Low dose HRT, major changes

[Transfused]

I am not trying to be a spammer on the boards, so to the mods : I apologize if I post too much. It's just that I like sharing my thoughts with a place of people who know what I go through.

I have been on a low-dose of Estradiol for quite some time now and love it.
The effects are very surprising for such a low dose. It's an Estradiol patch, to be replaced every three days. It's on the normal end of what is prescribed to menopausal women. Not listing dosages as I don't want to break the rules.

Has anyone else had major changes on a low dose?
My body started changing very fast for such a low dose. I'm not even on blockers.

My testosterone, Total, is 17 ng/dl. My free testosterone is 0,100 ng/dl. My Estradiol is at 114 pg/ml.

Breast growth, hip widening, bigger buttocks, thighs filling out, my facial features that softened a lot, my body odor that changed. I am quite happy with the effects and didn't expect to do so good on a low dose.

Has anyone else gone on a low dose and also seen major changes?

How do you take your Estradiol? Pills, patches, gel? Are you on a blocker?

[Jessica]

There isn't a limit on questions we have, so there is no limit in asking them.  All comments help.

All folks body chemistry is different, that's why YMMV (your mileage may vary) plays such a large part in how an individual will react to medication.  I too seem to be easily manipulated by estradiol, though you are more so it seems.
Yes your correct we should NOT  talk dosages at all, even patches per week could give the idea that it would work for someone without seeing a doctor.  That can be dangerous

Smiles, Jessica

[NCmuse]

I have been on a low dosage for 4 months. I feel great mentally and I have had much better than expected breast growth. I went to my Dr earlier this week and she wanted me to up my dosage, but I am feeling really good at my current dosage. I guess I am a little afraid of changes taking place too fast. I asked to continue with the same dosage and the Dr said stay were I feel comfortable but that I could just take more pills if I wanted to up my dosage but I got the same perscription I have had.
I am on estrodiol and Spiro. Estro is taken under the tongue . 

[Transfused]

I have been on a low dosage for 4 months. I feel great mentally and I have had much better than expected breast growth. I went to my Dr earlier this week and she wanted me to up my dosage, but I am feeling really good at my current dosage. I guess I am a little afraid of changes taking place too fast. I asked to continue with the same dosage and the Dr said stay were I feel comfortable but that I could just take more pills if I wanted to up my dosage but I got the same perscription I have had.
I am on estrodiol and Spiro. Estro is taken under the tongue .

Sublingual is 5 X stronger than oral.
You are actually on a high dose if you take it sublingually. If you want a slow transition, you might want to ask your doctor if you can take it orally or even better : ask your doctor for pellets or patches. Those put a lot less strain on the liver.
On pills I experienced symptoms of anxiety. On patches I feel very relaxed and happy. They give off a steadier dosage. I also had migraine on pills. No side effects on patches. Patches are also very effective for me from what they saw in my blood examination. I absorb all the estrogen when I stick them on my butt cheeks.

[Meghan]

I'm begin my third months on HRT and I will see my Endocrine in middle of March. Let see what he thinks after three months. So far I am feel okay.

Sent from my XT1650 using Tapatalk

[Dani]

Low dose or high dose does not make that much difference. The single most important thing to watch is the blood levels. Higher blood levels do not mean you will see results sooner. You just need to have your blood levels in the normal female range to make things happen and keep your blood levels at that female range for several years. Even with proper blood levels, everybody gets different results, so we always qualify our comments with YMMV.

[KayXo]

Sublingual is 5 X stronger than oral.

Studies have shown levels to be up to 10 fold higher vs. oral.

Those put a lot less strain on the liver.

Estradiol taken orally has never, in studies, as far as I know, shown to cause adverse effects on the liver. The issue seems to be more whether it significantly affects coagulation and findings seem to suggest the effect is much less pronounced compared to other oral estrogens which aren't bio-identical. This is reassuring.

On pills I experienced symptoms of anxiety. (...) I also had migraine on pills.

+ 1

Low dose or high dose does not make that much difference.

To me, it did. I know for some other women, it also did. It depends.

The single most important thing to watch is the blood levels.

Blood levels fluctuate, the numbers could be vastly different from one moment in time to another.

The right blood level for all transwomen, for optimal feminization is not known, according to a recent study. Individuals vary, respond differently to the same level due to genetics, their sensitivity and even their hormonal environment (progestogens/anti-androgens such as cyproterone acetate/medroxyprogesterone acetate downregulate estrogen receptors, first years of puberty, girls don't produce any progesterone and subsequently, only cyclically). Just think alcohol: do individuals all respond similarly to the same concentration of alcohol in the blood?

