Moving to injections... Help?

[Orchid]

My question is about switching from pills to injections. My medical provider told me that she won't start me at the full dose, so I'm wondering how I should be affected by this. I know that less might be more in this case, as apparently I can't absorb as much estrogen in pill form as I normally could via injections, but I'm still confused. Is that correct? Is it even possible to suffer adverse effects if you start at too low of a dose? I assume that it's a 'your mileage may vary' kind of thing, but I wanted to be sure. She told me that she would also prefer if I do this vi weekly as oppose to weekly, but she didn't really have an answer as to why. I'd like to keep the 'withdrawal' symptoms out as much as possible.

[stephaniec]

I do injections and I feel they work a lot better. Unless you have some serious suspicion about your doctor it's best to go with what they say.

[Dena]

It's Bi weekly or once every two weeks. Weekly will reduce your hormone fluctuation because you will be using half the dose but twice as often. This will reduce the amount your hormone levels will drop between injection. Some people are not sensitive to the level change and once every two weeks is fine for them. Others are sensitive and a smaller dose every week is better. Depending on your comfort level with injections, you might want to start with every two weeks and if that feels uncomfortable, have the doctor switch you to every week.

Pills are not the most effective way to deliver hormones and sometimes what works for one person may not work for another. My guess is you doctor couldn't reach the desired levels with pills so you are going to try another delivery method.

[whereto]

injections actually work much better than pills. the results start to show up quickly after first 3 months because injections go immediately into your blood stream. and in the long run, it won't do much damage to your liver and its function than pills.

can you ask her why doing it bi-weekly? if it's a very low dose then it's better to do it weekly so you don't have any withdraw effect. though it really depends from person to person. the first and the last day of injection usually feels horrible. so bi-weekly doesn't sound bad at all since you can expand the time you feel good.

mine started on a low dose, though not so low compared to others since i'm not on any medications and my health is fine. once my blood work is done, i can meet up with my doc to discuss about my hormone level and she'll up my dosage accordingly. she says it'll work for both ftm or mtf. one thing you don't want to do is asking for extra hormones. if your body has a higher level of estrogen, your body will automatically transfer them back to testosterone which is very counter productive.

[Lady_Oracle]

I'm so glad I made the switch to injections! Like everything got better, boob growth, fat redistribution, skin, etc... and this was on a conservative dose back then so I wouldn't worry too much about dosage unless you feel off and worst in general.

injections actually work much better than pills. the results start to show up quickly after first 3 months because injections go immediately into your blood stream. and in the long run, it won't do much damage to your liver and its function than pills.

can you ask her why doing it bi-weekly? if it's a very low dose then it's better to do it weekly so you don't have any withdraw effect. though it really depends from person to person. the first and the last day of injection usually feels horrible. so bi-weekly doesn't sound bad at all since you can expand the time you feel good.

mine started on a low dose, though not so low compared to others since i'm not on any medications and my health is fine. once my blood work is done, i can meet up with my doc to discuss about my hormone level and she'll up my dosage accordingly. she says it'll work for both ftm or mtf. one thing you don't want to do is asking for extra hormones. if your body has a higher level of estrogen, your body will automatically transfer them back to testosterone which is very counter productive.

Thats not true about the higher estrogen levels, if it were I'd be growing a beard by now and my T would at least be a lot higher but its practically dead at this point. My levels are usually in the thousands and I feel great. However excess testosterone can convert to estrogen.

[Laura_7]

if your body has a higher level of estrogen, your body will automatically transfer them back to testosterone which is very counter productive.

No.
There is a pathway from testosterone to estrogen via aromatase.
Its one way.
Pregnagt women have high levels of estrogen without adverse effects.
It can be safely applied only with internal applications like implants and injections.

Concerning biweekly levels raise very high the first days and there might be a low the last days.
Some people describe it as testo creeping in.
This might also affect mood. It can make for a menopausal like effect.
With weekly injections the high and low phases are much less, levels stay more steady.
With the right dosage its more likely the last days levels are still high enough so there are no adverse effects on mood.

