Although hormone pellet therapy is our preferred method of hormone therapy, it is not the only one that we can use. We can also use bioidentical gels and creams and testosterone shots. These therapies can have increased risks and problems over pellets. Pills by mouth can lead to liver disease and cancer. Shots are not bioidentical, leading to increased cholesterol and increased risk of heart attack, stroke, and blood clots. Gels and creams are bioidentical, meaning they are the same hormone that the body makes and knows how to metabolize but can be easily transmitted to others in your household, coworkers, and friends.