Blood levels don't necessarily reflect intracellular levels, as shown by several studies so could be misleading. Precursors such as estrone sulfate, dehydroepiandrosterone sulfate (DHEA-S) can convert to stronger forms of estrogens/androgens in cells so that levels of testosterone/estradiol may be identical in the blood but because of a difference in the levels of precursors or perhaps a different concentration of enzymes in cells, intracellular levels could be significantly different.

You just need to have your blood levels in the normal female range to make things happen and keep your blood levels at that female range for several years.

The normal female range is wide, varies from one lab, one study (and one woman) to another and even overlaps men's. From as little as 20 (in men, 10-60 pg/ml) to up to 1,000 pg/ml during a menstrual cycle.

Ciswomen and transwomen differ in many respects:
- puberty levels of growth hormones are significantly higher
- in-utero exposure to different hormones which *may* affect sensitivity to hormones later on in life, as confirmed by some studies in rodents
- some transwomen take estradiol orally, SHBG is affected differently, estrone (and estrone sulfate) levels are significantly higher
- ciswomen may have higher/lower levels of hormone precursors such as estrone sulfate or dehydroepiandrosterone sulfate which can result in different concentrations intracellularly
- their levels fluctuate much more than ours
- progestogen/progesterone levels, as mentioned above
- transwomen were exposed to very high levels of testosterone for several years compared to none for ciswomen

Just my 2 cents.

[Transfused]

Studies have shown levels to be up to 10 fold higher vs. oral.

Estradiol taken orally has never, in studies, as far as I know, shown to cause adverse effects on the liver. The issue seems to be more whether it significantly affects coagulation and findings seem to suggest the effect is much less pronounced compared to other oral estrogens which aren't bio-identical. This is reassuring.

+ 1

To me, it did. I know for some other women, it also did. It depends.

Blood levels fluctuate, the numbers could be vastly different from one moment in time to another.

The right blood level for all transwomen, for optimal feminization is not known, according to a recent study. Individuals vary, respond differently to the same level (i.e. sensitivity, genetics).

Blood levels don't reflect intracellular levels, as shown by several studies so could be misleading.

The normal female range is wide, varies from one lab (and one woman) to another and even overlaps mens'. From as little as 20 (in men, 10-60 pg/ml) to up to 1,000 pg/ml during a menstrual cycle.

Ciswomen and transwomen differ in many respects:
- puberty levels of growth hormones are significantly higher
- in-utero exposure to different hormones which *may* affect sensitivity to hormones later on in life, as confirmed by some studies in rodents
- some transwomen take estradiol orally, SHBG is affected differently, estrone (and estrone sulfate) levels are significantly higher
- ciswomen may have higher levels of bio-available T which converts to E within cells
- transwomen were exposed to very high levels of testosterone for several years

Just my 2 cents.

I put my patches on the scrotum. My levels are very high and my hypofyse is completely asleep :-) Bye Bye testosterone haha

[KayXo]

I put my patches on the scrotum.

You earlier stated you put your patch on your buttocks.

[Transfused]

You earlier stated you put your patch on your buttocks.

I switch between scrotum and buttocks :-)

My doctor wants me to put them on the arm because she is freaked out about cancer.
Levels above 100 pg/ml freak her out.
While cis women have 400 on some days!

[Transfused]

Also going to experiment with putting them in the back, where the bone marrow is.
I read something about that absorbing better.
I just changed my patch today and have headache now.
I sometimes leave on the old patch a bit longer but my doctor doesn't like that. She didn't forbade it fortunately.

[KayXo]

My doctor wants me to put them on the arm because she is freaked out about cancer.
Levels above 100 pg/ml freak her out.
While cis women have 400 on some days!

Up to 1,000 during a menstrual cycle and up to 75,000 during pregnancy. Studies have shown an inverse association between the number of pregnancies and the risk of breast cancer. But, causation cannot be inferred from associations.

[Transfused]

Up to 1,000 during a menstrual cycle and up to 75,000 during pregnancy. Studies have shown an inverse association between the number of pregnancies and the risk of breast cancer. But, causation cannot be inferred from associations.

I have a doctor who prescribes me Rodiola Rosacea to keep me away from stress. She believes in herbs. I don't have any other option than her.

I have to beg to keep this dose.
She wanted my Estradiol around 45 pg/ml. Can you believe that?

If I didn't stick them on places where the Estradiol is absorbed better I would be masculinizing.
I was so happy when blood tests revealed that I have suppression on low dose Estradiol.

My doctor even tries to beg me to delay FFS because she believes that I am looking feminine enough. While it's my body and I need it to feel happy.

Sadly, it's already a roll of the dice to find a doctor who wants to treat trans women. I should shut my mouth and be happy with her helping me. No other choice.
Especially since I'm a poor student. Can't travel too far to see some famous doctor.