Hormone Replacement Therapy (HRT) is a medical treatment designed to restore balance when the body’s natural hormone production begins to decline. When hormones fall out of range, the effects can extend far beyond energy levels, impacting metabolism, mood, sleep quality, sexual health, mental clarity, and overall vitality. Symptoms such as persistent fatigue, unexplained weight gain, low libido, brain fog, irritability, and disrupted sleep are often signs of hormonal imbalance rather than lifestyle alone.
At Resurrect Skin MD, we specialize in HRT in Dallas using a physician-guided, evidence-based approach focused exclusively on pellet-based hormone replacement therapy. We intentionally offer pellet HRT because it provides the most consistent and stable hormone delivery available. Unlike daily pills, creams, or injections that can cause hormone fluctuations, pellet therapy supports steady dosing over several months, helping patients experience more reliable symptom relief and long-term hormonal balance.
Pellet
1 week
3 months
Every 3-4 months
Every 4-6 months
Hormone Replacement Therapy is a medically supervised treatment that restores hormone levels that decline with age or are disrupted by stress, genetics, or health conditions. Hormones regulate energy, metabolism, mood, sleep, sexual health, cognition, and overall vitality, so when they fall out of balance the symptoms can show up across the whole body.
For women, perimenopause and menopause bring shifts in estrogen and progesterone that can cause hot flashes, night sweats, sleep disruption, mood changes, vaginal dryness, skin aging, and unexplained weight gain. For men, declining testosterone (andropause, or low-T) has its own pattern of symptoms; because men’s hormone optimization follows a different protocol, we cover it in depth on our dedicated TRT page.
Resurrect Skin MD focuses exclusively on pellet-based hormone replacement to ensure consistent, predictable dosing. Pellets such as the EvexiPEL® system are placed just beneath the skin during a brief in-office procedure and release bioidentical hormones gradually over several months.
Hormones act as chemical messengers that regulate critical processes throughout the body, including energy production, metabolism, mood, sleep, sexual function, and cognitive performance. As hormone levels decline with age or become disrupted by stress or health conditions, these systems can fall out of balance, resulting in a wide range of symptoms.
Hormone Replacement Therapy works by restoring hormones to an optimal range under medical supervision, allowing the body to function more efficiently. At Resurrect Skin MD in Dallas, we use pellet-based HRT to deliver steady, consistent hormone levels over time. This approach helps maintain balance without fluctuations commonly associated with daily or weekly dosing methods.
Hormone Replacement Therapy can be delivered in several forms, including oral medications, topical creams or gels, patches, injections, and pellets. Each option has potential benefits, and the best choice depends on a patient’s physiology, lifestyle, and treatment goals. However, many traditional methods require frequent dosing and can result in inconsistent hormone levels.
For this reason, Resurrect Skin MD focuses exclusively on pellet-based HRT. Pellets release bioidentical hormones gradually over several months, providing predictable, stable dosing without daily maintenance. This consistency helps minimize hormonal peaks and troughs, supporting more reliable symptom relief and long-term hormone balance.
"The steady hormone delivery that EvexiPEL provides is a game-changer. The pellets work around the clock, releasing hormones in response to your body's demands. This creates a more natural hormonal rhythm that many patients describe as feeling 'normal again' rather than experiencing the artificial highs and lows associated with other HRT methods. I've seen remarkable transformations in patients who previously felt like they had tried everything without success." --- Dr. Burns
The hormonal systems of your body influence virtually every cellular function, which explains the wide variety of symptoms that can occur when hormone levels change.
For women, estrogen and progesterone fluctuations can lead to:
Men experiencing low testosterone (low-T) symptoms such as fatigue, reduced muscle mass, increased body fat, low libido, and brain fog are typically treated through a testosterone-specific protocol. See our men's testosterone replacement therapy (TRT) page for symptoms, candidacy, and dosing.
Hormone deficiencies may also have long-term consequences, including increasing risk of osteoporosis and cardiovascular issues.
