Feeling very discouraged.... (HRT)

[Kadence1]

So I'm feeling very discouraged lately. I started HRT again about a mont ago (eeeek!!!) but I don't feel them working, like they did the last time. For an example, I feel like at this point last time, my chest/tummy hair stopped growing and my breasts started to grow. Like I had the buds, and they started to get puffy and the areola started to get bigger. The only thing I feel THIS time, is some mental changes, and body hair growing back slower, but not by much. My breasts look the same.... some days the muscle behind them is slightly tender, but not like last time (itchiness, extremely sensitive, etc.) My and lady junk doesn't work the same as it used too. My dose is the same exact dose as last time, and I take the estradiol the same way (sublingually.) Is this maybe what's causing it? I'm not getting enough E because I take it under my tongue? Like I let it dissolve and whatnot, and I keep my mouth shut for atleast 20 mins (it's so hard!!! Lol.) but I always end up tasting some. Which means I'm swallowing it. Am I taking it wrong? Should I just swallow it? My Endo says it doesn't matter, but I always read taking it sublingually gives you a better concentration and gives better feminization.  I just don't know what to do :/ sorry for the long post.


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[JeanetteLW]

  Sorry Kadence,
   I'm taking my lower dose of estradiol sublingually also and it seems to be doing okay. I'm not as tender most of the time as I was, but I am still seeing things slowly developing both more fatty  and breast tissue. So I don't think that is it.
  Hugs,
    Jeanette

[Dena]

I stuff the pill between my upper jaw and my cheek. The pill might stay up there as long as an hour and I taste very little of it. On the other hand, give it another month. When I returned to HRT it took nearly a month just for things to start up again.

[AshleyP]

My and lady junk doesn't work the same as it used too.

I'm not exactly sure what you mean by that, but if you mean that you don't get morning erections, or find it harder to maintain an erection, that's all I've noticed after 3+ months.

My dose is the same exact dose as last time, and I take the estradiol the same way (sublingually.) Is this maybe what's causing it?

I'm taking mine mostly sublingually, too. Maybe there's a correlation.

All the best,
--AshleyP

[Dani]

AshleyP,

Just continue with what you are doing now.

I too, take my estradiol sublingualy. At first, I felt a very tranquil sensation flowing over my entire body immediately after taking a tablet. Now after 2 years of HRT, I just feel normal.

Just because you are tasting some of the estradiol does not mean that you are taking it wrong. I always taste a little estradiol and after 2 years of HRT, my blood levels are just fine.

[KayXo]

Sublingually or orally, my results both physically and psychologically were the same. So, I took pills orally as it was more convenient.

[jentay1367]

Maybe you got an old batch of E or S? Had that happen to me once. You can definitely tell if it happens. Add to that if your just starting again, you have no frame of reference regarding efficacy. Just thought I'd mention it as a possibility.

[KayXo]

Maybe you got an old batch of E or S?

I've used E and even anti-androgens or progesterone from old batches way past the expiry date and they were still effective. They were well kept though. I don't know about Spiro, I never took it.

[Maybebaby56]

Hi Ashley,

There is a great deal of difference in serum estradiol (E2) levels depending on the route of administration. 

"Sublingual administation resulted in rapid absorption with significantly higher E2 levels than did comparable oral dosing".

Single-Dose Pharmacokinetics of Sublingual Versus Oral Administration of Micronized 17-Beta-Estradiol
Obstetrics and Gynecology, Vol. 89, No. 3, pp. 340-345 (1997)

When you swallow estradiol, it gets rapidly metabolized by the liver into estrone (E1) and is in the blood as the sulfate. E1 is a lot less potent than E2 as an estrogen, but E1 sulfate can get converted into E2 by blood enzymes, and is kind of an estrogen "reserve". So, no, you're not "doing it wrong" if you swallow or taste the pill, but it is better for your endothelial tissues (blood vessels) if you try not to swallow it.

You should have patience. Girls don't go through puberty in a month. It takes years.

With kindness,

Terri
 

[Ms Grace]

Just give it time hon, a month is a microdot of time. Each month is different anyway.

[KayXo]

There is a great deal of difference in serum estradiol (E2) levels depending on the route of administration. 

"Sublingual administation resulted in rapid absorption with significantly higher E2 levels than did comparable oral dosing".

Yes, for sure. Over the course of 24 hours, E2 levels end up being higher but, in my case, I found no difference whether taking pills orally or sublingually so, as far as I'm concerned, it comes down to more than just levels. There are several other things going on which may affect the body and psyche. Several girls though, have indeed noticed better results sublingually. Everyone reacts differently.

When you swallow estradiol, it gets rapidly metabolized by the liver into estrone (E1) and is in the blood as the sulfate.

Estradiol also gets metabolized by the intestines into estrone with high levels of estrone and estrone sulfate (E1S) ending up into the blood.

E1 sulfate can get converted into E2 by blood enzymes, and is kind of an estrogen "reserve".

Just to elaborate on this. Estrone sulfate first gets converted to estrone and estrone can then be metabolized into estradiol although this conversion is quite insignificant as compared to the rate of conversion from estrone to estradiol.

[DawnOday]

This does not happen overnight and is different for everybody. Be patient. You're young, pretty and seem to be intelligent. Twiggy was named Twiggy for a reason... Google her. But back in the 70's you could not question her being feminine. You know all those short skirts we like to wear. Twiggy was the first model famous for wearing them. Actually you look quite a bit like her.