Biote Reviews: What Patients Commonly Report, Pros and Cons

What is Biote, and what are people actually reviewing?

Biote is not a single clinic or a pharmacy. It is a company that trains and certifies clinicians (physicians, nurse practitioners and physician assistants) in its method of hormone pellet therapy. Those clinicians then evaluate patients, choose doses and insert the pellets in their own practices.

The pellets are small, rice-grain-sized cylinders of compounded hormone, usually estradiol, testosterone or both. They are placed under the skin of the upper hip or buttock through a small incision after the area is numbed, and they release hormone slowly over several months before the next insertion.

That structure matters when you read reviews. A “Biote review” is really a review of three things at once: the pellet as a way of delivering hormones, the specific dose a clinician chose, and the care that clinic provided before and after insertion. Two people can describe very different experiences with the same brand for those reasons.

What do Biote reviews commonly praise?

Across public reviews, forums and clinic feedback, the positive themes are fairly consistent:

• Convenience. No daily pill, patch change or cream. For people who struggle with daily routines, one visit every few months is the main draw.
• A steady feel. Many describe fewer ups and downs than they had with other methods. Research supports the idea of relatively stable levels after the first weeks: a 2025 review of estradiol pellets found levels peak in the first week and then stay fairly stable for four to six months.
• Symptom relief. Fewer hot flashes and night sweats, better sleep, and improvements in energy, mood and libido are the outcomes mentioned most often. Estrogen is the most effective treatment for hot flashes regardless of how it is delivered, according to The Menopause Society’s 2022 position statement.
• Feeling taken seriously. Some reviewers say a hormone-focused clinic was the first place their symptoms were treated as real rather than dismissed as stress or aging.

What are the most common Biote complaints?

Negative reviews tend to cluster around a handful of issues. Most of them trace back to the delivery method or to how a particular clinic manages care, rather than to anything unique about the brand.

Side effects from a dose that is too high

The complaint seen most often is androgen-type side effects: acne or oily skin, new facial or body hair, thinning scalp hair, irritability, and occasionally voice changes. These are linked to testosterone, and they are a known effect of testosterone therapy in general. A meta-analysis of randomized trials found women on testosterone were more likely to report acne and hair growth than those on placebo. Breast tenderness, fluid retention and spotting are more often linked to the estrogen component.

A dose that can’t be changed mid-cycle

Once a pellet is in, it keeps releasing hormone until it dissolves. Removal is possible in some cases but uncommon, so people who react poorly often describe waiting it out for weeks or months. This is the single most repeated theme in critical reviews, and it is the main practical difference between pellets and methods you take daily.

The insertion itself

Bruising, soreness and tenderness at the site for a few days are common and expected. Less often, reviewers describe infection or a pellet working its way back out of the skin (extrusion). Repeated insertions in the same area can also leave small scars.

Cost and add-ons

Pellets and insertion fees are usually paid out of pocket, and labs and visits are often billed separately. Some reviewers also mention being encouraged to buy branded supplements. See our guide to what Biote costs for typical ranges and the questions to ask before you pay.

Uneven care between clinics

Because each practice sets its own intake, lab and follow-up routines, people describe everything from very thorough monitoring to feeling rushed. Reviews that mention no follow-up labs, or concerns being brushed off, are usually about the clinic rather than the pellet.

How should you read Biote reviews?

Online reviews can tell you what is possible, not what is likely for you. A few things to keep in mind:

• People tend to write reviews at moments of peak satisfaction or peak frustration.
• Many reviews are written after one or two insertions, before the dose has been adjusted.
• Improvements are often reported alongside other changes, such as new exercise or sleep habits, which makes it hard to know what caused what.
• Reviewers rarely know their dose or hormone levels, so you can’t compare like with like.
• Reviews can’t tell you about long-term safety. That question needs research, not individual experience.

What does the research say about hormone pellets?

Estradiol pellets have been used for decades, and studies show they relieve hot flashes and help maintain bone density. The 2025 review above concluded they can be a reasonable option for some women, for example those who absorb skin products poorly or struggle with daily treatment, but that safety depends on careful dosing, monitoring, and protecting the uterine lining with a progestogen in women who have a uterus. It also noted that protocols are not standardized and long-term comparative studies are lacking.

Major medical groups are more cautious about compounded pellets in particular. A 2022 review in The Cancer Journal noted that compounded hormones lack the pharmacokinetic, safety and efficacy data that come with FDA-approved products, and that pellets producing above-normal hormone levels raise additional concerns. A 2020 National Academies report reached similar conclusions about compounded bioidentical hormones in general. The FDA explains that compounded drugs are not FDA-approved, which means it does not review them for safety, effectiveness or quality before they are used.

For testosterone, the international consensus statement endorsed by The Endocrine Society and The Menopause Society says the only evidence-based use in women is low sexual desire causing distress after menopause, with doses aimed at normal female levels. It found too little evidence to recommend testosterone for general wellbeing, mood or cognition. If libido is your main concern, our guide to testosterone and libido in women covers the evidence in more detail.

Do people report weight loss on Biote?

Weight is where reviews diverge most. Some people say they lost weight, usually alongside changes in diet, exercise or sleep. Others report fluid retention or weight gain, especially in the first weeks. In the testosterone meta-analysis, women on testosterone had a small overall increase in weight. No hormone therapy, pellet or otherwise, is approved as a weight-loss treatment. Hormone therapy can make sleep and energy better for some women, which may make other habits easier, but it is not a fat-loss tool on its own.

Biote compared with other ways to take hormones

Pellets are one delivery method among several. Here is how they compare on the points reviewers raise most often.

Amie HRT+ is one cream-based option. It is a compounded cream that combines estradiol and progesterone, with the strength chosen by a licensed clinician after an online review. Like Biote pellets, it is compounded and not FDA-approved. The differences are practical: there is no insertion procedure, it is used at home, and if the strength needs to change, the clinician can adjust the next prescription rather than waiting for a pellet to dissolve. A clinician decides whether it is appropriate for you.

Questions to ask a Biote provider before you start

• Which hormones will be in my pellets, and why each one?
• How do you choose my dose, and what levels are you aiming for?
• When will you recheck my symptoms and labs after insertion?
• What is the plan if I have side effects before the pellet dissolves?
• If I have a uterus, how will my uterine lining be protected while I’m on estrogen?
• Which pharmacy compounds the pellets, and what does the full year cost, including labs and visits?
• Would an FDA-approved option work for me, and why or why not?

When to call your clinician