oral vs sublingual estrogen - opinions and results

[Satinjoy]

Spinning off the how to take sublinguals, I would like to know peoples experience on oral vs sublingual results.

I crash on subs, worst in the morning, with euphoria an hour after taking my E. Its a pain to take it, and the feminization is fairly good, if I could just get rid of the stomach fat.  Which at 5-9 and 138 isn't much.

I have heard that sub is safer because of clotting risks.

I have also heard that oral is better for evening out the serums and for feminization through a thoughtful board member.
 
Thoughts?

What gets said is going to my endo next appt.

[Catherine Sarah]

Hi Satinjoy,

If DVT is your issue, anything other than oral is your answer. Patch and gel obviously have to compete with the hourly variants of you skin. Injections are subject to excessive peaks and troughs. Implants offer the most stable and consistent method of delivery. And the longest half life.

Hope your next appointment goes well.

Huggs
Catherine

[KayXo]

Clotting risk with oral bio-identical estradiol is quite low, almost negligible, especially at doses typically prescribed to us. Consider that doses in several times higher were prescribed to women at an advanced age with advanced breast cancer with only one person with a cancer in the most advanced stage having clotting complications. I've also explained the reason with several studies, historical facts in another post. So, whether you take it sublingually or not, doesn't really make much a difference and besides, some is always inevitably swallowed. Not worth the fuss in my opinion.

BUT, if you are genetically predisposed to clotting and have health issues as your doctor should be made aware, then just to be sure and be on the safe side, it's best to go the non-oral route. In my opinion, injectables are a good option if taken every week, avoiding the lows. Patches and gels may be a little inconvenient compared to once weekly injections and may not (depending on individual) provide enough for adequate feminization. I think they are more costly as well.

[JennyBaumann]

I've been taking Estradiol for over five years now, always sublingual.  Heard that taken orally it can cause liver damage, and since I also like my wine now and then, didn't want to tease the liver too much!  Have had absolutely zero side effects from taking it under my tongue.  Was even taking a double dosage at first, to increase and/or speed up the effect, while taking a t-blocker the same way.  I've reached my goal now (finely shaped natural C-cup, thank you very much), so I'll continue the maintenance level for the foreseeable future.


^{edit: sorry, no dosages please}

[Carrie Liz]

I've been taking my E sublingualy since the very beginning, and have had no problems whatsoever. Feminization has been pretty much ongoing, and I definitely can't complain about my results. 1 year in, and I'm already now living in a body that looks more female than male in terms of overall shape, skin texture, and body hair.

I've actually heard the opposite of what you've said... that doing it sublingualy is actually better for feminization. Because when estradiol has to pass through the digestive system, a lot of it is converted to less-potent derivatives like estrone and estriol. (Estrone is 10X less active than estradiol, estriol is 80X less active.) Where when it goes directly into the bloodstream, most of it remains 17β-estradiol, the most active form of estrogen. Plus it lessens the risks of clotting and liver damage.

Me personally, I've never seen a single study claiming any benefits to oral. Every single thing I've read points to sublingual being superior. And again, it's worked for me, so I can't complain.

[KayXo]

Heard that taken orally it can cause liver damage, and since I also like my wine now and then, didn't want to tease the liver too much!

Consider that other forms of estrogen (Ethinyl Estradiol, Premarin, DES) were used for decades by transsexual women, that these other forms were not only more potent (up to 500-1,500x) in terms of liver effects but that their doses were quite high by our standards today and that despite this, liver damage was quite uncommon. Harry Benjamin, the pioneer in transgender care, himself even states

"The liver is the organ that metabolizes ("digests") the estrogen and it is conceivable (although not actually shown) that it may be unfavorably affected by long-continued medication. A hazard may possibly exist if there is a history of hepatitis."

From The TRANSSEXUAL PHENOMENON
Harry Benjamin, M.D. , 1966
http://www.shb-info.org/sitebuildercontent/sitebuilderfiles/transsexualphenomenon.pdf 🔗

Consider as well that birth control pills contain ethinyl estradiol, that they are prescribed to thousands of millions of women worldwide, and are equivalent to at least 500x the dose of oral estradiol.

