Estrogen and clotting

[louise000]

The question's probably been asked before and there is probably an obvious answer, but I can't get my head round why I am told that estrogen taken by mtf transsexuals carries a high risk of causing blood clots to develop, whereas natal females are full of the stuff and are only at average risk of clotting.

Someone out there who's not as stupid as me will be able to explain it to me I hope. No long words, mind! :=)

[Kate]

The question's probably been asked before and there is probably an obvious answer, but I can't get my head round why I am told that estrogen taken by mtf transsexuals carries a high risk of causing blood clots to develop, whereas natal females are full of the stuff and are only at average risk of clotting.

Natal females don't process their estrogen through the liver, which is what happens when you swallow a pill. The liver sometimes freaks out when it sees hormones coming through it, setting off a cascade of effects which increases clotting potential in some people. I once read somewhere that your body suddenly thinks it's bleeding internally or something, so it tried to clot the leak. No idea if that's true...

~Kate~

[louise000]

Natal females don't process their estrogen through the liver, which is what happens when you swallow a pill. The liver sometimes freaks out when it sees hormones coming through it, setting off a cascade of effects which increases clotting potential in some people. I once read somewhere that your body suddenly thinks it's bleeding internally or something, so it tried to clot the leak. No idea if that's true...

~Kate~

OK, so what if the estrogen is being taken transdermally, by patch or gel application, instead of via the digesative tract? Does that have to go through the liver too?

Er, I meant "digestive tract"

[Cire]

OK, so what if the estrogen is being taken transdermally, by patch or gel application, instead of via the digesative tract? Does that have to go through the liver too?

Er, I meant "digestive tract"

It's much safer to take as a gel or transdermal for that exact reason. Or to put it under your tounge and let it dissolve.

I'm going to go with the last because patches are expensive (if I have the option by my endo)

[Keira]

The risks itself is way way way overblown.
Even if you take it in pill form... Unless
1) You've got a genetic predisposition to produce clotting agents
(very few people have ) In this case, no matter what type of estrogen
the risk remains, but still bio-identical would be better.
2)You take non bio-identical estrogens like
ethinilestradiol which ups the clotting risks (1000 times)
or conjugated estrogens like premarin.



Estradiol Valerate and Estradiol have just about no clotting risk
when used transdermally and by injection, or using gels.

In pill form, if you take it sublingually, the risk is just slightly higher, but still very very low.

In pill form, swalloed, if dosage are not high, the risk remains low.

[Lori]

The risks itself is way way way overblown.
Even if you take it in pill form... Unless
1) You've got a genetic predisposition to produce clotting agents
(very few people have ) In this case, no matter what type of estrogen
the risk remains, but still bio-identical would be better.
2)You take non bio-identical estrogens like
ethinilestradiol which ups the clotting risks (1000 times)
or conjugated estrogens like premarin.



Estradiol Valerate and Estradiol have just about no clotting risk
when used transdermally and by injection, or using gels.

In pill form, if you take it sublingually, the risk is just slightly higher, but still very very low.

In pill form, swalloed, if dosage are not high, the risk remains low.

Yup. Premarin is probably the worst. Well said Keira.

[taru]

The risks go like:

EE and premarin > a large gap > oral 17b-estradiol > sublingual 17b-estradiol > injectable/transdermal/gel estradiol.

[louise000]

The risks itself is way way way overblown.
Even if you take it in pill form... Unless
1) You've got a genetic predisposition to produce clotting agents
(very few people have ) In this case, no matter what type of estrogen
the risk remains, but still bio-identical would be better.
2)You take non bio-identical estrogens like
ethinilestradiol which ups the clotting risks (1000 times)
or conjugated estrogens like premarin.



Estradiol Valerate and Estradiol have just about no clotting risk
when used transdermally and by injection, or using gels.

In pill form, if you take it sublingually, the risk is just slightly higher, but still very very low.

In pill form, swalloed, if dosage are not high, the risk remains low.

The risks go like:

EE and premarin > a large gap > oral 17b-estradiol > sublingual 17b-estradiol > injectable/transdermal/gel estradiol.

Thanks you two. I'm pleased because you've confirmed what I needed to know. 

[Wing Walker]

The risks itself is way way way overblown.
Even if you take it in pill form... Unless
1) You've got a genetic predisposition to produce clotting agents
(very few people have ) In this case, no matter what type of estrogen
the risk remains, but still bio-identical would be better.
2)You take non bio-identical estrogens like
ethinilestradiol which ups the clotting risks (1000 times)
or conjugated estrogens like premarin.



Estradiol Valerate and Estradiol have just about no clotting risk
when used transdermally and by injection, or using gels.

In pill form, if you take it sublingually, the risk is just slightly higher, but still very very low.

In pill form, swalloed, if dosage are not high, the risk remains low.

The risks go like:

EE and premarin > a large gap > oral 17b-estradiol > sublingual 17b-estradiol > injectable/transdermal/gel estradiol.

Thanks you two. I'm pleased because you've confirmed what I needed to know. 

I was taught how to give myself injections by a registered nurse and I use estradiol valerate, one injection every two weeks.  As I don't want to run afoul of the protocols here about discussing medications you can send me a pm if you want to know more.

Premarin is scary to me, as is its generic equal, conjugated estrogens.  I'm not a petite woman but equine I'm not. 

Wing Walker
My Liver's Fine - Is that any way to end a posting?