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Estradiol Valerate IM. - high metabolism or just strange reaction.

Started by EndlessEden, March 25, 2017, 07:01:04 PM

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EndlessEden

Hi, sorry im not active nearly enough...

Well, for the past six months, ive been on EV in pill form, my results were promising, but, i wanted to go on what i personally seen as superior. IM Injections.

This past week i convinced my Endo, to start treatment with IM Injections instead. (By convince i asked and provided a good reason)

All was well and good. On wednesday (3/22) i had my first injection, and will be continuing them at home, after the nurses give me a training course, on 4/04(next injection date)

Well, thats where the good news begins to end. - The nurse gave me the Injection on my right hip, closer to my buttox, on the waistline.(which i personally found strange since all the girls told me to do it in the gluteus on other forums)

after injecting it, she told me to continue to rub it for several minutes and then go sit in the waiting room.
Which i did shortly and went at waited. After 30 minutes, i went to the window, and was told i was free to leave.
So i did, fast forward to yesterday.

Friday morning (2/24) i noticed my skin was becoming oily and emotionally i was getting frustrated and angry very easily. Dysphoria was starting to come back something fierce. i tried to distract myself, but found it very difficult...

Saturday(3/25 - today) I woke up feeling extremely dysphoric, i was getting extremely angry, and suicidal again, for the first time in 6 months... i also noticed my cheeks had lost alot of the shape i was so proud of, that gave me such feminine looks... Instead faced with a oily, flat face, of my own unspeakable horror. so upset, unsure of what to do. i took a tab i had from my emergency stash.
Which within the hour, made a 90% difference, emotionally.

Trying to figure out what could possibly had gone wrong, i asked my friends. to which the only thing they could guess is increases metabolism of EV-IM. now none of them are on IM, and all the one's that do receive IM are not available.

Confused, left with no other options, i decided to rubb the injection site, while i pondered what could of possibly gone wrong... did i do something wrong... why am i feeling this way...

Then a hot flash hit like a hot tornado. i realised the area of the injection, the longer i rubbed it, the more my body felt tingly and hot...

Confused, i just continued to rub for 10 minutes or so.

---

Is any of this normal?

Has anyone else experienced this?

Did i do something wrong!?

(NOTE: id call my Clinic's office, but they are closed on weekends)
  •  

Rachel

There are different places you can inject. I inject with a 1.5 inch needle the outer thigh muscle.

You can google IM injection locations to see if where she injected was correct.

I would call your health care provider Monday and inquire.
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  •  

Dena

I can think of several possibilities. There may be an issue with the blocker you are using, the injection may be a starter dosage and you will work up to the final dosage, your body may not handle injected EV as well as tablets and there is the possibility that the bottle didn't contain estrogen. At the point, all you can do is get through the week end and have a discussion with the doctor to see were things might have going wrong.
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  •  

EndlessEden

Quote from: Rachel Lynn on March 25, 2017, 07:23:03 PM
There are different places you can inject.

Sadly, i thought the possibility of where, but it looks correct. im very confused.

Quote from: Dena on March 25, 2017, 07:42:56 PM
I can think of several possibilities. There may be an issue with the blocker you are using, the injection may be a starter dosage and you will work up to the final dosage, your body may not handle injected EV as well as tablets and there is the possibility that the bottle didn't contain estrogen. At the point, all you can do is get through the week end and have a discussion with the doctor to see were things might have going wrong.

I plan either way, monday contacting them, ceasing any additional sources of E tomorrow morning(as much as i may suffer to do so. im full-time pre-op, so it makes it a real struggle...)

Just for reference (Aldactone and Finasteride). no Progesterone.
I can verify the bottle Contained Estrogen, to the best of my knowledge. or my pharmacy has some explaining to do. Perrigo, Lot#612600.
  •  

KayXo

When I started injections and switched from pills, it was weird not taking any pills and I often wondered if the IM EV was doing anything so like you, I took pills from time to time to reassure myself. It was just strange not having to take anything and I worried. Changes to the face also don't happen so fast. So, all this may be in your head due to the change that happened and the doubts you may have re: IM EV. Taking pills daily may have given you a sense of security while not taking any E for 2 weeks worries you.

OR...it could be the levels drop very quickly but this is VERY unlikely as you experienced symptoms on day 2. In my case, levels dropped from 2,500 pg/ml to 1,300 pg/ml in just 2 days from day 3 to day 5.

