As a newcomer to the board, one area I'm convinced about is the advantage of transdermal estrogen over ingesting estrogen pills.
After taking standard Estradiol pills for ~2 years, a sonogram (that was looking for unrelated issues) picked up a mass on my liver. An MRI revealed it as an hepatic adenoma. It's a benign tumor that is almost unheard of except in women taking birth control, and based on some quick searches, largely off everyone's radar here, too.
It turns out they're mostly found incidentally as they're minimally symptomatic (if at all) on their own. An HA has a low lifetime chance of turning cancerous, but can rupture spontaneously if it grows too large - which is actually somewhat dangerous with a ~10% fatality rate from HA-related internal bleeding. I hear ~5" is about the threshold for concern. Mine is less than half that size.
After being diagnosed about 4 years ago, my doctor switched me to compounded estradiol cream, the same kind commonly taken to relieve menopause symptoms. Usually doctors recommend tumor excision, especially if it can be done with keyhole entry, but mine is so small and central on the liver that the recovery would mean resecting half the liver and thus probably be more dangerous to my health than letting it be. My doc has a great reputation and recommended just a yearly MRI to check for changes.
In the time since being on estradiol cream, at least a year or more of which was spent on an estrogen dosage that my doctor later read from my blood levels as "too high", my tumor has not changed in size or nature, leading us to conclude in my case that this treatment is not having the adverse effects that estrogen pills did - and thus, anecdotally, that others in my situation may benefit from this knowledge as well.
We don't really see hepatic adenomas in this population, but they apparently can form with HRT. I suppose this is food for thought in case anyone is on the fence about how to administer estrogen (talk it over with your doctor, but at least for me, it's healthier.) I'd be curious to hear if others have had related experiences.
