Can hormonal swings get worse as the hrt pellets dissolve?

Yes: There are many better ways to get estrogen that are more cost effective. Speak to another gynecologist who does not profit from implanting pellets.

Yes for all Tx modes: Yes, but this is true for any form of hrt you undergo {oral, topical, injection, pellet implant}. Compounded pellet implants for women come in the form of Estradiol and testosterone. The pellets usually last between 3-6 months and are monitored by your subjective response {how you feel} and objective date {labs}. Your hrt balance is probably off, but this may be corrected by various tx methods.