If using HRT, the safest option seems to be a transdermal estradiol patch vs. pellets. The dose is easier to adjust if necessary. Dr Felice Gersh has been mentioned a few times here and I'll add my endorsement as well. She's been prescribing HRT for decades and is extremely knowledgeable. I have had two appointments with her that have been very beneficial. She does not recommend pellets, especially if you are going to use testosterone. She said so many of patients on testosterone pellets end up at male physiologic levels which can cause unpleasant side effects.