OR...the IM EV may be stimulating less the production of SHBG (which binds testosterone) relative to oral EV so that more testosterone is now available and is responsible for the oily skin.

My guess is it's psychosomatic, I could be wrong...
Discuss this with your doctor.
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
  •  

EndlessEden

::UPDATE::

I really should of replied sooner. - a few weeks passed with this, i notice that gluteal injections give a slower release. so i dont end up as dysphoric. but im still typically somewhat dysphoric on day 7.

now, my dosage was change to every 7 days. across 2 panels(taken on day 3 and 4, seperate weeks), i was 550 pg/ml on my recent tests. which was too high for my doctor (which is frustrating, as i feel my best around 600pg/ml...).

Waiting for most recent batch of Estradiol, panel. which my doctor is hesitant but does regardless for me.

----

Physically most of the changes have returned, although i have noticed a distinct fluctuation of breast size.

I am also now on Progesterone(nightly)
  •  

KayXo

Quote from: EndlessEden on June 20, 2017, 12:59:38 AMi was 550 pg/ml on my recent tests. which was too high for my doctor (which is frustrating, as i feel my best around 600pg/ml...).

Women of a certain age (up to 58) and men, up to 91 yrs old, with advanced prostate cancer, exposed to an even greater risk of complications were found to have no side-effects (cardiovascular or thromboembolic) despite high levels, comparable to yours (100-1,000 pg/ml, average around 500) while either being on implants or patches/injections. Some women even had higher levels, up to 3,000 pg/ml.

Also, in women aged 40-92 yrs old, with advanced breast cancer, despite high levels (around 2,500 pg/ml) on oral bio-identical estradiol (non-oral is safer), only 1 case of thromboembolism in 54 women after 6 to 22 months of treatment. How about that?

Sadly, most doctors are unaware of these studies and so, based on guidelines, believe these levels to pose serious health risks when the literature on men, transwomen and ciswomen doesn't support this.

Consider, too, that during pregnancy, levels skyrocket, to up to 75,000 pg/ml but the risk of DVT is low at 0.1%, and of PE is 0.01%.

I, myself, am on injectables, with levels around 1,000-4,000 pg/ml. I've been injecting three years, been getting blood tests regularly with everything coming back normal or as expected. The doctors supervising my treatment have no problems with these levels.
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
  •  

Wednesday

Very interesting thread. I'd like to ask you to keep us updated!

As @KayXo pointed out, it may be a psychosomatic issue. It is important to trust to some extent (obviosly not with blind faith!) your doctor and your medication.

Quote from: EndlessEdeni was 550 pg/ml on my recent tests. which was too high for my doctor (which is frustrating, as i feel my best around 600pg/ml...).

If I were you I'd do a "blind test" with myself by writing down in a diary my symptoms/mood/useful info *without* asking for my levels in the tests performed, and then after some weeks would ask for them to stablish a more proper correlation.

Keep in mind many doctors highly regard the "primum non nocere" principle so they might be often too conservative and cautious on their approaches. This is not necessarily bad if you encourage (and demand) your doctor to first focus on solving your actual mood/physical issues before worrying about long term risks.

As wisely @Dena pointed out, it may be a problem related to your T-blocker, or more broadly, to your T levels and T sensitivity. Estrogen is well known for its anti-androgenic effects when delivered at relatively high doses, which at a first glance may look like it is your case.

IMHO would be nice to focus mainly on physical and well-measurable androgenizing effects (like skin oil production) and not so much on "dysphoria feelings" or other mood disorders when it comes to evaluate your HRT dosages and hormone levels. What you may describe as dysphoria could be an imbalance on brain neurochemicals due to the very nature of "the standard woman hormonal balance" or due to any other reason not caused by an excess of T or a lack of E. Keep in mind that women constitute the majority of antidepressant users, so if I were you I would go first for the most obvious androgenizing symptoms, and when solved, look carefully at other issues like "mood swings" and see if something can be done aside from changing again your HRT regime.

Just my 2 cents. Hope you'll get better!
"Witches were a bit like cats" - Terry Pratchett
  •  

EndlessEden

I had a additional test done last tuesday, (day 2, monday is injection day)

levels were 1549.7 pg/ml.

