the area for 20 minutes at a time during the first 4–5 hours. Use a cloth between ice and skin—never apply it directly. Continue as needed for swelling.
- Avoid tub baths, hot tubs, and swimming for 3 days. Showering is fine, but do not scrub the site until healed (about 3 days).
- Gluteal location: Avoid strenuous exercise involving the incision area (running, squats, lunges, elliptical, etc.) for 3–4 days, or as directed by the provider. Moderate upper body work and walking are okay.
Expected Site Reactions
- Mild discomfort may last 2–3 weeks.
- Bruising, swelling, or redness can last from a few days up to 2–3 weeks.
- Light pinkish or bloody staining on the bandage is normal.
- If bleeding occurs, apply firm pressure for 5 minutes.
Reminders
- Get post-insertion bloodwork done 4 weeks after the procedure if advised by your provider.
- Most females will need reinsertion every 3–4 months.
- Make sure to schedule your next appointment at checkout.
After Pellet Insertion
You may experience hormone level imbalances. We administer the hormone dosage we believe will be best for each patient; however, every patient breaks down and uses hormones differently. Most patients will have the correct dosage at the first insertion, but some patients may require dosage adjustments and blood testing. If results are not optimal, we may suggest you return so we can administer additional pellets or a “boost” (at no charge). This would require bloodwork to determine the correct dose. A significant hormonal transition will occur in the first four weeks after the insertion of your hormone pellets. Therefore, certain changes might develop that can be bothersome. In some cases, symptoms may not be noticeable until after the second pellet procedure.
SIDE EFFECTS
Most side effects are temporary and improve as your body adjusts. They may include:
Fluid Retention:
- Testosterone can cause your muscles to hold water, leading to a temporary weight increase of 2–5 pounds.
- This is most common with your first insertion and during hot or humid weather.
Swelling of Hands/Feet:
- Swelling is more common in hot or humid weather.
- You can reduce this by drinking plenty of water, limiting salt, or using a mild diuretic prescribed by your provider.
Pellet Extrusion (<1%):
- If the site becomes sore, oozes, or blisters, contact the office.
- Warm compresses may help relieve discomfort.
Mood Swings/Irritability:
- These may occur if you were very deficient in hormones.
- They typically improve once hormone levels stabilize.
Facial Breakout:
- Some women experience mild acne if their body was very deficient in testosterone before treatment.
- This is typically temporary and improves with consistent skin care (cleanser, toner, astringent).
- If breakouts persist, please call our office for further recommendations or prescription options.
Hair Loss:
- Hair loss is rare, but can occur if testosterone converts to DHT.
- It often improves with dosage adjustments.
- In very rare cases, prescription medication may be needed.
Hair Growth:
- Testosterone may stimulate hair growth on the chin, chest, nipples, or lower abdomen.
- You may also notice faster growth on arms, legs, and pubic regions.
- This is partly hereditary and can often be managed with dosage adjustments.
Breast Tenderness or Nipple Sensitivity:
- This is more common with the first pellet insertion.
- It’s caused by increased estrogen and blood flow to breast tissue (which also helps nourish the tissue).
- Taking 1 capsule of DIM daily may help reduce excess estrogen.
Uterine Spotting/Bleeding:
- Light spotting or bleeding may occur in the first few months after an insertion.
- This is more likely if you have been prescribed progesterone and are not taking it consistently (missing doses) or are on too low a dose.
- Bleeding does not necessarily mean there is a serious uterine problem. More often, the uterus is shedding tissue that was already present prior to pellet insertion, in response to the hormone changes.
- Please notify our office if you experience spotting so we can guide you appropriately.
When to call the office:
- Bleeding at the insertion site, not relieved with firm pressure after 5 minutes (not just light oozing)
- Pus or significant drainage from the insertion site
- Heavy or prolonged vaginal bleeding
- Severe swelling of hands, feet, or legs
- Persistent or worsening mood changes
- Severe acne or skin reactions that are unresponsive to routine care
- Sudden or significant hair loss
- Nipple or breast tenderness/pain that does not improve over time
- If the procedure area is warm to the touch and or with fever
MEN POST-INSERTION INSTRUCTIONS
Bandage Removal
Your insertion site has been covered with two layers of bandages
- Outer pressure bandage: Remove 2–3 days after procedure.
