IM vs. Patch

[Wynternight]

G'day all. I've been on transdermal patches since starting HRT 8-31-14 but I'm finding they give me an itchy rash so I'm considering asking to change to IM Q10 days. Any thoughs or advice anyone can offer would be very appreciated. I would have to get over my fear of injecting myself but I think I can manage. Has anyone made the chance to IM from patches and if so, how different were the effects? Did you notice a change in mood and effects? Were the changes more dramatic vs. on the patch? Lastly: how different was the pricing for the vials and syringes vs. the patches?

[Jessica Merriman]

I love injections and was on the patch initially. Once you pierce the skin there is no more pain. I feel the benefits are incredible. Much better feminization has occurred and at only once a week for me is great. Can't help with the cost though as mine are covered under Medicare.

[mrs izzy]

When i lived in the states i used a compounding pharmacy.

Prices are cheaper then the big box pharmacy.

Check internet or local phone directory.

[PinkCloud]

I  went from IM to patches. I got the rash alright, but after a year I don't notice it as much. My skin got used to it I guess. I was on IM for close to 6 months, but I found it to be an unstable method of delivery. Besides, I got tired of stabbing myself.

[Wynternight]

I  went from IM to patches. I got the rash alright, but after a year I don't notice it as much. My skin got used to it I guess. I was on IM for close to 6 months, but I found it to be an unstable method of delivery. Besides, I got tired of stabbing myself.

Unstable in what way?

[AnonyMs]

I changed over from the weekly to twice a week patches and that helped a lot. I also had a vitamin D deficiency that was causing rashes in general. I don't know if it was causing rashes from the patches as I'd already changed over to implants by the the time I found out. I found out about the vitamin D from a blood test and took vitamin D3 supplements to fix it (a lot of them as well).

[Wynternight]

I'm going to give the IM a go and see how I do. I'm on the twice weekly patch and still getting a rash. I just got back from seeing my pcp and she's fine with me trying the IM so we'll see how it goes. She also wrote me more refills on the patches just in case I decide to stick with those.

Pretty sad that I'm a nurse, going to be going to school to be an Advance Nurse Practitioner, and I'm scared of needles. I can stick people all day but me getting stuck? Nononono!! 

[primrose]

I don't know which method of delivery is most effective. I've only used patches and gel. Injectable oestrogen is banned in the UK l. Btw does anyone know why this is the case?

[AnonyMs]

Injectable oestrogen is banned in the UK l. Btw does anyone know why this is the case?

I find that really disturbing. I've lived in the UK, and the more I hear about it the more it scares me.

I just found this 2008 NHS document "Guidance for GPs, other clinicians and health professionals on the care of gender variant people" and it only mentions patches, gel, and tablets. And no implants or progesterone either. Patches and gel don't work well for me, and I'm too old for tablets. My life would be in danger if I were still using patches. I actually feel a bit sick writing this.

[PinkCloud]

Unstable in what way?

The way a muscle absorbs the solution. I found it to be fairly rapid, similar (but slower) to sublingual administration. Transdermal is a lot slower and more steady in my opinion. But this is my anecdotal experience.

Besides I was also worried about muscle hardening, denervation and atrophy building over chronic use. I injected in the vastus lateralis, and sometimes walking was a bit sore for some time. The buttock is a more risk area, make a small mistake and it can cause permanent paralysis if you hit the sciatic nerve. One tiny mistake, and the oily substance can stay subcutaneous if you are unlucky. One girl I knew got a IM morphine injection in her leg after SRS, and after 4 years her leg still hurts. I chose to stay away from needles.

When I had my SRS, every night, nurses injected me with a solution to prevent thrombosis. 1 evening, a nurse made a mistake and injected me too shallow, or in the wrong angle, don't know, and I had bruises and a painful leg for 5 weeks in total because the fluid started to migrate under my skin. Even they make mistakes with such a simple procedure they perform thousands of times.

Don't want to scare anyone, but I think it's healthy to consider the possible risks involved. I always try to minimize them myself.

[Mariah]

I made the switch on 10/31 after being on the patches since 9/20. I didn't see a whole lot of things happen while I was on the patches, but after I made the switch I started to notice somethings that I have been waiting for including the breast budding. It's not to say the patches didn't play a role in that or the different dosing didn't play a role either. I have been happy with IM self injectioins though. Do remember that the stable constant dosing you were getting with the patches doesn't happen with the shots especially if your on a 14 day cycle. Only real mood change that wasn't present with the patches is the fact I tend to get a bit moody the last couple of days before the next shot. I really noticed that this last time. Your insurance, which estradiol shot you use, and the pharmacy will effect your pricing. I do all my perscriptions through the Group health Mail order pharmacy in my case. I only paid 9 dollars for a 3month suppy of Delestrogen (estradiol valerate) and 2.2 for 3 month supply of the syringes and needles. I would say they were more dramatic, but do keep in my mind the fact I had been on patches for about 42 days if you include the partial day of 10/31 and dosing being different than it was with the patches. The other thing to keep in mind in my case was that the first does of Spiro didn't happen tell a couple days after switching to IM self injections so that could have played a huge role too. As some have mentioned before have you tried switching to the smaller patches. You might have less problems with them.

