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Hormone Replacement Therapy

Hormone replacement therapy (HRT) is a treatment that can help to alleviate the symptoms of menopause. Hormones are a crucial component of a well-functioning body, and when they’re off balance it can cause several unpleasant symptoms. 

BioTE Hormone Therapy is a hormone replacement therapy that can restore levels of estrogen and testosterone. The treatment involves the insertion of a pellet just under the skin, where it releases a steady stream of hormones into the body. This method of hormone replacement provides consistent doses of hormones that avoid the “roller coaster” effect of some other techniques. The pellets provide hormones for the body for 3-5 months, making them a convenient option for many patients. 

At Rotemberg Plastic Surgery, Dr. Silvia Rotemberg offers fine-tuned hormone therapy that can bring your body back to a healthier level of functioning. 

For more information about hormone replacement therapy in South Miami, call (305) 274-5170 or visit our contact page.

Do I Have a Hormonal Imbalance?

Hormone imbalance can have negative effects on the mind and body in countless ways. Here are just a few of the symptoms that HRT may be able to improve or correct.

  • Difficulty falling or staying asleep
  • Low energy
  • Loss of memory and mental focus
  • Depression, anxiety, and mood swings
  • Weight gain and stubborn midsection fat
  • Decreased muscle strength
  • Muscle and joint discomfort
  • Low libido and sexual performance
  • Frequent headaches

Furthermore, HRT has been shown to reduce the risk of and/or prevent:

  • Diabetes
  • Heart disease
  • Osteoporosis
  • Alzheimer’s disease

What is BioTE?

BioTE Hormone Therapy uses small pellets – smaller than a grain of rice – that release bioidentical estrogen and testosterone into the body to promote hormone balancing. The pellets are embedded in the tissue under the skin and release small controlled doses of hormones to consistently stabilize the body’s natural hormone levels. Unlike creams or medications, which can have a “roller coaster” effect on symptoms, pellet therapy offers regular doses that maintain positive results.

After the age of 30, hormone production decreases by 3-10% each year. BioTE uses comprehensive blood work analysis to determine the proper hormone dosage for each individual patient. The hormone pellets used in BioTE Pellet Therapy are created by specialized compounding pharmacists who fuse natural plant derived bioidentical estrogen or testosterone with small cylinders. Once placed in the body, the pellet will deliver hormones 24/7 and naturally dissolve over the course of 3-5 months.

HRT for Women

Menopause is the stage in a woman’s life when their menstrual cycle ends permanently. During menopause, the body produces less of the hormones estrogen and progesterone. The resulting hormone imbalance causes many unpleasant symptoms. (1) These symptoms can affect the quality of a woman’s life. Unfortunately, the negative implications of menopause have historically been thought of as something women simply had to suffer through in silence. However, BioTE Pellet Therapy can change that.


Estrogen is a woman’s primary hormone. As women lose estrogen production with age, they become more susceptible to a variety of health concerns, including Parkinson’s disease, diabetes, Alzheimer’s disease, and premature ovary failure. Loss of estrogen can also negatively impact the appearance of the skin, bone strength, and cognitive abilities. By repairing this estrogen loss, BioTE Pellet Therapy can reduce and reverse these health issues. Furthermore, studies have shown that normal estrogen levels can play a critical role in a woman’s overall mood and happiness.

Many women suffer from menstrual migraines or recurrent headaches. BioTE Hormone Therapy has proved to be incredibly beneficial in minimizing or eliminating recurring head pain.

Hormone replacement therapy can fix these problems at their source by re-introducing the hormones that are depleted by menopause. When it is administered soon after menopause begins, it can significantly reduce the risk of chronic heart disease, menopausal symptoms and osteoporotic fractures. (2)


Sometimes we forget that women produce testosterone too. Testosterone is important for maintaining muscle tone and mass. It also affects mental clarity and weight stabilization. When women lack normal testosterone levels, they may experience weight gain or poor muscle tone, despite continuing a regular diet and exercise regimen. They may also experience mental confusion or distraction.

A regular balance of both estrogen and testosterone is necessary for women to produce serotonin, the chemical responsible for mood, appetite, sleep, memory, and libido.

Women typically need new pellets every 3-4 months.

HRT for Men

Poor levels of testosterone are linked to many serious conditions. For example, loss of testosterone has been linked to andropause – the male equivalent of menopause. However, hormone balancing, like that provided by BioTE Pellet Therapy, can reduce or erase these symptoms.