You might talk about it with your doc.

*hugs*

[KayXo]

She told me that she would also prefer if I do this vi weekly as oppose to weekly, but she didn't really have an answer as to why. I'd like to keep the 'withdrawal' symptoms out as much as possible.

Usually, if the estradiol you inject is estradiol valerate, it's best to inject on a weekly basis to avoid negative symptoms (depressed mood, irritable, headaches, fatigue, hot flashes, etc.).

Contraception. 1980 Apr;21(4):415-24.
A comparison of the pharmacokinetic properties of three estradiol esters.

"The average duration of elevated estrogen levels was shortest in the benzoate group (4-5 days) followed by the valerate (7-8 days) and cypionate (approximately 11 days). In none of the subjects studied were elevated estradiol and/or estrone levels encountered 2 weeks after the injection of the various esters."

it won't do much damage to your liver and its function than pills.

One needs to understand that the main concern with estrogen is not liver damage as so far, no studies have noted liver damage with bio-identical estradiol, oral or not (imagine if estrogen were harmful, women, especially during pregnancy, would experience serious hepatoxicity). Also, one needs to differentiate between certain forms of estrogens not native to the body and bio-identical estradiol which is metabolized more easily and quickly by the body. High doses of non-bio-identical estrogens *may* indeed harm the liver. Finally, the main concern as I indicated earlier is not hepatoxicity but rather, risk of clots (DVT, PE), higher with non-bio-identical forms, relatively low with oral bio-identical estradiol and negligible with non-oral bio-identical estradiol, as studies and observations have suggested.

one thing you don't want to do is asking for extra hormones. if your body has a higher level of estrogen, your body will automatically transfer them back to testosterone which is very counter productive.

This is incorrect. Chemically, the only conversion that occurs is from testosterone to estradiol, androstenedione to estrone and between estradiol and estrone.

http://www.genome.jp/kegg/pathway/hsa/hsa00140.html
http://www.angelfire.com/sc3/toxchick/images/S/steroidogenesis.gif
http://tau.amegroups.com/article/viewFile/2762/3634/49844

If this were indeed the case, high estrogen doses would never be prescribed to males with prostate cancer whose cancer thrives on androgens or pregnant women would experience some masculinization due to very high levels of estradiol (up to 75,000 pg/ml). I have E levels that range from 1,000-4,000 and my T is lower now than ever before, at 8 ng/dl, while free T is undetectable.

[Laura_7]

"The average duration of elevated estrogen levels was shortest in the benzoate group (4-5 days) followed by the valerate (7-8 days) and cypionate (approximately 11 days). In none of the subjects studied were elevated estradiol and/or estrone levels encountered 2 weeks after the injection of the various esters."

Yes, with biweekly injections levels can really drop during the last few days.


*hugs*

[Orchid]

I appreciate the timely responses everyone, I'm actually heading to the doctor in an hour, so it couldn't be better. I'd reply to everyone but I don't have much time.

Concerning biweekly levels raise very high the first days and there might be a low the last days.
Some people describe it as testo creeping in.
This might also affect mood. It can make for a menopausal like effect.
With weekly injections the high and low phases are much less, levels stay more steady.
With the right dosage its more likely the last days levels are still high enough so there are no adverse effects on mood.

You might talk about it with your doc.

*hugs*

Thanks for the response!

When I was off estradiol for even one day, I had some pretty strong hot flashes. I've never had that before so I could only equate that to being off of it,

Honestly, the main reason for me is the fact that I can opt to inject every week as oppose to take pills every day. I still take spiro, but to eliminate at least some of the ache is a relief.

I'm so glad I made the switch to injections! Like everything got better, boob growth, fat redistribution, skin, etc... and this was on a conservative dose back then so I wouldn't worry too much about dosage unless you feel off and worst in general.

Thanks for responding! I've read your posts about your development, and that's a big reason why I'm switching. If I may ask, how did you find your development while taking estradiol orally?