Hormone Therapy for Men: Men's hormone optimization primarily centers on testosterone and follows a different protocol, dosing schedule, and candidacy workup than the estrogen and progesterone balancing many women need. If you are a man researching low-T treatment, our dedicated TRT page covers symptoms, lab testing, pellet and alternative delivery, and what to expect.
Ideal candidates for Hormone Replacement Therapy (HRT) are men and women experiencing symptoms related to hormonal imbalance who are seeking a consistent, medically guided, long-term solution. Many patients begin noticing changes in their 40s or 50s, though hormone disruption can occur earlier due to stress, underlying medical conditions, or genetic factors.
You may be a good candidate for HRT if you experience persistent fatigue, unexplained weight gain, reduced muscle tone, low libido, mood changes, brain fog, sleep disturbances, or a general sense that your body is no longer functioning the way it once did—despite healthy lifestyle efforts. These symptoms are often linked to declining or fluctuating hormone levels rather than age alone.
At Resurrect Skin MD, candidacy for Hormone Replacement Therapy is determined through a comprehensive consultation and detailed laboratory testing. This evaluation allows your provider to assess hormone levels, review your medical history, and determine whether pellet-based HRT is an appropriate and safe option for your individual needs and goals.
Treatment Time – Pellet insertion is a brief in-office procedure that typically takes less than 15 minutes to complete.
Anesthetic – A local anesthetic is used to ensure comfort during the pellet insertion process.
Downtime – Most patients return to normal daily activities immediately, with brief exercise restrictions for a few days.
Noticeable Results – Many patients begin noticing improvements within the first few weeks as hormone levels stabilize.
Treatments Needed – Pellet therapy is typically repeated every three to six months, depending on individual needs and metabolism.
Hormone Replacement Therapy helps restore energy levels by addressing hormonal deficiencies at their source. Many patients report improved stamina, motivation, and reduced fatigue once hormone levels stabilize.
Balanced hormones play a critical role in emotional regulation and cognitive function. HRT may help reduce brain fog, improve focus, and support greater emotional stability and stress resilience.
Optimized hormone levels can support healthier metabolism, improved muscle tone, and reduced fat accumulation. This often helps patients see better results from diet and exercise.
Hormone balance is closely tied to sexual function. Many men and women experience improved libido, sexual performance, and overall satisfaction with consistent hormone replacement therapy.
By maintaining stable hormone levels, HRT can support bone density, cardiovascular health, and overall vitality, contributing to healthier aging and improved quality of life.
"Most patients initially seek hormone therapy for relief from immediate symptoms like fatigue or hot flashes, but the long-term benefits are even more significant. Proper hormone balance supports cardiovascular health, maintains bone density, preserves cognitive function and protects muscle mass, all critical factors in how well we age. I tell my patients that hormone optimization isn't just about feeling better today; it's an investment in healthier aging for decades to come." --- Dr. Burns
Before beginning Hormone Replacement Therapy, you will meet with a provider at Resurrect Skin MD for a comprehensive consultation. During this visit, we review your symptoms, medical history, current medications, lifestyle factors, and health goals to determine whether HRT is an appropriate option for you.
Comprehensive laboratory testing is ordered to evaluate your hormone levels and identify any imbalances that may be contributing to your symptoms. These results allow your provider to establish a baseline and design a personalized treatment plan focused on safe, consistent, and effective hormone optimization.
Hormone Replacement Therapy at Resurrect Skin MD follows a comprehensive, medically guided process designed to ensure safe, consistent, and personalized results. Your treatment begins with a detailed consultation to discuss symptoms, medical history, lifestyle factors, and overall health goals.
Comprehensive hormone testing is performed to evaluate baseline hormone levels and identify any imbalances. This testing allows your provider to assess how your hormones are functioning and to determine appropriate dosing. Your lab results are reviewed in detail and used to create a personalized hormone replacement therapy plan tailored to your specific needs.
Once your treatment plan is established, pellet insertion is performed in-office under local anesthesia. A small incision is made, and the hormone pellet is placed just beneath the skin. The procedure typically takes less than 15 minutes and does not require stitches.
Follow-up appointments are scheduled to monitor hormone levels, evaluate symptom improvement, and make adjustments needed to support long-term balance and optimal results.