----

@Wednesday
My Clinic Physician does NOT test my levels, they take a Risk/Reward approach. if they 'Feel' a higher dosage would be beneficial, but it does not exceed the dosage maximum in there Guidelines. Then they prescribe it. It is not based upon levels, physical/emotional/psychological effects. its purely based upon the Emotions of the Clinician and the Patients level of Distress...

My T levels range a average of 4 ng/dl to 12 ng/dl. (pre-hrt level 77 ng/dl)

I could go on and on, about the negative effects i feel at lower levels. i keep a diary and have my PCP test my levels 2x a month. Its not just me that notices them. My partner, and Relatives/siblings notice it as well. its quite measurable to my experiences while my levels exist in certain ranges and REPEATABLE. as my doctor has several times lowered my dosage to try and keep me under 400 pg/ml i have watched features come and go a few times. its quite nerve wracking to have hips for a months, and then for 2 weeks, while levels are lower, watch them disappear.


600-1600 pg/ml - no Emotional negativity, or feelings of Inadequacy. Often i feel Prideful, and quite happy overall in my transition. Often feeling much more energetic. Emotions seem to swing more often, but i feel things much deeper. Emotions are more impactful. - Skin and Hair are extremely soft. Skin shows much more Radiance, but seems thinner. Hair growth rate(head) exceeds 1.6"/per month. Facial/body hair growth slows by 60-90%(Shaving/plucking is not necessary, peaking at the maximum of a week), Body hair becomes much more softer and transparent. Facial hair thins and becomes far less noticeable. Breast growth often exceeds on a nightly to weekly basis, and lactation occurs occasionally. Genital function is at is lowest(desired), and underarm hair reduces. Pubic mound hair slowly shapes into a inverse triangle, growing quite slowly. Hips noticeably widening, and often sore. belly-fat seems to be slowly reducing/relocating.

430-600 pg/ml - Feeling more stable, a little social anxiety still exists, but, it is manageable most days. emotions seem more wide-ranging. Feelings of 'Correct-ness' and 'Balance' seem to often be the case. Happy with Self-image. | hair-growth on head, increases from 1"/per 3-months, to 1"/per month. Facial/body hair reduces in growth rate and often thickness(this happens more abruptly and strongly at higher levels). Skin Softens and is more sensitive to touch. Facial features, soften and more roundness appears in the face. Facial hair growth only needs removal once a day, sometimes less(.20). Facial hair is much softer and finer. Hips appear to have much more round, firm size and texture. Often accompanied with gluteal growth.

350-430 pg/ml - Feelings of inadequacy around other women(feel less than them, intimidated), Anxiety returns. often feelings of genitalia being 'Wrong' return. Skin starts to display oily traits, hair-growth slows on head. Facial hair/body hair growth increases by 40%, some area's growing 0.4"/week. Facial hair needs removings minimum of 2-times daily (.25"), but it grows in patchy and slightly thinner.

100-350pg/ml -  near constant state of depression, with social anxiety preventing human interaction. Feelings of anger and rage permeate my personality. Combined with severe, Genital anxiety. Often resulting in Self harm and genital mutilation. other emotions are weak and often not impactful. Skin very oily, with large amounts of sweat being produced often. Body hair grows at around .8"/per week. Maximum length reaching 1.7" in some areas. Chest/abdomen hair rate increases to 0.6"/per day, breasts loose much of there volume and facial features become more flat and closer to male face. Facial hair needs removing every 2 hours (.37-.45"), often very thick and growing in evenly. hips/butt maintain a very narrow, firm shape. having no/little feminine curve.

my estradiol has never been below 90pg/ml. before Transition/hrt(oestradiol).

@KayXo
if you can provide the sources of this information, i can try to get it to the right people... or you can try to get it to PP(Planned Parenthood) who provide my IC Clinic. and convince them, you would help alot more than just me...

I believe your 100% correct, because the higher the levels, the happier and more stable(emotionally) i feel. less anxiety, dysphoria, feelings of gender expression depression. i dont have all those worries and i feel like my 'Transition' is balanced...

---

@both:

im using Sprio/Fin. as i cant discuss dosages, i will say its a average dosage. i can sometimes skip them without feeling any ill effects.
  •  

KayXo

Quote from: EndlessEden on June 21, 2017, 01:37:14 AM
@KayXo
if you can provide the sources of this information, i can try to get it to the right people... or you can try to get it to PP(Planned Parenthood) who provide my IC Clinic. and convince them, you would help alot more than just me...

PM sent. :)
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
  •