EvexiPEL and SottoPelle Pellets: Cost, Side Effects and FDA Status

What are EvexiPEL and SottoPelle?

Both are branded methods of hormone pellet therapy, in which small pellets of hormone are placed under the skin, usually near the hip, and release hormone over several months. Like Biote, neither company is a single clinic. Each trains independent clinicians, who then evaluate patients, choose doses and insert the pellets in their own practices.

• EvexiPEL is the pellet method of EVEXIAS Health Solutions. Its site describes EvexiPEL as a method “developed by the functional medicine experts at EVEXIAS Health Solutions” and “delivered through a dedicated network of highly trained providers across the nation,” using “custom-compounded” hormones (evexias.com, read October 26, 2026).
• SottoPelle describes itself as a bioidentical hormone therapy training company and lists more than 3,000 trained providers across the US. It says its pellets for women contain estradiol and testosterone that release over 3 to 6 months (sottopelletherapy.com, read October 26, 2026).

What do EvexiPEL and SottoPelle cost?

Neither company lists patient prices on its website. When we checked on October 26, 2026, the EVEXIAS patient pages described the treatment but did not mention cost or insurance, and SottoPelle’s only pricing page was its programs and pricing for providers, not prices for patients. Each clinic that offers the method sets its own fees.

That means the only reliable price is the one a clinic gives you in writing. When you ask, make sure it covers:

• the pellets and the insertion fee, per visit;
• how many insertions a year they expect for you;
• lab tests before starting and between insertions;
• consultation and follow-up visits; and
• any supplements or add-ons the clinic recommends, and whether they are optional.

Compounded pellets are usually paid out of pocket. Our guide to hormone pellet costs covers insurance and HSA/FSA questions that apply to every pellet brand.

Are EvexiPEL or SottoPelle pellets FDA-approved?

Neither website says they are. EVEXIAS describes its pellets as custom-compounded, and pellets made by compounding pharmacies are not FDA-approved. The FDA explains that it does not review compounded drugs for safety, effectiveness or quality before they are used. The hormones in the pellets, estradiol and testosterone, are used in FDA-approved products, but the compounded pellets themselves have not been through that review.

Both sites make claims about pellets compared with other methods. SottoPelle, for example, says pellets are the only method that “can release more hormone when the body needs it,” and EVEXIAS says its method “minimizes side effects.” Neither site cites studies for those statements, and major reviews are more cautious: a 2022 review in The Cancer Journal noted that compounded hormones lack the safety and effectiveness data that come with FDA-approved products, and raised concerns about pellets producing hormone levels above the normal range.

How long do the pellets last?

SottoPelle says its pellets release over 3 to 6 months and that patients report a single treatment lasting 4 to 6 months. EVEXIAS says its pellets deliver a steady dose “for several months” without naming an interval. Independent research on estradiol pellets fits that range: a 2025 review found levels peak in the first week and then stay fairly stable for about four to six months. Your clinician decides when to re-insert, usually based on symptoms and labs.

What are the side effects?

Neither company lists side effects on the pages we read, so the best guide is the research on pellets and on the hormones they contain:

• At the insertion site: soreness, bruising and tenderness for a few days are common; infection and a pellet working its way out (extrusion) are less common.
• From testosterone: acne, oily skin and unwanted facial or body hair. A meta-analysis of randomized trials found women on testosterone reported these more often than women on placebo.
• From estrogen: breast tenderness, fluid retention and spotting. Women with a uterus need a progestogen to protect the uterine lining while using estrogen.
• A dose you can’t change quickly: once a pellet is in, it keeps releasing hormone until it dissolves, so side effects from a dose that is too high can last weeks or months.

For a fuller rundown, see hormone pellet side effects.

Pellet brands compared with other ways to take hormones

Amie HRT+ is one cream-based option: a compounded cream that combines estradiol and progesterone, with the strength chosen by a licensed clinician after an online review. Like pellets, it is compounded and not FDA-approved. The practical differences are that there is no insertion procedure, it is used at home, and 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 an EvexiPEL or SottoPelle provider

• Which hormones and doses will be in my pellets, and how were they chosen?
• Which pharmacy compounds the pellets?
• What labs will you check before and after insertion, and when?
• What happens if I have side effects before the pellet dissolves?
• If I have a uterus, how will my uterine lining be protected?
• What is the full cost for a year, in writing?
• Would an FDA-approved option suit me, and why or why not?