For my own, I don't see huge differences but they have been subtly pointed out by others. My breast growth is mediocre. I don't know what the standard is. I'm an a-cup. My face has feminine characteristics prior to hrt, but I've noticed fat development around my cheeks and forehead, and in general, soft skin. Things are slow but steady on hrt, and I don't mind that, but I'm hoping that I'll actually benefit from switching to injections.

I'm about 5 months in.

[Laura_7]

I appreciate the timely responses everyone, I'm actually heading to the doctor in an hour, so it couldn't be better. I'd reply to everyone but I don't have much time.

Thanks for the response!

When I was off estradiol for even one day, I had some pretty strong hot flashes. I've never had that before so I could only equate that to being off of it,

Yes, it sounds like menopausal symptoms. Menopausal women also have hot flashes because of receding estrogen levels.

Concerning levels many endos strive for estrogen levels of 200 pg/ml or above.
(The units are important. There is another unit where it is a third).
Especially with internal application many endos consider this safe.

You might talk with your endo about it.


*hugs*

[Orchid]

Just a little update:

I started injections! It's a normal dose, and I'll be taking it weekly. It does feel odd, though... I heard the first day is a difficult one. Also, very strange not following an oral regimen. Very strange.

[Laura_7]

Just a little update:

I started injections! It's a normal dose, and I'll be taking it weekly. It does feel odd, though... I heard the first day is a difficult one. Also, very strange not following an oral regimen. Very strange.

LOL there are people who see it differently ... being high on the first day and enjoying it 

Congratulations 

Basically there are two ways ... intramuscular and subcutaneous with a short needle ... you might talk with your doc about it.

Well ... no more daily doses ...


*hugs*

[Lady_Oracle]

I appreciate the timely responses everyone, I'm actually heading to the doctor in an hour, so it couldn't be better. I'd reply to everyone but I don't have much time.

Thanks for the response!

When I was off estradiol for even one day, I had some pretty strong hot flashes. I've never had that before so I could only equate that to being off of it,

Honestly, the main reason for me is the fact that I can opt to inject every week as oppose to take pills every day. I still take spiro, but to eliminate at least some of the ache is a relief.


Thanks for responding! I've read your posts about your development, and that's a big reason why I'm switching. If I may ask, how did you find your development while taking estradiol orally?

For my own, I don't see huge differences but they have been subtly pointed out by others. My breast growth is mediocre. I don't know what the standard is. I'm an a-cup. My face has feminine characteristics prior to hrt, but I've noticed fat development around my cheeks and forehead, and in general, soft skin. Things are slow but steady on hrt, and I don't mind that, but I'm hoping that I'll actually benefit from switching to injections.

I'm about 5 months in.

aww <3 yay people do read my posts lolol

omg congrats on starting! welcome to needle land lol! Every time I do my injection I feel a slight buzz, idk if its a placebo effect or what but its calming and feels nice. It feels like what P does sometimes, that same calming effect. 

Same I had more of an andro face prehrt, I think thats why my facial changes look so drastic when comparing prehrt pics. It almost looks like I had ffs done. About breast growth, I found comparing mine to the tanner stages helped keep things in perspective. Especially like how long it takes cis women to develop, so I mean for us its obviously going to be longer since we have to suppress T first. My boob maturity rate even on pills matched the tanner timeline almost exactly. 5 months and already an A cup, I'd say that's pretty good! Like I was an AA for almost a year and a half before I reached a true A and now I'm a small b, 32b.

Orally the physical effects were pretty decent like you're describing slow and steady. My cheeks were filling in, hair all over was becoming sparse and light. I was definitely feminizing well enough but its the mood swings, lack of energy that made me switch to injections. I was on pills for about 2.5 years. I really tried giving pills a chance but it just wasn't working for me. I think the reason why oral was giving me issues is cause of my fast metabolism, like the half life with pills is short especially if you do sublingual. So I think I was just experiencing too many ups and downs with my levels. Also my E levels were a lot lower on pills of course, I was hovering around 120 pg/ml to about 150pg/ml. On injections its like 2,000+ and falls to about 300pg/ml by the end of the injection week.

