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Estradiol patches vs injections

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I recently switched from using estradiol patches to weekly self-administered IM (intramuscular) injections of estradiol valerate (my doctor is monitoring my hormone levels). I found this thread which has a lot of good information:

'Gels vs Patches vs Pills',259425.msg2458413.html#msg2458413

However, there wasn't much discussion about injections. Other than getting over the physical and visual aspect of using a 1.5 inch needle on myself every week, switching to injections has been going well so far. Patches had been working just fine, but I had reached the point where I didn't like the constant visual reminder of having external ovaries (patches).

Other than hormone levels which will now vary daily depending on the date of last injection, is there anything else I need to be concerned about? Are there any side-effects unique to injections?

Love always -- Jessica Rose

I've performed five injections (one per week) since switching delivery methods. Initially I used a 23g needle to draw the estradiol, then a 25g needle for the injection. My injection site was outer, mid-thigh (around the two o'clock or ten o'clock position). There was some soreness at the injection site for a day or so.

My new prescription is for 22g needles, and it does not allow for swapping between 'draw' and 'injection'. I can definitely feel the difference between a 25g and a 22g needle during the injection! I was also instructed to inject in my upper thigh at the twelve o'clock position. Even with the larger needles, I don't notice any soreness after an injection.

I am on what's considered a low dose, but my estradiol levels are significantly higher than when I was using patches. For three years my levels were around 180 pg/mL. When they were checked in February (patches), my level was 269 pg/mL. My estradiol level was checked on day 6 after my third injection, and it was 490 pg/mL! We plan to check my level again in three months.

I have noticed a few things. My breasts are very tender and sore, almost like a few months after I first started HRT. I am also a little more emotional, and I became euphoric for a little while last week. So far, I'm enjoying the changes.

Love always -- Jessica Rose

Courtney G:
Congratulations on the switch, Jessica. I do like patches and they've been very effective for me, even at lower doses but I hear what you're saying about the visual thing. At this point in my transition, the sight of a patch is actually affirming for me but I can understand that at your point, you don't need to see that. Pills were never an option to me, due to my age and a previous blood clot.

Thanks Courtney! Patches are definitely simple and effective, they also keep your hormone levels more stable than many of the other options. Now instead of carrying a small box of patches, I need alcohol prep pads, syringes, needles, a vial of estradiol, and a sharps container! Every method has pros and cons, you just have to weigh them all based on what is important to you. I may switch back to patches at some point, but I want to give injections a long trial run.

Love always -- Jessica Rose

I'm just going to throw my 25 cents into this.


Those things were a total disaster for me. They would only stick 50% of the time (which crashed my E levels). They also gave me a wicked rash. That was no fun.

Viva la estrogen gel!!


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