Hormones Best of 3 choices

[jgravitt01]

Just curious Ladies MtF Hormone choices..which is better?
Pills, Patch or injections?
I have to make this decision on Wednesday. ...

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[Dena]

Define what you mean by better.

Patches can have sticking issues and you may need to wear more than one. Some have skin reactions to them.

Needles are sharp and you need proper preparation when injecting yourself.

Pills need to be taken daily and sometimes more than once a day. Holding them in your mouth can be time consuming.

Injections may provide better delivery but I am getting results on pills. Others feel patches are best. It boils down to what you are comfortable with.

[MissGendered]

Hey, Girl!

Congrats on starting E!!! Big yay!!!

Umm, well, you'll get various answers to your question, I am sure, but here is what I found...

First, I've never used patches, my prescribers didn't think highly of them for various reasons, but others may like them for whatever reason. I didn't like the idea of them nor the idea of messing with hiding them or bathing with them, etc..

When I started E, I took pills, and that was great, since it gave me full control of dosages...

Sublingual use came later as I wised up, lol, and it still serves me now..

I prefer injections, the influence of E is a constant, and you only need deal with them every 5-14 days, depending on dosages and dosing strategy.

I have also used a combination of pills and injections, but I cycle, so that made it easier to adjust my injection levels with more E on days I require more..

My insurance won't cover injections, so I am on oral now, but I am gonna make a fuss for injectables again at my next doctor appointment.

I personally feel like injectables are more effective in development, but I have no data that proves it. Still, I like to add a pill when I feel low on E, if I can..

My advice? Start with pills, with the caveat that you can switch to injections after a few weeks or months, once you feel like you are ready for a turbo boost, lol..

Hope that helps, but realize these are just my opinions and personal experiences.

Missy

[Devlyn]

My doctor put me on patches, the first one has been on me for a few hours now!    I have a needle phobia, so injections were off the table. I'm 55, and the doctor wanted to avoid stress on my internals, so oral estrogen was out, too. "Best" is going to vary from patient to patient.

Hugs, Devlyn

[jgravitt01]

Dena, Missy & Devlyn My doctor stated that I would be starting on both Estrogen & Spironolactone at the same time so I assume that's normal. Dont mind injections since I do that for occasional migraines anyway. I initially chose the patch but im second guessing it for shower/bath purposes and I have to wear it for 3 1/2 days.

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[Devlyn]

Same mix of drugs for me, with a retest of blood in three months. The patches say they aren't affected by showering. I'm  doing 3 1/2 days between changes. I'll update if there are any adhesion or irritation issues.

Hugs, Devlyn

[Sophia Sage]

I've taken all three... and with injections, I've used both Estradiol Valerate (EV) and Estradiol Cypionate (EC).

First, I got very poor results with the patch, with multiple patches even.  For some reason the transdermal delivery was ineffective in transfering estrogens into my bloodstream, as attested by the very low serum levels I'd get from my blood work.

On the other hand, I've found both pills and injectibles to be effective, and have had good results with both, both in terms of serum levels and in actual effects both physiological and psychological.  I eventually opted for injectibles for my regular regimen, as I'm not so good at remembering to take daily pills.  (Although I've been quite good lately since adding progesterone back to my regimen, maybe that's just the wisdom of aging!) 

I've also found a difference between EV and EC, a difference that actually makes sense.  EV is processed faster by the body than EC -- which means it produces a higher peak, in fewer days (about 2, for me), but then the low point of the cycle comes faster too, around a week.  EC is processed slower, produces a discernible peak but a lower one, about 4 days out after injecting, and then tapers off more gradually before processing out, usually in about 10-11 days. 

So I actually prefer EC, overall, because I can take a lower dosage, have a steadier ride, and only need to inject 3 times a month instead of 4+. 

[jgravitt01]

Same mix of drugs for me, with a retest of blood in three months. The patches say they aren't affected by showering. I'm  doing 3 1/2 days between changes. I'll update if there are any adhesion or irritation issues.

Hugs, Devlyn

Thanks Devlyn, much appreciated!-Jaime

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[Sophia Sage]

Also, I don't like the sticky residue that's left behind by the patch.

And... the nice thing about injections is that if you're pretty sure you're committed to transition, it's a nice ritual... because I'll tell ya, things aren't quite the same when you've made the big decision, and that estrogen will run its course and you just know that you're committed and going full speed ahead, no stopping you now...

YMMV...

[jgravitt01]

I've taken all three... and with injections, I've used both Estradiol Valerate (EV) and Estradiol Cypionate (EC).

First, I got very poor results with the patch, with multiple patches even.  For some reason the transdermal delivery was ineffective in transfering estrogens into my bloodstream, as attested by the very low serum levels I'd get from my blood work.

On the other hand, I've found both pills and injectibles to be effective, and have had good results with both, both in terms of serum levels and in actual effects both physiological and psychological.  I eventually opted for injectibles for my regular regimen, as I'm not so good at remembering to take daily pills.  (Although I've been quite good lately since adding progesterone back to my regimen, maybe that's just the wisdom of aging!) 

I've also found a difference between EV and EC, a difference that actually makes sense.  EV is processed faster by the body than EC -- which means it produces a higher peak, in fewer days (about 2, for me), but then the low point of the cycle comes faster too, around a week.  EC is processed slower, produces a discernible peak but a lower one, about 4 days out after injecting, and then tapers off more gradually before processing out, usually in about 10-11 days. 

So I actually prefer EC, overall, because I can take a lower dosage, have a steadier ride, and only need to inject 3 times a month instead of 4+.

Thanks for the information Sophia, I really do appreciate it.

