Hormone Replacement

Testosterone, estrogen, and progesterone naturally decline over time as we age. Around age 35, men experience a gradual reduction in testosterone, typically 2 to 10 percent per year. For women, pre-menopause may start as early as in the 30s.
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As we age, testosterone, estrogen, and progesterone naturally decline over time. Around age 35, men experience a gradual reduction in testosterone, typically 2 to 10 percent per year. For women, pre-menopause may start as early as in the 30s. In fact, hormone imbalance kicks in long before hot flashes do-by 10 to 15 years! Patients need to listen to their bodies. Is the body saying, "I feel a bit off?" In other words, do they feel like many men and women in their 30s, 40s and beyond who....... lack motivation and feel more tired than usual, gain weight for no reason-especially belly fat, experience mood swings more frequently, feel anxious and depressed, struggle with brain fog and insomnia, wonder why their sexual desire and libido have tapered off. If these symptoms sound familiar, the patient may be an excellent candidate for hormone pellet implants.

As women age, the body will naturally begin to produce fewer hormones. Women will typically see a drop in production in the early 30s. Most will see a huge drop in estrogen and progesterone during menopause. The sex hormones progesterone, estrogen and testosterone play a key role in regulating major body functions. When there is even a smallest imbalance of one or more hormones, the body will experience significant problems.

Many women struggling with a hormone imbalance will experience most of the following symptoms:

  • Night sweats
  • Fatigue
  • Hot flashes
  • Decreased sex drive
  • Weight gain
  • Insomnia
  • Mood swings
  • Anxiety
  • Discomfort during intercourse
  • Irritability


There are also long term consequences for hormonal deficiencies. Estrogen loss puts women at a higher risk for premature ovary failure, osteoporosis, heart disease, colon cancer, Alzheimer's disease, Parkinson's disease, diabetes, and more.. These risks increase the longer a woman suffers from estrogen deficiency. However, women also need testosterone. Imbalanced testosterone levels in women may compromise mental clarity, libido, and muscle tone and mass. The brain also needs testosterone in balance with estrogen, to produce serotonin, which supports emotional balance and positive mental health.


Men do experience effects of testosterone decline with multiple symptoms of:

  • Fatigue, lethargy, and lack of motivation
  • Mood swings, anxiety, and depression
  • The decline in general well-being, feeling burned out
  • Inability to focus and remember things
  • Insomnia
  • Stubborn weight gain, belly fat and food cravings
  • Frequent illness
  • Hair loss
  • Saggy, dry, aging skin
  • Aches, joint pain, and longer recovery time from injuries
  • Loss of libido and inability to achieve or maintain an erection


Hormone Replacement Therapy can restore hormonal balance and improve the quality of life for many patients. HRT can also replace the hormones that are lost during menopause and may be used to treat menopause symptoms such as vaginal discomfort and hot flashes.

Bio-identical Hormone replacement therapy with pellets is a natural alternative to synthetic hormone replacement therapies. With bioidentical hormones, the structure of the hormone- testosterone, estrogen or both- is matched to the individual patient's needs. Bioidentical hormones are natural, plant-based substances that metabolize in our bodies the way nature intended. Synthetic hormones are mass-produced and artificially formulated in a lab. Artificial hormones are intentionally manufactured to be slightly different from natural human hormones, so the manufacturer can patent the formulation. Consequently, synthetic hormones may not provide a good fit or optimum outcome for the human body as bio-identical hormones do.

Composed of either estradiol or testosterone, bio-identical hormone replacement pellets are larger than a grain of rice and smaller than a Tic Tac. EvexiPEL sources its pellets from FarmaKeio, a leading compounding pharmacy in the US. that presses the hormones into the tiny, solid cylinders. During the sterile procedure, the doctor applies a local anesthetic, makes a small incision, then inserts the pellets into the fatty tissue under the skin- typically in the flank or upper buttocks. The incision is then closed without any need for stitches. The pellets release testosterone or estrogen into the bloodstream. This steady stream of hormones helps keep symptoms such as mood and energy fluctuations at bay.

On average, pellet implants last five to six months in men (two visits per year) and four to five months in women (three times per year). Patients receive a topical anesthetic before the procedure, so most can expect little to no discomfort during or after the pellet is implanted. 

Although most people experience substantial benefits after the first round of therapy, many patients experience a more pronounced benefit after the second round of pellet implants. We advise patients to have the procedure performed at least twice before expecting optimum results. Our hormone levels do not get out of balance overnight, so it often takes several months for them to normalize. 

We do ask patients to rest and avoid strenuous exercise for a few days following the procedure; 72 hours for women and 5-7 days for men. This helps ensure that the incision heals and prevents extrusion of the pellet from under the skin.

Patients of all ages- as young as in their 20s and others well into their 90s- can be treated with bio-identical hormone replacement therapy. It's a matter of personal preference dependent upon their personal health issues. The patient can decide how long he or she wants to best manage their symptoms and continue to receive the protective benefits of BHRT.

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Zina was amazing and very knowledgeable. You can tell that she truly cares about her patients and gives great results. She is also very gentle and sweet during the process. Would highly recommend her and will be returning. Also, the office is beautiful and clean
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Cinzia
Excellent experience for a first timer. Was prompted to visit this facility after being gifted a Groupon. The booking and use of the coupon form of payment was very easy. Whole team was kind and informative. My Botox injections were easy and almost painless. The Doctor gave great consulting advice without making me feel like she was trying to sell me. Will definitely be back!
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Kathleen Honigsberg
Dr. Turok did an excellent job at fixing uneven arm issues due to nerve damage using smart lipo.  He made sure I wasn’t in any pain during or after the procedure.  He was able to fix an issue that couldn’t be resolved any other way.  His staff goes above and beyond I recommend his help in any pain prevention or procedure.  Best doctor I have seen for pain control.  So grateful I found him.
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