Low testosterone levels in men can lead to excessive tiredness, mental confusion, loss of libido, and difficulty achieving or maintaining an erection. Bio-identical hormone pellet therapy helps restore a man’s natural testosterone levels. Plus, since the hormones are delivered to the body at a consistent rate right for the patient’s body, there is no need to take medication when a symptom appears. Medications can often leave men feeling like they are chasing their symptoms, but never addressing the root cause. BioTE Pellet Therapy is there for men, before they even know they need it.

Men typically need new pellets every 4-5 months.

Benefits of Hormone Replacement Therapy

With BioTE Pellet Therapy, the pellet is placed underneath the skin for 3-5 months. This means that patients don’t need to remember to take pills every single day or apply creams. Plus, the pellet consistently releases hormones to maintain the body’s individual hormone levels, eliminating the “roller coaster” effect.

All-Natural Hormones

Furthermore, the hormone pellets used by BioTE are all natural and include no synthetic materials. They are plant-derived and contain the same chemical structure as the body’s natural hormones, and are known as bioidentical hormones. The pellet is metabolized by the body organically as needed. It’s a purely biological approach to greater overall health and wellness.

Who is a Candidate for Hormone Replacement Therapy?

Good candidates for BioTE Hormone Therapy are patients who suffer from any of the symptoms associated with hormonal imbalance. They also may be suffering from symptoms of menopause or andropause, the male equivalent of menopause.

Most of our patients begin BioTE Pellet Therapy at age 30 or older. However, in some cases, the therapy may be beneficial for patients in their 20s. In order to determine one’s candidacy, please contact our office in Miami, Florida to schedule a private consultation with Dr. Rotemberg.

Personal Consultation

In order to determine whether or not a patient would be a good candidate for BioTE Hormone Therapy, Dr. Silvia Rotemberg must first consult with the patient in her Miami, Florida office.

During the personal consultation, Dr. Silvia Rotemberg will ask the patient about the symptoms that they are experiencing. She will also ask them about any prior treatments, therapies, or medications that have been used in an attempt to combat these symptoms. She will also ask them about their medical history, including any illnesses they suffer from or surgeries they have had in the past.

If Dr. Silvia Rotemberg believes that the patient may be a good candidate for BioTE Hormone Therapy, then she will complete a comprehensive blood work analysis. This may be performed at the time of the consultation or at a later date.

Pellet Insertion Process

After performing blood work and determining the patient’s unique doses of estrogen and/or testosterone, Dr. Silvia Rotemberg will receive a package personalized for the patient and containing the pellets and sterile equipment for insertion.

First, Dr. Silvia Rotemberg will use local anesthetic to numb the area for gluteal insertion. Using a sharp blade, she will make a small incision about 5 mm long and 5mm deep into the subcutaneous tissue. Then, she will insert a cannula into the incision and the pellets will be placed inside of the cannula. Using a blunt trocar, she will gently slide the pellets through the cannula and into the subcutaneous tissue.

After the pellets have been inserted into the body, she will make sure that the incision is closed using adhesive strips called steri-strips. Then, the entire area will be properly bandaged.

Recovery & Results

Following the procedure, patients will be instructed to avoid vigorous activity for at least two days. There may be slight redness and swelling around the insertion site, which is normal and will disappear on its own over the course of 2-3 days. The bandages may be removed and the patient can shower 24 hours after the procedure. However, the steri-strips must remain on the incision for one week.

Patients may experience minor discomfort around the procedure site in the days following insertion. This is normal and can be controlled with over-the-counter medications such as Tylenol. A warm washcloth or heating pad may also be used to soothe the area.

Patients may start noticing an improvement in their symptoms in as little as 24 to 72 hours. However, optimal results will not appear until about the three-week mark. For patients who are using BioTE Hormone Therapy to counteract hormonal weight gain, their results will depend on their diet and exercise routine. It is important to maintain a steady diet and exercise routine following the procedure.

In order to maintain results from BioTE Pellet Therapy, patients will need to regularly return to Dr. Silvia Rotemberg’s office to receive a new pellet. Women will require new pellets every 3-4 months, while men will require them every 4-5 months.

How Much Does Hormone Replacement Cost in South Miami?

Find out how all-natural BioTE Pellet Therapy can revolutionize your life by calling the office of Dr. Silvia C. Rotemberg today and scheduling a personal consultation in Miami. See how much hormone replacement therapy costs at Rotemberg Plastic Surgery, by calling (305) 274-5170 or fill out this form for more details.


  1. Vigneswaran K, Hamoda H. Hormone replacement therapy – current recommendations. Best Practice & Research Clinical Obstetrics & Gynaecology. 2021;81. doi: 
  2. Lobo RA. Hormone-replacement therapy: current thinking. Nature Reviews Endocrinology. 2016;13(4):220-231. doi: