A patient sits on the exam table in a Naples clinic. The insertion site is numb, the trocar is ready, and in a few minutes a rice-sized pellet will sit in the subcutaneous fat for the next three to six months. Unlike a gel, a patch or a weekly injection, that dose cannot be paused tomorrow if the patient feels wrong. The decision that matters most happens before the incision: how much hormone goes in, who decides, and what lab result will change the next insertion.
For readers who know the pharmacology of androgens, the practical question is how individual clinics turn baseline labs into a pellet dose. This guide looks at five Naples-area practices and compares only what each one publishes on its own website about baseline testing, the clinician who sets the dose, and follow-up monitoring. Where a website is silent, the article says so, because a missing detail is a question to ask at the consultation, not proof that a clinic has no protocol.
How Clinics Set a Pellet Dose
A sound starting dose does not come from one testosterone number. The clinician combines symptoms, a medical history, current medications, fertility plans and contraindications with laboratory results that were drawn correctly.
For men, a baseline panel commonly includes total testosterone, free testosterone when appropriate, and markers that guard safety, such as a complete blood count with hematocrit and a prostate-specific antigen (PSA) level based on age and risk. Depending on the history, the clinician may add estradiol, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, thyroid or liver tests. For women, the work-up usually centers on estradiol, progesterone and testosterone, with other labs chosen from symptoms and history.
Testing after insertion falls into two groups. Some protocols check levels a few weeks after the procedure to see how the patient responds. Others, or the same protocols later, test near the end of the cycle, before the next pellet goes in. That second result is the one that can change the next pellet count or interval, because the dose already in place keeps releasing hormone until the pellet dissolves.
Two cautions apply to every clinic below. First, compounded hormone pellets are not FDA-approved products. In a public statement on adverse-event reporting for compounded drugs, the FDA said it could attribute 61 reports, such as pellet extrusion and cellulitis, to compounded testosterone pellets, and that missing data in the reports limited its review. Second, extrusion is a known problem with this route. ClinicalGate’s chapter on androgens and antiandrogens notes that the need for surgical implantation and the tendency of pellets to extrude through the skin have limited their use in the United States.
1. Contemporary Health Center
Contemporary Health Center is led by medical director Richard L. Bloy, MD, FACOG. Its Naples Clinic is at 1213 Piper Blvd, Ste 203, Naples, FL 34110, and the practice also runs separate women’s and men’s clinics in Fort Myers.
Contemporary Health Center is specific about how a dose is set. Before any pellet is placed, the clinic draws a blood sample and sends it to a laboratory. The results establish baseline hormone levels and are used to determine the dose. For men, the clinic lists the markers it measures: testosterone, PSA, estradiol, a complete blood count and a liver profile. For women, estrogen and progesterone may be evaluated, with other labs added according to symptoms and health history. Readers who want the full background can consult the clinic’s guide to bio-identical hormone replacement therapy, which explains the baseline blood draw used before pellet treatment.
The pellets are plant-derived and compounded by a pharmacy. The clinic states that they release hormone for about 4-6 months in men and 3-4 months in women. Insertion is an in-office procedure under local anesthetic.
The site is also direct about safety monitoring. It explains that testosterone can raise red blood cell production in men and that a blood donation may be advised if hemoglobin or hematocrit climbs too high. It names the side effects patients should report so the plan can be adjusted, and it sets activity limits after insertion, 48 hours for women and 5-7 days for men, to lower the risk of extrusion. New patients start with a free consultation and a blood test.
What to confirm at the visit: the date of the first follow-up blood draw and the lab values that will change the next insertion.
2. Elevate Medical Naples
Elevate Medical Naples is in the Shoppes of Vanderbilt at 2349 Vanderbilt Beach Road, Ste 508, Naples, FL 34109. It offers hormone pellet therapy for men and women, and it describes its men’s testosterone care as lab-guided, starting with blood work and a review of symptoms and health history.
Elevate publishes a detailed list of the tests a provider may order for men: total testosterone, free testosterone when appropriate, SHBG when clinically indicated, LH, FSH, estradiol when appropriate, prolactin when indicated, CBC and hematocrit, PSA based on age and risk, thyroid testing and other metabolic labs. The site says treatment depends on testosterone levels, symptoms, medical history, other medications, goals, fertility plans, risks and patient preference, and should not follow a one-size-fits-all protocol.
For women, Elevate states that pellet therapy typically uses estradiol and/or testosterone, depending on symptoms, laboratory results, medical history and goals. Its women’s lab list includes estradiol, progesterone when clinically appropriate, total and free testosterone, SHBG, FSH, LH, TSH, a CBC and metabolic testing. During treatment, monitoring may include testosterone levels, blood pressure, hematocrit or hemoglobin, and PSA or prostate checks when appropriate.
What the site does not publish: the pellet source, the number of pellets or milligrams, the timing of the first draw after insertion, or the clinician who signs the final dose.
What to confirm at the visit: whether the same provider reviews every follow-up result, and which value would delay or reduce the next pellet.
3. Dr. B (Diane Brzezinski, D.O.)
The practice known as Dr. B is at 1250 Pine Ridge Rd Ste 101A, Naples, FL 34108. It is led by Dr. Diane Brzezinski, D.O., FACOI, a board-certified internal medicine physician. The hormone team also includes Dr. Michael Hellman, D.O., and Kelly Fennemore, MSN, ARNP, a nurse practitioner who, according to the site, evaluates candidacy, administers therapy and manages follow-up care.