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[MissGendered]

Dena, Missy & Devlyn My doctor stated that I would be starting on both Estrogen & Spironolactone at the same time so I assume that's normal. Dont mind injections since I do that for occasional migraines anyway. I initially chose the patch but im second guessing it for shower/bath purposes and I have to wear it for 3 1/2 days.

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My prescribers echoed concerns that reflect Sophia's experience, both saying it wasn't as predictable of a delivery method as oral or shots. I know of at least one girl that was on them for a long time, over 6 months and was never able to get her serum levels even close to where she needed them to be. Her transition was stalled by this problem, and she felt she had lost 6 months of her life. Because the blood tests are expensive, they are usually spaced out months between, so yeah, I opted for a method that gave me confidence in getting the goods into my body as fast and securely as possible.

But, as you know, your experience may be different...

Missy

[MissGendered]

And... the nice thing about injections is that if you're pretty sure you're committed to transition, it's a nice ritual... because I'll tell ya, things aren't quite the same when you've made the big decision, and that estrogen will run its course and you just know that you're committed and going full speed ahead, no stopping you now...

YMMV...

I agree completely, there is something VERY comforting about injecting the goods. I looked forward to every one, once I got over my fear of needles. It had a profound effect on my resolve, just as Sophia mentioned. Like I said, I am gonna make a stink to get an override on my insurance so I can start injecting again, I like it, every part of it..

Oh, I just remembered, when I started on HRT, the plan was to just take the edge off my dysphoria, but my body took off, lol. Still, I was on low dosages of both E and Spiro for the first 10 months, though I developed very well anyway. He also put me on progesterone at 5 months, since my boobage was coming in sorta tubular, which rounded them out nicely. I was trying to save my relationship, so I kept stalling on committing to more HRT, even when my doctor was telling me that my body was clearly female, and that I should seriously consider committing to a 'full transition'. When I finally realized I was only kidding myself, and said 'okay', he immediately put me on injections. I was amazed at how much more relief and joy and development came afterward. Suddenly, I was in the zone, and within a few months, I was being gendered female in boy clothes, even with a compression shirt holding down my boobs. I went full time 4 or 5 months later...

My point? My first endo saw injections as being the best way to get the most desirable results for a full transition. Once it became clear that I cycled, he added oral back into my regime to help me keep on top of my daily needs on 'peak' days.

Hope this helps..

Pretty excited for you, such a vicarious joy, lol..

Missy

[Devlyn]

It wouldn't have mattered in my case because of the needle phobia, but my doctor said she wasn't prescribing injectable due to the ongoing shortage.

[Denise]

My Dr only prescribes injections and I think only EV.  I Love it.  I shoot up every 7 days.  Spiro is a daily pill.  I've had, what I consider good results and I FEEL GREAT.  I don't notice the wave (some might describe it as PMS) on Saturday, but I do feel good on Tuesdays.

Good luck.

I'm thinking I may ask for the pellets under the skin that need replacing every 6 months or so.

[JeanetteLW]

   I have tried both pills and patches. I was using the 7 day patches and made sure to clean the nea skin area with alcohol before applying one. Despite this they always loosen some in the shower. They did not come all the way off but that is a possibility. Once the skin dried under the patch it reahered w/o problem.
   My VA doctor order pills after I told him I feel I am transgendered as that is what the VA supplies. I take them sublingually with no problems. I feel they are more convenient than patches and dosage is easier to adjust when necessary.
   Injection was not an option given but not that I have gotten used to giving myself insulin shots twice a day I don't see it as a problem. There was a time I swore I could never become a drug addict because I could never give myself a shot. I guess I could now, fortunately recreational drugs are no longer part of my story. I gave them up many years ago along with smoking and alcohol. In fact today marks 18 years since alcohol has passed my lips.

   So for ease of administration I vote for pills.

  Jeanette

[MissGendered]

   In fact today marks 18 years since alcohol has passed my lips.
  Jeanette

Jeanette,

HUGE congratulations for you on such a momentous anniversary!!!

I won't say how long it has been for me, lol, cuz lotsa girls can do math, and I am waaay too vain to let that kinda info loose, lol..

But, yeah, very, very sweet! Good for you, baby!

Missy

[JeanetteLW]

  Thank you Missy.  yeah I'm getting old but still trying to be a better me.

[Michelle_P]

I know of at least one girl that was on them for a long time, over 6 months and was never able to get her serum levels even close to where she needed them to be. Her transition was stalled by this problem, and she felt she had lost 6 months of her life.

[emoji112]

Yah.  At the 6 month point my estradiol level was an awesome:

<= 50 pg/mL

That is, somewhere in the normal male range.  I'm supposed to be a MtF, Doc! 

I offered to switch to injections, but Doc was having none of it.  DVT risk!  Huh?  Not in the literature I can find...

I'm sitting here swapping patches every 3 1/2 days, wearing four of the $10 wonders right now. Goddess, they itch!  I had the usual breast soreness for a couple weeks after the last adjustment, but nothing lately.  8 months in and the facial appearance changes are due entirely to my improved skills at contouring and highlighting, plus a little skin improvement in the areas cleared in electrolysis.

I do a blood draw on Sunday, an 8 month check, pulled in from 9 at my insistence.  I'll likely be looking for a new endocrinologist in the Kaiser system shortly thereafter.



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[KathyLauren]

I have been on patches for two weeks and have had no issues with adhesion.  Well, I had one that didn't stick right to the edge, but it didn't work loose in the shower.

[Nina_Ottawa]

Four years on pills, I switched to needles. It was ok for the first couple months, then I just got icked out injecting myself. Went back to pills after six months. Never tried patches, was never recommended to me as an alternative by my endo.