- Allow steri-strips to fall off on their own, preferably after 6–7 days.
Site Care
- Apply an ice pack over the area for 20 minutes at a time during the first 4–5 hours. Use a cloth between ice and skin—never apply it directly. Continue as needed for swelling.
- Avoid tub baths, hot tubs, and swimming for 7 days. Showering is fine, but do not scrub the site until healed (about 7 days).
- Gluteal location: Avoid strenuous exercise involving the incision area (running, squats, lunges, elliptical, etc.) for 7 days, or as directed by the provider. Moderate upper body work and walking are okay.
Expected Site Reactions
- Mild discomfort may last 2–3 weeks.
- Bruising, swelling, or redness can last from a few days up to 2–3 weeks.
- Light pinkish or bloody staining on the bandage is normal.
- If bleeding occurs, apply firm pressure for 5 minutes.
Reminders
- Get post-insertion bloodwork done 4 weeks after the procedure if advised by your provider.
- Most females will need reinsertion every 3–4 months.
- Make sure to schedule next appointment at checkout.
After Pellet Insertion
You may experience hormone level imbalances. We administer the hormone dosage we believe will be best for each patient; however, every patient breaks down and uses hormones differently. Most patients will have the correct dosage at the first insertion, but some patients may require dosage adjustments and blood testing. If results are not optimal, we may suggest you return so we can administer additional pellets or a “boost” (at no charge). This would require bloodwork to determine the correct dose. A significant hormonal transition will occur in the first four weeks after the insertion of your hormone pellets. Therefore, certain changes might develop that can be bothersome. In some cases, symptoms may not be noticeable until after the second pellet procedure.
SIDE EFFECTS
Most side effects are temporary and improve as your body adjusts. They may include:
Fluid Retention:
- Testosterone can cause your muscles to hold water, leading to a temporary weight increase of 2–5 pounds.
- This is most common with your first insertion and during hot or humid weather.
Swelling of Hands/Feet:
- Swelling is more common in hot or humid weather.
- You can reduce this by drinking plenty of water, limiting salt, or using a mild diuretic prescribed by your provider.
Pellet Extrusion (<1%):
- If the site becomes sore, oozes, or blisters, contact the office.
- Warm compresses may help relieve discomfort.
Mood Swings/Irritability:
- These may occur if you were very deficient in hormones.
- They typically improve once hormone levels stabilize.
Facial Breakout:
- Some men experience mild acne if their body was very deficient in testosterone before treatment.
- This is typically temporary and improves with consistent skin care (cleanser, toner, astringent).
- If breakouts persist, please call our office for further recommendations or prescription options.
Hair Loss:
- Hair loss is rare, but can occur if testosterone converts to DHT.
- It often improves with dosage adjustments.
- In very rare cases, prescription medication may be needed.
Hair Growth:
- Testosterone may stimulate hair growth on the chin, chest, nipples, or lower abdomen.
- You may also notice faster growth on arms, legs, and pubic regions.
- This is partly hereditary and can often be managed with dosage adjustments.
Aromatization (Estrogen Conversion):
- Some men convert testosterone to estrogen, leading to nipple tenderness or emotional sensitivity.
- These symptoms typically resolve by taking 2 capsules of DIM daily, but a prescription may be needed.
Testicular Shrinkage:
- Expected with testosterone therapy.
- Speak to your provider if shrinkage becomes severe.
Low Sperm Count:
- Some patients’ sperm count will be reduced for up to a year while on testosterone.
- If planning for children, discuss alternative therapies.
Elevated Red Blood Cell Count:
- Testosterone can increase red blood cells that may require active management, including:
- Adjust dosage
- Donate blood routinely to manage levels
- See a hematologist to rule out other causes
When to call the office:
- Bleeding at the insertion site, not relieved with firm pressure after 5 minutes (not just light oozing)
- Pus or significant drainage from the insertion site
- Severe swelling of hands, feet, or legs
- Persistent or worsening mood changes
- Severe acne or skin reactions that are unresponsive to routine care
- Sudden or significant hair loss
- Nipple or breast tenderness/pain that does not improve over time
- If the procedure area is warm to the touch and or with fever