The practice describes its hormone plans as lab-guided: bloodwork confirms candidacy, and an experienced provider reviews it before a plan is set. Pellets are presented as one option, not the only one, and the consultation and bloodwork decide which method fits. The pellets contain estrogen or testosterone, are compounded by a compounding pharmacist, and are placed in the office by a physician or a licensed nurse practitioner.
On duration, the site says pellets typically last three to six months, depending on the person and the dose, and that the provider tracks progress with follow-up bloodwork and adjusts the plan as needed. For men, it states that treatment includes ongoing monitoring of prostate health through periodic bloodwork.
What the site does not publish: the baseline panel by name, the target testosterone range, or the timing of follow-up labs relative to the next insertion.
What to confirm at the visit: which team member sets the starting dose, and whether a level is drawn near the end of each cycle before reinsertion.
4. Wellness for Women of Naples
Wellness for Women is at 6610 Willow Park Drive, Ste 102, Naples, FL 34109. Its providers include Tracye Zlobl, MD, and several advanced practice nurses. It is the only women-only practice in this comparison, and its site states that it provides pellet therapy for women with low estrogen and testosterone levels.
The published process is clear. At the consultation, a provider reviews symptoms, medical history and family history and performs a physical exam. The practice then checks hormone levels. If levels are low, the provider uses the test results to develop a customized hormone pellet. The pellet is placed through a small incision, usually above the buttocks, after the site is numbed. Afterward, patients are told to avoid strenuous exercise and to shower rather than bathe while the incision heals. The practice schedules regular follow-up appointments to monitor symptoms and hormone levels and replaces pellets as needed.
This entry shows why male and female dosing cannot be treated as one topic. Testosterone in women works in a narrow range, so the method used to stop levels rising too high matters as much as the starting amount.
What the site does not publish: the exact baseline panel, the target range, the pellet milligrams or source, or when the first follow-up draw occurs.
What to confirm at the visit: how the starting testosterone amount is chosen, and how the practice watches for signs of excess androgen before it inserts another pellet.
5. Advanced Individualized Medicine of Naples
Advanced Individualized Medicine of Naples, or Naples AIM, is at 501 Goodlette-Frank Rd, Ste B-100, Naples, FL 34102. Its medical director is Dr. Clint Potter, a family medicine physician.
Its testosterone therapy page states two facts about pellets. The practice offers BioTE pellet treatment as an alternative to weekly or biweekly intramuscular injections, and the pellets are administered every six months.
That calendar interval is the main point of comparison. The page does not list baseline labs, a confirmatory testosterone draw, the pellet count or milligrams, who approves the dose, or any testing before reinsertion. A fixed six-month cadence on a web page does not show whether the interval changes with symptoms or lab results.
What to confirm at the visit: whether the six-month interval is shortened if testosterone falls sooner, whether a level is drawn before each new pellet, which blood count and prostate markers are tracked, and how the plan changes after an extrusion or an unexpectedly high result.
Questions to Ask Before Your First Insertion
A pellet commits the patient to its dose for months, so these questions belong in the first consultation:
- Who sets and signs the final dose, and what credential does that clinician hold?
- Which baseline tests are required, and is a low or borderline testosterone result confirmed with a second draw?
- For men, does the panel include a CBC or hematocrit and an age-appropriate prostate check?
- For women, which findings decide whether testosterone is added, and at what amount?
- Which pharmacy compounds the pellets, and how many pellets and total milligrams are planned?
- What target range does the clinic use?
- When is the first blood draw after insertion, and is another drawn near the end of the cycle?
- Which result changes the next pellet count or interval?
- What is the plan if testosterone, hematocrit, estradiol or PSA moves outside the range?
- What aftercare lowers the risk of infection and extrusion, and what happens if a pellet comes out?
- Can a shorter-acting, more adjustable form be tried first, especially if fertility is still a goal?
- Will the patient receive the lab results, the dose and the next evaluation date in writing?
Frequently Asked Questions
Can Testosterone Pellets Be Stopped or Removed After Insertion?
Not in the way a cream or an injection can be stopped. Once placed, a pellet keeps releasing hormone as it dissolves. Removing it means another procedure, and that may not give a clean reversal once the pellet has started to break down. This is why a careful starting dose and a written plan for side effects matter.
What Is Pellet Extrusion, and Why Does It Matter?
Extrusion is when a pellet works its way back out through the insertion site or the skin. An extruded pellet delivers less hormone than planned and leaves an open site that can become infected. Clinics lower the risk with activity limits and wound-care instructions. Patients should report redness, drainage, pain or a visible pellet promptly.
Are Compounded Hormone Pellets FDA-Approved?
No. Compounded pellets are prepared by a pharmacy for each prescription and do not go through FDA approval as finished drugs do. Patients should ask whether their pellet is compounded, who made it, and why that formulation was chosen.
Final Thoughts
Pellet therapy trades daily or weekly dosing for a dose that stays in place for months. That trade makes the dose-setting process more important than the convenience. The useful test for any Naples clinic is whether it runs meaningful baseline labs, names the clinician who decides the dose, plans follow-up testing, and has a documented way to change the next insertion. A detail missing from a website does not mean a clinic lacks a protocol, but it should be answered before consent, ideally after comparing pellets with more adjustable options with a qualified clinician.