Now that I've been on injections for a few years I can make some comparisons. On pills I managed to reach stage 3 of boob development (a cup) but they kind of stagnated there. My family is small busted in general so its not much of a surprise. I cared more about them maturing and fitting my chest wall proportionally than the size really. Injections helped push them into the 4th stage after my first month. Fat redistribution was going well but my upper body seemed like it was taking forever to round out but they finally did after a few months. I have naturally dry skin but it was way worst on pills, I mean its still dry on injections but its not nearly as bad. I'd say that change was practically instant like I went from having to moisturize 4x a day to like 2x.

Anyways not that I'm like close to hitting 2 years on injections, my boobs have continued to mature and are still growing, subtle changes (larger nipples, areola darkened more and expanded some recently). I think fat redistribution is mostly done with at this point. I'm sort of trying to gain another 10lbs, seeing if I can push them into a full b cup.

[KayXo]

I still take spiro

On injections, you most probably won't need Spiro as E alone will reduce your T to female levels. Less is better especially considering some of the side-effects associated with Spiro. It's something you could discuss with your doctor. 

I had more of an andro face prehrt

+1

It almost looks like I had ffs done

People often ask me if I had any FFS done.

I have naturally dry skin but it was way worst on pills, I mean its still dry on injections but its not nearly as bad. I'd say that change was practically instant

Same here. The change was SIGNIFICANT and instant which made me wonder if, really, the progesterone was necessary to keep skin from drying or if estrogen was key. I would say I no longer had dry hair or skin, at all, a first since being pre-op. My skin was SOOOOO soft! When I later increased progesterone, my skin/hair actually seemed less soft and to go back to being a bit dry which suprised me. Often, women will report less dryness when decreasing E and/or adding/increasing progesterone, this would be due to E suppressing and P increasing sebum production BUT, in my case, this didn't pan out. Perhaps, progesterone's diuretic effect (similar to Spiro, due to the anti-mineralocorticoid effect) is responsible for this and not enough sebum is produced to counter this. I really don't know.

Anyways not that I'm like close to hitting 2 years on injections, my boobs have continued to mature and are still growing, subtle changes (larger nipples, areola darkened more and expanded some recently). I think fat redistribution is mostly done with at this point. I'm sort of trying to gain another 10lbs, seeing if I can push them into a full b cup.

Like you, in general, I did much better on injections. Felt better, looked better, skin was amazingly in better condition, the difference was night and day. Face/body more feminine, younger looking, fuller face. Boobs is the only area where I actually did better on pills, strangely.

[Lady_Oracle]

On injections, you most probably won't need Spiro as E alone will reduce your T to female levels. Less is better especially considering some of the side-effects associated with Spiro. It's something you could discuss with your doctor. 

+1

People often ask me if I had any FFS done.


Same here. The change was SIGNIFICANT and instant which made me wonder if, really, the progesterone was necessary to keep skin from drying or if estrogen was key. I would say I no longer had dry hair or skin, at all, a first since being pre-op. My skin was SOOOOO soft! When I later increased progesterone, my skin/hair actually seemed less soft and to go back to being a bit dry which suprised me. Often, women will report less dryness when decreasing E and/or adding/increasing progesterone, this would be due to E suppressing and P increasing sebum production BUT, in my case, this didn't pan out. Perhaps, progesterone's diuretic effect (similar to Spiro, due to the anti-mineralocorticoid effect) is responsible for this and not enough sebum is produced to counter this. I really don't know.

Like you, in general, I did much better on injections. Felt better, looked better, skin was amazingly in better condition, the difference was night and day. Face/body more feminine, younger looking, fuller face. Boobs is the only area where I actually did better on pills, strangely.

Ha yeah its strange right about like the facial changes. When I initally started hrt I went into it with no expectations at all. I just wanted to feel better. So it was an awesome surprise, I thought I was gonna need ffs.

