Are there any disadvantages to pellet therapy for testosterone? i'm wondering why my endocrinologist didn't mention them as an option.

Yes!: There's no such thing as a free lunch, so yes, there are disadvantages to pellet therapy for testosterone replacement. 1st it's an invasive procedure (so if you don't like getting stuck w/needle, you won't like idea of trochar). 2nd greater risk of infection, pain & extrusion 3rd we can only guess how much you need based upon weight etc - so it's difficult to adjust if necessary eg more/less pelle