The Rationale of Halve

[Newgirl Dani]

I wish someone could explain this to me once and for all, I've almost wore out the internet doing searches.  This concerns injections of EV and the numerous times I have read posts that deal with the 'running on empty' thing that affects many people just prior to the end of their two week cycle.  Just as often I read about how the remedy is possibly to cut the dosage in half, and go to once a week.  Well ok, but this is where my logic seems to put its foot in the door every time and say " wait a darn minute, doesnt that just mean I'll repeat the same problem, only at 5 or 6 days into my week?"  My mind says, if the drug absorption rate or ' Tmax' is constant, which it would have to, and the bioavailability remains the same, what would make a one week rate slower than a two week rate? 

I just want to get this clear so that I can keep up an informed converstion with my doctor as I want to decrease from 14 day to 10 day BUT keep my former dosage the same in order to accommodate this 'for lack of a better term, rationale of halve.   Any help would be deeply appreciated.

And for anyone who may remember an old post of mine that said this had been resolved,  well.....I thought it had at my last appointment, but I just got a letter from her saying (my words)  "yeah its all good"  but then goes on to use my old dosage in the sentence.  Egads, what is a girl to do?   Dani

[Rachel]

Hi, I am new to injections; however, at day 10 through 14 I definitely felt an noticeable decrease in the feeling of well being and my areolas and nipples definitely became less sensitive. On day 14 I had a very bad dysphoria event. I mentioned this to the nurse last week and she said some girls go to 10 day cycles to reduce this. I need my PA to agree and I will work on this.


To answer your question I believe, may be wrong, but the dose cut in half would mean a more stable dose through out the cycle with a lower high not a higher low. I really enjoy the high and just want to avoid the low.

[Kaelin]

It'll be more stable.  Your body may lag slightly since you're only putting in half to start when your body is begging for a jolt the most, but it'll get better within a dose or a few.  If your body still isn't holding up to your satisfaction after a month, you may need a slightly greater dose.

[Newgirl Dani]

Hi, I am new to injections; however, at day 10 through 14 I definitely felt an noticeable decrease in the feeling of well being and my areolas and nipples definitely became less sensitive. On day 14 I had a very bad dysphoria event. I mentioned this to the nurse last week and she said some girls go to 10 day cycles to reduce this. I need my PA to agree and I will work on this.


To answer your question I believe, may be wrong, but the dose cut in half would mean a more stable dose through out the cycle with a lower high not a higher low. I really enjoy the high and just want to avoid the low.

OK, so your first sentence is exactly what has happened to me, practically word for word.  Let me try to say this another way because you nailed it so exact.  We will use the 14 and 7 day example.  If the meds get so low near the end of the 14 day period bad enough to cause a return of dysphoria, then if you look at a 7 day period why wouldnt the dose get just as low near its end?  Maybe that says it a tad clearer.  This is why when I talk to my doctor I'm going to ask if the only way to truly fix this is to shorten from 14 to 10 and not cut the dose at all.  Sort of like putting the same amount of air back into a tire just when it begins to get low.  Gosh I could be way off but it makes sense to me.     Dani   and thanks Kaelin/on same page.

[Jessica Merriman]

I do mine every week and have not experienced any lag effects at all. Would that be doable for you? 

[Newgirl Dani]

Hi Jessica, well I suppose every week is doable, although even every 10 days kinda seems like a lot but something I could do.  About my point though I guess there just isnt any answer as to why a drop off can happen at two weeks but yet none at one week with half the dose  .  Well (inward smile) I will let sleeping dogs lie and wait for my doctor discussion.  I sure thank you all though for putting your two cents in.  I'ts rainy here so I think whats called for is a semi hot bath with some stress relieving aromatherapy salts, some music, and drift for awhile     Dani

[Randi]

The half life of estradiol valerate and most other variations is about 8 days.
The valerate or cypionate is an "ester" that has extra atoms attached to the estradiol.  It takes a while for this to break off and change it into a usable form.

Serum (in the blood) estradiol peaks about 24 hours after the injection, it gradually decreases and 8 days later is about half the level it was at it's peak.  16 days later there is 1/4 of amount left, and 24 days later it is 1/8th.

It would take a graph, spreadsheet or an understanding of calculus to explain in detail, but injecting half the previous amount twice as often will smooth things out.  After your second injection's ester is being broken down, there is still a portion of each of the previous week's injection remaining.  And there is still a portion of the injection you took two weeks ago (and even earlier shots to a lesser degree).

After a few months on a weekly schedule all those "half-lives" add up and the blood level approaches twice the one week peak.

In summary, if you are currently injecting a certain amount every 14 days, and start injecting half that amount every 7 days, the serum levels will even out.  You are not really changing your dosage at all, just evening things out.

Best Wishes,
Randy

.  About my point though I guess there just isnt any answer as to why a drop off can happen at two weeks but yet none at one week with half the dose.

[Newgirl Dani]

Ahhhh thank you Randi, I was dancing all around the fringe of this (Tmax/Cmax, half lives etc.) but just couldnt nail it down.  My studies were in petrochemical analysis and quality control, so medical pharmacokenetics was just out of my grasp.

I was going to tell you, yeah I've had my share of probability & statistics, and calculus, but thought 'no' those cells have just too much dust on them, better to not wake those puppies up  .  You have also saved me making another doctors appointment, much appreciated.  Dani

[KayXo]

One study showed that levels decreased significantly after 7-8 days with EV whereas with EC, they decreased later, around 10-12 days, if i recall correctly. This is why I usually think 1 week is best for EV and 10-14 days is ok for EC. I get my EV injected every 5 days and I'm fine.

[Newgirl Dani]

One study showed that levels decreased significantly after 7-8 days with EV whereas with EC, they decreased later, around 10-12 days, if i recall correctly. This is why I usually think 1 week is best for EV and 10-14 days is ok for EC. I get my EV injected every 5 days and I'm fine.

Nice to know, thanks.