Switching to injections?

[missmacyrose]

I have been on HRT for just over 9 months now, and have been on pills the entire time. I actually had planned to start with injections but my Endo decided it would be best to start me on oral first. I have had decent results so far but I have noticed that after just 9 months, my breasts seem to have peaked at a small A cup and don't seem to be growing anymore. There have been lots of great changes and overall I am happy with my transition but I wish some things would go faster and I have heard from almost everyone that injections are preferred. I have already emailed my Endo about switching but I wanted advice on some of the finer points. First of all, do you prefer weekly or bi-weekly? I have heard horror stories of sharp drop offs with bi-weekly and I already get a phantom period even on pills (last week of the month I get abdominal cramps, mood swings, fatigue, pretty much all period symptoms sans bleeding) and have heard injections can make these mock menstrual periods worse when levels begin to drop? I also have heard horror stories of shortages with injections. I really want to try injections and I know I can switch back to pills if I don't like them, but I'm sure I will. I just don't know whether weekly or bi-weekly is the way to go. Please if anyone can give me some advice on which I should go with I would appreciate it.

Side Note: I'm not necessarily complaining about my preiod...  I love having it as it makes me feel more "real" in a sense, I even have female friends i discuss my period with. It makes me feel good to be able to say the words "my period"

[2.B.Dana]

I switched to IM injections a couple months ago. It took me a short time to adjust but I like them very much. Here is a link which has a list of links that can offer some great info on this;

http://cotransgenderinfo.blogspot.com/2017/03/hormones.html

My endo originally said one shot a month, I laughed, then complained and he went to 14 days. I told the nurse I would do 7 days, her response was she couldn't control what I did once I left the office. After about 6 weeks I could tell my moods were riding the weekly wave of shots/estrogen levels. I then switched to  4 day cycle and as predicted in all the literature my life evened out and I seem to be doing good at that rate. I do seem to have a bit of water retention the first day then it levels off but other than that no side effects. Other than what we all hope for in HRT.

I highly recommend the literature above in the link.

[missmacyrose]

Thank you for all the info! I've emailed my Doctor and am just waiting for a response. Hopefully he will reply soon so I can get changed over, the injections will just be so much more convenient for me plus the added bonus of faster and better results. I currently have barely A cups and really want to get up to a B, hoping that injections will do that for me like they seem to for these other girls I hear from. I'm really interested in how you divide up your medication into a 4 day cycle, I know we can't publicly discuss dosages but perhaps you can message me privately and let me know how you do that math? I'd be worried about injecting the wrong amount. Also are you injecting just Estrogen or Progesterone as well?

[Shadowsister]

Heya,

I was on estrogen pills for a bout a year before my doc switched me to weekly injections. I take my injections subcutaneously. When I first began injections, toward the end of the week I'd begin feeling blue and would even begin craving my next injection, but after just a couple months I started feeling much better.  My injection dosages remained the same. Maybe I "equalized" or something, I am not sure. Personally, I wouldn't want bi-weekly as it would probably leave me feeling bad toward the end of week two just before my next injection. 

Here is a topic where I talked about it

https://www.susans.org/forums/index.php/topic,232545.msg2070717.html#msg2070717


It's all better now. However, sometimes I still do get a bit of a phantom period as you describe. It is indeed more intense on injections. Could be a placebo deal though, so please keep that in mind.

From what I have read the estrogen shortages are a thing, but I am just sure to call in my refill as soon as I am able just in case anything gets backed up. This was a recommendation from my doctor! I was never unable to get my estrogen in a timely manner. For reference, I am in the United States.

My testosterone put up a fight against oral estrogen so my doc opted for injections+finasteride. This brought all my numbers within a female range. With that I do feel better and I am beginning to see changes after being on injections since December, 2017. It's like the physical aspects (how I look) of my transition really picked up steam after beginning injections. The changes experienced are as follows, and remember I was on pills for about a year before beginning injections:

-More boob growth. Before I was working with little more than buds, but growth has now accelerated to the point I cannot just walk around in public with a thin t-shirt and no bra.

-Softer'' looking face. Subtle though it may be, within that framework it's still a marked difference and I suspect things are going to get even better.

-Slowed hair growth. I was never particularly hairy to begin with, but now it's really slowed down. For example, I can make it two weeks without shaving my legs whereas before I only got a week out of a shave.

-Emotions are much more intense. I'll cry more and now I am far more likely to be repulsed by conflict of any sort.


Switching to injections was one of the best things for me. It's almost like when my HRT really began. I hope my words here today have helped you in whatever you decide.