About the P yeah Idk like I've been on P for four years straight now and like I mostly still take it for mood stabilization. Skin wise I don't think I noticed much of a difference with or without it. I think a large part of my dry skin issue is the fact I'm on a high dose of spiro. I drink water like crazy but on the days where I just get lazy about it, my skin definitely starts to suffer. I hate spiro, I cannot wait to be off of it.  Technically I shouldn't be on such a high dose but my T shot up one time and I've been kind of paranoid since. I'm still preop too. I think i'll ask my doc to lower the sprio dosage. I should be ok since the dose I'm on for injections, should suppress things ideally. lol now I'm laughing at myself because I've feminized as best as anyone can on hrt, like so no way would all of my feminization be undone even if my T does shoot up. Its a bit of an irrational thought but when T has wrecked your life for so long, its kinda hard not to be extra cautious. 

[Orchid]

So, an interesting development...

I might have mild allergies to the medication. I found out that at least this injection given to me uses sesame oil. I don't handle sesame oil well. I have some throat swelling and difficulty breathing through my nose- I'm not badly-allergic to sesame oil, but I think it'll be best for me not to push it. I expect break outs to come.

Suffice to say, I won't be using this type of injection. I was very excited, but I'm glad I know it now. I used estradiol valerate.

[KayXo]

I think a large part of my dry skin issue is the fact I'm on a high dose of spiro. I drink water like crazy but on the days where I just get lazy about it, my skin definitely starts to suffer. I hate spiro, I cannot wait to be off of it.  Technically I shouldn't be on such a high dose but my T shot up one time and I've been kind of paranoid since. I'm still preop too. I think i'll ask my doc to lower the sprio dosage. I should be ok since the dose I'm on for injections, should suppress things ideally.

I see no reason to take Spiro (which is causing you side-effects) while on injections with the levels you have. T will be low, just as low as it would be post-op. You should discuss with doctor, most definitely. Your skin will thank you!

So, an interesting development...

I might have mild allergies to the medication. I found out that at least this injection given to me uses sesame oil. I don't handle sesame oil well. I have some throat swelling and difficulty breathing through my nose- I'm not badly-allergic to sesame oil, but I think it'll be best for me not to push it. I expect break outs to come.

Suffice to say, I won't be using this type of injection. I was very excited, but I'm glad I know it now. I used estradiol valerate.

It can be dissolved in other oils, like castor oil, peanut oil, cottonseed oil, olive oil, ethyl oleate, etc.

[Orchid]

I apologize for continuing this thread, I hope it's not a complete pain.

Is it normal for the site to burn as well? It's been well 8 hours since the injection. It has to just be the reaction to the oil. I'm going to make an appt with them as soon as possible. It's actually throbbing- I can deal with pain, that's not the issue, it's that I hope it's not a sign of something worse. I know that the needle was clean, the site was sterilized, what was in the injection, etc.

I'm sure it's nothing. I'll see how I feel tomorrow. Is this something that happens? I hope so.

[KayXo]

Rarely happens to me but if it does, lasts no more than a few mins, after the injection, as far as my experience goes.

[Laura_7]

I apologize for continuing this thread, I hope it's not a complete pain.

Is it normal for the site to burn as well? It's been well 8 hours since the injection. It has to just be the reaction to the oil. I'm going to make an appt with them as soon as possible. It's actually throbbing- I can deal with pain, that's not the issue, it's that I hope it's not a sign of something worse. I know that the needle was clean, the site was sterilized, what was in the injection, etc.

I'm sure it's nothing. I'll see how I feel tomorrow. Is this something that happens? I hope so.

Well I'd say try to relax.

Part of it might be psychological.
You might try to see internal application as something positive .. more direct delivery, more close to ovaries ...

other people also reported some pain for some days if the injection was unfortunate ...

you might talk with your doc about subcutaneous delivery which is with a small and short needle ...

and as Kay pointed out there are a few different substances used for solution ...
so lots of room for improvement.


*hugs*