The greater concern is clotting but bio-identical estrogen's effects are still negligible and absent if taken non-orally.

However, alcohol interacts with orally administered estrogen and reduces its concentration in the blood by increasing enzymes responsible for metabolizing estrogen. Alcohol is also more harmful to the liver than estradiol but drinking from time to time is fine. 🙂 Unless, you have issues with your liver, of course!

[Ltl89]

I'm no authority figure on which method is safer or more effective.  What I can say is that I take my estradiol sublingually and have been noticing positive results without any negative consequences.  I should note that I've been taking estrogen since June of 2013 and have been on various dosages without problems.  So, it's been safe enough for me, though I can't say if oral is better or just as safe.  I'm interested to hear what others have to say.

In any case, best bet is to talk to your doctor because all of us have different medical histories and our bodies may not all react the same way.

[Rachel]

I use the sublingual method.

I too heard it to bypass the intestines and has a more effective form.

I have no study to prove either way is better. I do know a lot of Trans* do sublingual and I suspect for the same reasons. Best effect and less liver filtering. I do not know if either is obtained.

[Missy~rmdlm]

Standard estradiol pills are far too tasty to swallow. Sub-lingual all the way.
It's my impression that sub-lingual estradiol does cause serum spikes, I tend to break my day into multiple doses and I break pills to spread the intake out.

[Satinjoy]

This is great.  And thanks everyone.  No I don't have clotting, I don't drink at all (been there, done that, cant do that) and yes I am confused.  I could do without the spikes but I am conservative concerning the health.  And I love the taste of Estrogen, but conversely I try not to taste the Estrogen!   Estrogen feels great.

We get all kinds of docs stuff and rightly so, but I like to see this particular "real life experience" in a massive share.

Moneys tight I need the pills, and I really don't want the patch.  Saw the other thread on the other methods and its a great thread.

Love to hear others experiences... I get obsessed with serum levels its part of my dysphoria.  Actually, I am obsessed with my dysphoria period.

[Oriah]

Standard estradiol pills are far too tasty to swallow. Sub-lingual all the way.
It's my impression that sub-lingual estradiol does cause serum spikes, I tend to break my day into multiple doses and I break pills to spread the intake out.

this pretty much sums my opinion up

[KayXo]

Btw, Oriah, you look like Eugenie Bouchard, except for the hair...but totally the face...Canadian tennis player who's one of the best players in the world. very pretty and from my city, Montreal. 🙂

https://www.google.ca/search?q=eugenie+bouchard&rlz=1C1PQHA_enCA567CA567&espv=210&es_sm=122&source=lnms&tbm=isch&sa=X&ei=I6XxUuSKEoqTyQG30oD4Cw&sqi=2&ved=0CAcQ_AUoAQ&biw=1024&bih=645 🔗 [Link: google.ca/search/]

[Oriah]

Btw, Oriah, you look like Eugenie Bouchard, except for the hair...but totally the face...Canadian tennis player who's one of the best players in the world. very pretty and from my city, Montreal. 🙂

https://www.google.ca/search?q=eugenie+bouchard&rlz=1C1PQHA_enCA567CA567&espv=210&es_sm=122&source=lnms&tbm=isch&sa=X&ei=I6XxUuSKEoqTyQG30oD4Cw&sqi=2&ved=0CAcQ_AUoAQ&biw=1024&bih=645 🔗 [Link: google.ca/search/]

aww, thanks!  She's really pretty! 

[AMDERS]

Why did I just read that entire post as if it was a rap. Am I the only one?

[AMDERS]

Why did I just read that entire post as if it was a rap. Am I the only one?

[AMDERS]

Why did I just read that entire post as if it was a rap. Am I the only one?

[amZo]

Why did I just read that entire post as if it was a rap. Am I the only one?

Girl, you can say that again!   

I kinda get what you're saying.