What did @beautyisfearless actually say?
She said she received "a bioidentical hormone of testosterone inserted straight into the booty" via a small subcutaneous pellet, described the procedure as a "small incision" with a "small rice-sized pelt," and framed this as part of her perimenopause management. She also implied low libido was a driving symptom. The video is less a medical claim and more a documentation of a real procedure she underwent. That context matters for evaluating it fairly.
What she did not claim: she did not promise specific outcomes, did not cite dosages, and did not tell viewers to skip other treatments. That restraint is worth acknowledging. What she did leave out is significant, though, and we will get into that.
Does the science back this up?
Testosterone therapy for women in perimenopause is legitimate medicine, but it is more complicated than this video suggests. The evidence base is real but narrow, and the delivery method she chose carries specific trade-offs that were not mentioned.
Testosterone pellet implants for women have been studied, and low-dose testosterone does have evidence supporting its use for hypoactive sexual desire disorder (HSDD) in postmenopausal women. Davis et al. (2019, The Lancet Diabetes and Endocrinology) conducted a systematic review of 36 randomized controlled trials and found testosterone improved sexual function in women, but noted the evidence for non-sexual outcomes like mood or energy was weak. The Global Consensus Position Statement on testosterone therapy for women, published the same year, endorsed testosterone for HSDD but specifically flagged pellets as a delivery method that can produce supraphysiologic levels, meaning levels higher than what a woman's body would naturally produce, which raises safety questions.
Perimenopause specifically, as opposed to postmenopause, is underrepresented in the existing trial data. Most studies recruited postmenopausal women. So the science supports the general concept, but the evidence for this exact scenario is thinner than a TikTok video implies.
What did they get wrong (or right)?
She got the basic procedure description right. Subcutaneous pellet insertion does involve a small incision, typically in the hip or gluteal area, and the pellet is roughly the size of a grain of rice. That matches standard clinical descriptions. Calling the hormone "bioidentical" is where things get murkier.
"Bioidentical" is a marketing term as much as a clinical one. Compounded bioidentical hormones are not FDA-approved, and the FDA has explicitly warned that claims about their safety or superiority over conventional hormone therapy are not supported by evidence. The North American Menopause Society has stated the same. She used the word without explaining what it means or does not mean, which is a real omission for 84,000 viewers.
The bigger issue is pellets specifically. Unlike gels or patches, pellets cannot be adjusted or removed once inserted. If a patient experiences side effects, including elevated testosterone, acne, hair loss, or mood changes, they have to wait weeks to months for the pellet to dissolve. Glaser and Dimitrakakis (2013, Maturitas) noted that pellet dosing is highly variable and difficult to standardize, raising legitimate clinical concerns about consistency.
What should you actually know?
Testosterone therapy for women with perimenopause symptoms is a real clinical option, and low libido is one of the symptoms with the strongest evidence base for testosterone intervention. None of that is snake oil. But the delivery method and the "bioidentical" framing deserve more scrutiny than this video gives them.
If you are considering this route, the questions worth asking your provider include: What is the target serum testosterone level, and how will it be monitored? What happens if levels come in too high? Why a pellet over a transdermal gel or cream, which are easier to dose-adjust? Is this provider operating under evidence-based protocols or selling a proprietary wellness package?
The Endocrine Society and NAMS both recommend against routine use of testosterone in women outside of specific indications, and neither organization currently endorses pellets as a preferred delivery method. That does not mean pellets are never appropriate, but it does mean the conversation with your doctor should be more involved than this video suggests.
- Monitor your testosterone levels before and after starting therapy.
- Ask about the reversibility of whatever delivery method you choose.
- "Bioidentical" does not automatically mean safer or more natural.
- Perimenopause-specific data on testosterone is limited compared to postmenopause data.