transdermal less effective than oral estrogen?

[JessicaAlba]

So my endo prescribed me Spiro / Aldo and put me on transdermal E as that's way safer according to her.
I was all happy to get started and to see my E levels booming and then I met this other transwoman at this party who told me that my endo prescribed me a non-effective method. According to her almost none of the transwomen getting transdermal E prescribed experience reaction. My endo and I agreed on a first cycle of 3 months before having my levels measured again. Now I'm basically freaking out and don't even think it's worth bothering if it won't work anyway. Spiro alone won't do alot and I shouldn't expect changes from my transdermal according to this gal. Should I see my endo again ASAP and have me switched to oral E? It's very important to get the most E out of it for me so that I can demasculinize as fast as possible. I'm a complete mess since I spoke with that gal. So is she exaggerating? Have there been gals who experienced fabulous things on transdermal as well? Or is it lesser than oral E? I eat a lot of sweets, drink tuns of coffee and have a lot of junkfood which overall isn't great either so it's important for me that my treatment does something.

[Mariah]

Hi Jessica, welcome to Susan's. Everyone's mileage will differ depending on the delivery method. Is long as your levels are where they should be the delivery method shouldn't matter. Endo would be someone I would ask though. I look forward to seeing you around the forums. Good luck and Hugs
Mariah

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[LivingTheDream]

Transdermal E has been much more effective for me than oral was. I was on oral for about 9 months or so and my T was really high still and E really low. Switched to patches in September, had labs done a month or so later and wow what a change. Still not great numbers but way way way better than before. So ya, as Mariah said, it just depends on the person. Just give it 3 months and see what happens.

[Cindy]

I've been on pills (nearly killed me), implants (awesome) and now patches all under supervision of an endocrinologist.

Somewhat unsurprisingly the endocrinologist knew an awful lot more about hormonally reassigning me safely than any one I have met at parties etc

I have to admit I have met people at such events who thought they knew more appropriate chemotherapy regimes than I. They read it on Google; I only have 30 years medical experience in the area. Who am I to argue with Google

[JessicaAlba]

I've been on pills (nearly killed me), implants (awesome) and now patches all under supervision of an endocrinologist.

Somewhat unsurprisingly the endocrinologist knew an awful lot more about hormonally reassigning me safely than any one I have met at parties etc

I have to admit I have met people at such events who thought they knew more appropriate chemotherapy regimes than I. They read it on Google; I only have 30 years medical experience in the area. Who am I to argue with Google

It seams like we get smarter at parties
You probably would hate me to then cause I think I know everything about chemo to after my map sent me to "road cancer" thrice 
Bet you never heard about topotecan lol

[Cindy]

I hate to say but I do know Campethcin quite well. I use topoisomerase and increasingly kinase inhibitors regularly

But I also have a preference for immunotherapy and the current UK & USA trial for non-responsive CALLA uses the CD19 monoclonal antibody I developed in the 1990s, I removed the patent so that it could be reversed engineered and it appears to be having some success in an otherwise fatal childhood leukaemia. The only person not referenced in the Lancet paper was ----me!

And I really don't care! Just glad it works!

[JessicaAlba]

I hate to say but I do know Campethcin quite well. I use topoisomerase and increasingly kinase inhibitors regularly

But I also have a preference for immunotherapy and the current UK & USA trial for non-responsive CALLA uses the CD19 monoclonal antibody I developed in the 1990s, I removed the patent so that it could be reversed engineered and it appears to be having some success in an otherwise fatal childhood leukaemia. The only person not referenced in the Lancet paper was ----me!

And I really don't care! Just glad it works!

Damn,you won :'D Still have my Xeloda anyways :'D
Don't know much about immuno as I was her2neu neg

[stephaniec]

After the previous couple of posts I feel a little embarrassed about adding my two cents, but what the heck. I use patches and they work great. If you can deliver estrogen through monoclonal antibodies I'm all for it.

[jennyfer]

I've had excellent results with transdermal estrogen (Oestrogel), for about one year.  That includes physical changes as well as blood serum levels.  Why not give it a chance?

[Isabelle]

Delivery methods are all ultimately the same. E goes in your blood and binds to cell receptors that tell them to behave in a certain way. If you're on transdermal because your Endo says that's what you should be on, then that's what you should be on. I've read that people over 40 and smokers are often put on transdermals because of lower risks. If you're in your late teens ethinyl estrodiol can be used safely in pill form, if you're over about 25ish estrodiol valerate is fine in pill form. I don't know anything about implants or injectables as they're not used where I'm from. The reason they say for this is, if something starts to cause a problem, you can fix it by stopping taking the pills, but you can't "un-inject" something once it's in there.... You have to wait it out.. Precautionary principle and all that..
As for implants, I'm not sure if they're funded. I've heard they're very popular with endo's treating transsexuals in Australia though. I'd quite like to give implants a go personally. 

[Laura_7]

Well as usual there is some truth to it but that should not make you concerned.

People have different skins so rate of absorption is different.

So it can work well.

Otherwise one possibility would be to use one patch for a steady level and bioidentical estrogen pills dissolved under the tongue, which is also less straining on the liver. It might be preferable to split the daily dose in pills in a few small doses instead of two big ones to keep levels more steady. Peaks and lows might affect mood.
Other effective methods are implants and injections.