After pellet insertion, most patients are able to resume normal daily activities right away. Mild soreness, swelling, or bruising at the insertion site may occur and typically resolve quickly. Your provider will give you specific aftercare instructions, including short-term exercise restrictions, to ensure proper healing.
Hormone levels gradually increase and stabilize over the following weeks. Many patients begin noticing improvements in energy, mood, sleep quality, and mental clarity within the first few weeks, with continued benefits developing as hormone balance is restored. Follow-up visits and periodic lab testing allow your provider to monitor progress and adjust as needed to support long-term results.
You have questions? We have answers.
Hormone Replacement Therapy can produce side effects, though most patients experience minimal or mild effects when treatment is properly dosed and monitored. Temporary redness, swelling, or soreness at the insertion site may occur.
The incidence of side effects is generally lower with bioidentical hormones compared to synthetic hormones. Pellet-based hormone delivery provides consistent dosing over time, which helps reduce many of the issues associated with hormone fluctuations seen with other forms of hormone replacement therapy. At Resurrect Skin MD, careful dosing, precise insertion techniques, and ongoing follow-up help minimize potential risks and support safe, effective treatment.
Many patients notice improvements in energy levels and mental clarity within the first one to two weeks after starting Hormone Replacement Therapy as hormone levels begin to rise and stabilize. Early benefits are often followed by improvements in sleep quality, mood balance, and overall sense of well-being.
Sexual health improvements commonly develop within the first month, including increased libido and improved sexual function in men, as well as enhanced desire and comfort for women. By weeks four to six, many patients experience relief from the majority of their hormone-related symptoms.
Physical changes such as improved muscle tone, reduced body fat, and healthier-looking skin often become more noticeable as hormone levels stabilize. Cognitive and emotional benefits may include sharper focus, improved memory, and greater emotional resilience.
Full benefits are typically achieved by the three-month mark, when hormone levels have fully stabilized and the body has had time to respond to treatment. Results vary based on individual physiology, lifestyle, and consistency of therapy, and benefits generally last throughout the duration of each pellet cycle.
Hormone Replacement Therapy is typically approached as a long-term treatment rather than a short-term solution. Hormone levels naturally decline with age, and this process does not reverse on its own. As a result, the benefits of HRT generally continue only while therapy is maintained.
Many patients choose to continue HRT long term because of the sustained improvements in energy, mood, sleep quality, sexual health, and overall well-being. Over time, hormone needs may change due to aging, lifestyle factors, or health conditions. Your treatment plan can be adjusted as needed based on symptoms, lab results, and clinical response to ensure ongoing safety and effectiveness.
At Resurrect Skin MD, we view hormone optimization as part of a comprehensive approach to health and aging. We offer many complementary services that can enhance your results and target specific concerns, such as:
CoolSculpting Elite can help with stubborn fat deposits that persist despite hormone balance and healthy habits. This advanced fat-reduction technology uses controlled cooling to eliminate resistant fat cells permanently without surgery.
Accufit is an innovative muscle-building technology that strengthens and tones muscle tissue beyond what’s possible with exercise alone. This treatment is particularly valuable for counteracting the muscle loss that often accompanies hormone decline.
From advanced laser treatments like HALO and Moxi to cutting-edge technologies like BBL HERO, Genius RF microneedling, INDIBA, and Sofwave, we offer solutions for regenerating collagen and treating virtually every skin concern.
For optimal results, many patients incorporate a skincare routine into their treatment plan. Our skincare experts can recommend products from our favorite medical-grade skincare lines that target the specific benefits you’d like to see in your skin.
Dr. Burns and our team will partner with you to develop an individualized long-term strategy that addresses all of your cosmetic and wellness goals.