G'day all. I've been on transdermal patches since starting HRT 8-31-14 but I'm finding they give me an itchy rash so I'm considering asking to change to IM Q10 days. Any thoughs or advice anyone can offer would be very appreciated. I would have to get over my fear of injecting myself but I think I can manage. Has anyone made the chance to IM from patches and if so, how different were the effects? Did you notice a change in mood and effects? Were the changes more dramatic vs. on the patch? Lastly: how different was the pricing for the vials and syringes vs. the patches?

[Mariah]

I'm sure you know this, but these shots hurt way less than getting blood drawn. It's quick and basically painless. I know it is easier said than done. I'm not fond of needles either, but after taking a nice deep breath I get over it and I get it done. I try not to think about it to much because if I did think about it to much I probably would never get it accomplished. All the fear and anxiety would get in the way. I hope your able to, but I know it's easier said than done. I hope you have the courage to be able to get past your fear of needles and be able to accomplish this. Hugs
Mariah

I'm going to give the IM a go and see how I do. I'm on the twice weekly patch and still getting a rash. I just got back from seeing my pcp and she's fine with me trying the IM so we'll see how it goes. She also wrote me more refills on the patches just in case I decide to stick with those.

Pretty sad that I'm a nurse, going to be going to school to be an Advance Nurse Practitioner, and I'm scared of needles. I can stick people all day but me getting stuck? Nononono!! 

[ChrissyChips]

Hmm, I've been trying to find out about injectable hormones here in the UK. I can't find anything saying they are banned here.
Injections still seems to be one of the available options, as far as I can see anyway. I haven't started yet but I was planning on asking for the injections.

[Mariah]

One thing I would check in regards to that are you sure it was banned for use on humans and not on meat (food).

Hmm, I've been trying to find out about injectable hormones here in the UK. I can't find anything saying they are banned here.
Injections still seems to be one of the available options, as far as I can see anyway. I haven't started yet but I was planning on asking for the injections.

[ChrissyChips]

One thing I would check in regards to that are you sure it was banned for use on humans and not on meat (food).

I'll check that out . It was the message above from Primrose about it being banned that got me worried!  I hadn't personally heard anything about it being banned.

[primrose]

I find that really disturbing. I've lived in the UK, and the more I hear about it the more it scares me.

I just found this 2008 NHS document "Guidance for GPs, other clinicians and health professionals on the care of gender variant people" and it only mentions patches, gel, and tablets. And no implants or progesterone either. Patches and gel don't work well for me, and I'm too old for tablets. My life would be in danger if I were still using patches. I actually feel a bit sick writing this.

I am sorry to hear that and I know it can be frustrating having to rub off gel every day not knowing if you've actually done it right or having to constantly wear a nasty patch on your tummy...

I'm on private care and my doctor has told me that injectables and implants are not available in this country (UK). He also said that with injectables people get spikes and then the levels dwindle down - whatever that means... The irony is that in the UK every tom dick and harry can inject you with fillers or do laser on your face without any med qualification but hey no injectable oestrogen as of safety concerns?! Go figure...

[Mariah]

It means are estradiol levels up to their highest levels based on our bodies and the dose we are on. Then they steadily fall tell your next dose. All that really means is your cycling your estradiol levels.

I am sorry to hear that and I know it can be frustrating having to rub off gel every day not knowing if you've actually done it right or having to constantly wear a nasty patch on your tummy...

I'm on private care and my doctor has told me that injectables and implants are not available in this country (UK). He also said that with injectables people get spikes and then the levels dwindle down - whatever that means... The irony is that in the UK every tom dick and harry can inject you with fillers or do laser on your face without any med qualification but hey no injectable oestrogen as of safety concerns?! Go figure...

[Leila]

Injectable oestrogen is banned in the UK

I think saying injectables are banned in the UK is technically not correct. They are simply not licensed for use in UK. Whilst injectables are not available in the NHS, implants are licensed in UK for cis women requiring HRT.

[AnonyMs]

I am sorry to hear that and I know it can be frustrating having to rub off gel every day not knowing if you've actually done it right or having to constantly wear a nasty patch on your tummy...

I didn't know you have to rub it off. Oops. I usually put too much on as well.

Sorry, I don't think I was very clear before. I used to live in the UK at one point, before all my transgender issues blew up. I'm in Australia now, and changed from patch/gel to implant. I was getting seriously depressed on patches and gel, it was quite scary. The though of that happening to me in the UK was horrible. I feel so incredibly good with the implant, its actually quite hard to believe the difference.

I'm on private care and my doctor has told me that injectables and implants are not available in this country (UK). He also said that with injectables people get spikes and then the levels dwindle down - whatever that means... The irony is that in the UK every tom dick and harry can inject you with fillers or do laser on your face without any med qualification but hey no injectable oestrogen as of safety concerns?! Go figure...

As far as I can tell the injectable spikes are from high to low, while the patches are from very low to very low. I know which I'd rather have. Implants though have a very long cycle (maybe a year, not sure yet), and you can keep them pretty high by getting another well before the previous one runs out.