You might simply talk that through with your endo, when checking your levels.

Coffee and cigarettes should be cut down...

[AnonyMs]

It seams like we get smarter at parties
You probably would hate me to then cause I think I know everything about chemo to after my map sent me to "road cancer" thrice 
Bet you never heard about topotecan lol

Cindy's a bit shy, so you might want to take a look at this.
http://www.zoominfo.com/p/Cindy-Macardle/-1931158476 🔗

[Isabelle]

All that matters is, is the dose at a therapeutic and safe level. The same as any other pill or potion. More doesn't mean better. You'll only piss away anything extra. The method of delivery doesn't matter. You've been put on transdermals because a professional with years of expertise and specialised study thinks that's the best option for your case. Thankfully, science isn't democratic. 

[Laura_7]

As for implants, I'm not sure if they're funded. I've heard they're very popular with endo's treating transsexuals in Australia though. I'd quite like to give implants a go personally.

There are endos in the us who do implants.
Here is info that might help an endo to start with them:
https://www.susans.org/forums/index.php/topic,192044.msg1713877.html#msg1713877

Upside is no hassle, effective and steady levels.
There are also bioidentical progesterone implants. They are more given to extrusion but according to literature intramuscular application should help.
There is one form of hrt with implants and injections where the levels of estrogen are driven well into the female range and t is driven down into the female range without further anti androgens.

[Cindy]

It seams like we get smarter at parties
You probably would hate me to then cause I think I know everything about chemo to after my map sent me to "road cancer" thrice 
Bet you never heard about topotecan lol

Cindy's a bit shy, so you might want to take a look at this.
http://www.zoominfo.com/p/Cindy-Macardle/-1931158476 🔗

And I thought of going stealth

[iKate]

Delivery methods are all ultimately the same. E goes in your blood and binds to cell receptors that tell them to behave in a certain way. If you're on transdermal because your Endo says that's what you should be on, then that's what you should be on. I've read that people over 40 and smokers are often put on transdermals because of lower risks. If you're in your late teens ethinyl estrodiol can be used safely in pill form, if you're over about 25ish estrodiol valerate is fine in pill form. I don't know anything about implants or injectables as they're not used where I'm from. The reason they say for this is, if something starts to cause a problem, you can fix it by stopping taking the pills, but you can't "un-inject" something once it's in there.... You have to wait it out.. Precautionary principle and all that..
As for implants, I'm not sure if they're funded. I've heard they're very popular with endo's treating transsexuals in Australia though. I'd quite like to give implants a go personally.

Pills have to pass through the digestive tract and liver, which is why they are less effective than injections. If you take them sublingual however they bypass the liver.

[Jenna Marie]

I think which method is most effective varies by person, and that for ANY method you will find someone who swears by it and someone else who insists it never works. 🙂 I've heard the same story - this is ineffective, switch to something else - for oral, injections, gel, and even implants. I'm sure the people saying so are telling the truth for their own bodies, but people are different.

Anyway, I've been on patches from the start (and a super low dose to boot) and was outed at work within the first four months by the changes coming so fast and dramatic. By six months I couldn't get anyone to accept my male ID as me anymore and was a curvy C cup. So patches CAN work fine, and the only way to find out which method is best for you is trial and error anyway.

[Laura_7]

... the only way to find out which method is best for you is trial and error anyway.

Yes, this is what endocrinologists say... endocrinology is the adaption to the reaction of the patient  🙂

[Joi]

Between 1997 & 2002, I was on a low dose Estradiol pill with no andro blockers.   I was 50 yrs old at the time.  I experienced fairly rapid changes (breast budding, skin changes and fat re-distribution + emotional changes i.e. tearful reactions to simple things like a sad movie).  Fast forward to 2015,  started Xsex hormone therapy in early March.  this time Spiro, Medroxyprogesterone, Estradiol Patches.  After 90 days T levels off the chart low, E levels only 31. At 150 days & new labs, T-levels still below 1.0,  E level 42.  My endo dbld my E patches. So far: some breast tenderness, but little noticeable growth, skin dryness, and some softening.  No emotional reactions at all.  ?  Will test again in Nov.  My endo said he wanted to see my E level at or below 200.  I'm older now and have been told not to expect much at age 67.  Sure would like to see something movement at least above 100, but it's wait and see for now.

[JessicaAlba]

I hate to say but I do know Campethcin quite well. I use topoisomerase and increasingly kinase inhibitors regularly

But I also have a preference for immunotherapy and the current UK & USA trial for non-responsive CALLA uses the CD19 monoclonal antibody I developed in the 1990s, I removed the patent so that it could be reversed engineered and it appears to be having some success in an otherwise fatal childhood leukaemia. The only person not referenced in the Lancet paper was ----me!

And I really don't care! Just glad it works!

You seam like a wonderful oncologist , Cindy xx
People helping us to battle cancer should be praised more
Have gotten intestinal cancer thrice so know how important docs as yourself are!
That was wat has driven me to go study medecines myself
Oh well , if I wouldn't have been that bad at mathematics I would have graduated in oncology
Take care , you seam like a lovely and wonderful person to me