If you experience a combination of fatigue, depressed mood, and lower/absent libido, you may have Androgen Insufficiency Syndrome (AIS). Hormone Replacement Therapy (HRT) is a highly effective treatment for AIS. Additionally, if you prefer a minimally invasive procedure every 3-4 months (4-6 months for men), you are an ideal candidate. Other symptoms that often improve with bio-identical hormone optimization include insomnia, early waking, anxiety, lack of energy/drive, lethargy, joint pain, and daytime sleepiness. To confirm a suspected diagnosis of AIS and begin your evaluation, your physician will order lab work to assess your hormone levels. These results will be discussed during your initial consultation
Initial bloodwork is performed to establish baseline hormone levels, aid in diagnosing AIS, and assess any imbalances in other major hormone systems (e.g., adrenal, thyroid). These values will help determine your initial dosage. Four weeks after your first pellet insertion, you will have repeat labs (a smaller panel). These results will be reviewed at your six-week follow-up visit. Thereafter, a full panel of labs is drawn annually. If you experience any significant changes in symptoms related to hormone therapy, your nurse practitioner will recommend reassessment at that time
Hormone pellets used in Hormone Replacement Therapy are small, custom-compounded implants made from bioidentical hormones. “Bioidentical” means the hormones are structurally identical to those naturally produced by the body, allowing them to be recognized and utilized efficiently.
The pellets are placed just beneath the skin during a brief in-office procedure and gradually release hormones over several months. This delivery method provides consistent, steady dosing without the daily fluctuations often associated with pills, creams, patches, or injections. Hormone pellets are compounded in FDA-regulated facilities and are used as part of a personalized, physician-guided treatment plan.
For women, the effects typically last an average of 3-4 months. Very active individuals may require therapy every 3 months or sooner, while less active or elderly individuals may experience benefits for longer than 4 months. In men, the typical cycle ranges from 4 to 6 months. The return of early symptoms of hormone insufficiency, such as fatigue, joint pain, or decreased libido, can indicate the need for your next insertion.
The individual ingredients within the pellets are FDA-approved, and the distribution of these pellets is regulated by the FDA. However, the pellet insertion procedure itself is not FDAapproved. It’s common for physicians to prescribe medications or therapies for uses not explicitly approved by the FDA (off-label) if they believe them to be safe and effective for their patients. The reason bio-identical hormones (compounded drugs) are not FDA-approved is due to their individualized dosing nature.
Pellets are inserted using a very minor surgical procedure, performed in the office setting and requiring only local anesthesia. Using a very small incision (~ 1-2 cm in women, ~ 3-4 cm in men), they are inserted subcutaneously below the belt and above the buttock in women, and in the posterior flank in men. Recovery is very quick and uncomplicated; exercise restrictions for 3 days in women and 5 days in men are simply to avoid complications.
Not at all. Certain types may have an influence on therapy, which your physician/provider will review with you.
There are no serious or permanent side effects. In some cases, nuisance side effects can occur, such as hair growth or acne, both of which are very treatable.
Transitioning to pellet therapy from other forms of HRT is common. Your physician can assess your needs even if you’re currently using another type of hormone replacement therapy. If you prefer to continue with your current HRT but are not ready for pellets, we can offer alternative formulations.
There is no direct causative link between bio-identical 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 18 years. The number of patients receiving HRT 5 to 10 years after breast cancer treatment and remission 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. Finally, patients with or recently recovered from breast cancer can receive testosterone alone to help manage both AIS and menopausal symptoms.
Hormone testing typically evaluates testosterone, estrogen, progesterone, thyroid hormones, cortisol, and related markers. These labs help identify imbalances and guide personalized hormone replacement therapy dosing.
Hormone Replacement Therapy may support weight management by improving metabolism, muscle mass, and energy levels. Balanced hormones can help the body respond more effectively to diet and exercise efforts.
For patients whose primary goal is weight loss, our medical weight loss program can complement hormone optimization.
Pellet-based HRT dosing is highly personalized and based on lab results, symptoms, age, metabolism, and health goals. Ongoing monitoring allows adjustments to ensure safe, effective, and consistent hormone levels.
Hormone levels typically begin stabilizing within several weeks after treatment. Most patients experience progressive improvement over the first one to three months as the body adapts to optimized hormone levels.
Yes. Hormone Replacement Therapy is often combined with aesthetic and wellness treatments to enhance body composition, skin health, and overall results as part of a comprehensive, personalized care plan.