I wish you happiness, safety, and love as you continue your transition.

[missmacyrose]

Update:

My Endo is refusing to switch me to injections saying that in the past he has had patients run out due to shortages (nothing surprising) then went on to try and say that the two are the same and any reports of injections being more effective are purely anecdotal. I emailed him back refuting that claim and also saying that since nobody can predict when these shortages will stop happening, I would rather switch how and have the option to go back to my pills if I run out. I will wait for him to reply and if he still won't switch me I'll be emailing Kaiser Permanente member services to complain as it's my treatment and I shouldn't be forced to stay on pills if I'm unhappy with how they're working. Looks like, like most trans women, I'm gonna have to take charge of my own treatment 

[Shadowsister]

Update:

My Endo is refusing to switch me to injections saying that in the past he has had patients run out due to shortages (nothing surprising) then went on to try and say that the two are the same and any reports of injections being more effective are purely anecdotal. I emailed him back refuting that claim and also saying that since nobody can predict when these shortages will stop happening, I would rather switch how and have the option to go back to my pills if I run out. I will wait for him to reply and if he still won't switch me I'll be emailing Kaiser Permanente member services to complain as it's my treatment and I shouldn't be forced to stay on pills if I'm unhappy with how they're working. Looks like, like most trans women, I'm gonna have to take charge of my own treatment 

Please be sure to double or even triple check what I say here, but I have seen some literature suggest that injections were safer, something about it being easier on the liver. If that is so, maybe argue from that platform. You want the best for your health and if injections are shown to be safer it makes sense that is what you would want to do. Cite that stuff and see what happens. Be armed with knowledge though.

[120716]

Hi, I am on injections. Have had a few shortages, then I thought to myself how will I get a surplus? Well on my little pamphlet it stated discard after 28  days... hmmm a vial lasts me 90ish days so my MD wrote for a monthly refill. I have built a bit of a reserve now and she even gave me a script for oral if I were to run out. The best thing she did was write a script for the HMO pharmacy and one I could take else where. The HMO it is $7 a vial and Walgreens it is $55 a vial. I fill both monthly.

She put me on X mg every 7 days I split it for every 3.5 days and no lows and minor peaks. She worte a script for oral progestrone and I fill them. I also buy IM P (Strone bioidentical) from an overseas pharmacy and inject 24 hours after E.  I feel 100% amazing, pills I noticed ups and downs. Since moving to IM 1 year 3 months ago things I have noticed. My blood pressure is low normal, I have lost weight, moods are mostly stable. Before gcs was told to stop a month prior (damn I knew I forgot to stop something pre surgery) The nurses were amazed with no HRT how low my bp was, how good my moods were etc... I confessed to one nurse that I did not stop, she told me her best friend did not either and had a great recovery too. So maybe if your endo is worried about a shortage have them write for a higher precentage of EV ie 40mg a ml, will last 2x longer than 20mg a ml Maybe they will be kind and write one for insurance and one for non insurance, just make sure you can fill once a month.
Best of luck
-M

[Dani]

...Looks like, like most trans women, I'm gonna have to take charge of my own treatment 

Everybody has the responsibility to take charge of their own treatment. You are the only person who will live in your body. So, stop the sad face and make some lemonade with those lemons! 

I specifically look for doctors who include me in my health care decisions for all health care needs.

120716 has a doctor who has all the bases covered. Her doctor has given her options that allow her to manage her transition. One thing I would caution about stock piling medications; keep track of the expiration dates on the bottles. All medications do break down over time into less than effective drugs. In the US all drugs have an expiration date of no more than 5 years. When the manufacturers studies show a 10% degradation the expiration date can be sooner. Some drugs can break down into dangerous compounds. So, watch those expiration dates.

[Daniellekai]

I started on injections, got pills after a few months due to shortage, but they didn't keep my levels in the proper range like the injections, both T and E were wrong again. Back on injections, and it's fixed like magic. I feel "growing pains" still, but only in the first half of (weekly) injection. Been going something like 9 or 10 months, with three of that being when levels were too out of whack for anything you be changing.

[missmacyrose]

Update:

Endo emailed back. He said that as long is I'm aware that I might have to go back to pills in a pinch, he would switch me to injections now. I told him that is perfect. So just waiting for him to email back and tell me my prescription is ready for pickup! Hopefully tomorrow. I will wait until a little later in the day before taking my pills so that in case he emails I can go pick it up and hopefully have my first injection tomorrow! Will keep you all updated as it goes on