Published Research

Our founding physician, Dr. Gregory J. Bailey, is an actively publishing researcher in women’s health. In November 2025, the peer-reviewed journal North American Proceedings in Gynecology & Obstetrics published his study comparing two ways of delivering bioidentical hormone replacement therapy: subcutaneous pellets and a compounded transdermal lotion. Both are approaches we talk through with patients at Well Balanced Healthcare, so the findings speak directly to the care we provide.

What the study looked at

This was a retrospective observational study of 404 women being treated for menopausal symptoms between 2018 and 2021. Of those, 200 received bioidentical estradiol and testosterone by subcutaneous pellet, and 204 used a compounded transdermal lotion containing the same hormones. The researchers compared how each group’s symptoms changed, their measured hormone levels, any side effects, and how many women stayed on their treatment over the year that followed.

What the study found

• Women in the pellet group reported greater improvement in hot flashes and in most other menopausal symptoms measured, including night sweats, sleep, memory, vaginal dryness, fatigue, and libido. Depression, abnormal hair growth, and hair thinning showed no significant difference between the two groups.
• Pellet users had larger increases in testosterone and larger decreases in follicle-stimulating hormone (FSH).
• Reported side effects were similar between the two groups.
• Women who started on pellets were more likely to stay on their therapy (76% versus 59%) and more likely to say their treatment had addressed their symptoms (89% versus 78%).

Important context

The authors are careful about what this study can and cannot show. It was retrospective and observational, which means women chose their own treatment rather than being randomly assigned, and that can introduce bias. The two groups were also followed on different schedules, and only about half of the women completed the one-year follow-up questionnaire. Major medical organizations, including the American College of Obstetricians and Gynecologists, currently recommend FDA-approved formulations and have called for more long-term research on compounded and pellet therapies. The authors agree that randomized, long-term studies are needed, and they present this work as one contribution to that larger body of evidence.

Read the full paper

The complete study, including all data tables, methods, and references, is available below and through the publisher.

Download the full paper (PDF)
View on the publisher’s site

Published open access under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license (CC BY-NC-ND 4.0). The study was funded by an unrestricted research grant from the Foundation for Female Health Awareness, and the authors report no conflicts of interest.

---

Talk with us about hormone therapy

This page summarizes published research for general education. It is not medical advice, and individual results vary. Hormone therapy is not right for everyone. To learn more about how we approach it, see our hormone replacement therapy services or read what every woman in Gainesville should know about BHRT. When you are ready to talk through your options, request an appointment with Dr. Bailey and our team.