Just a quick update. I just got back from my tri-monthly follow-up visit with my Endocrinologist. I talked to her about changing over to Estradiol Valerate self injections. I went in armed with a very interesting read by Dr. William Powers that SassyCassie and Stephanie talked about in their threads. I talked to her about Dr. Powers findings on the imbalance levels of estradiol, estrone and total serum estrogen and there effects on MTF development, as well as his beliefs that estradiol should be closer to 300 pg/ml.
1: Kaiser follows the WPATH protocol for transgender health, so my doctor is bound to those standards. Which mean estradiol at 200 pg/ml max for younger patients, and in my case, (older patients) my doctor feels it's safer to be at 157 pg/ml or less and no progesterone. (She did say maybe on the progesterone after my GCS and I get off spiro).
2: Kaiser does not require my doctor to monitor estrone and total serum estrogen. They are only required to monitor estradiol levels, along with all the other important vitals. My doctor does agree with Dr. Powers but her point is that if the level of estrone and total serum estrogen were that high, my estradiol level would be very low, in which case my doctor would increase my estradiol. Since the amount of estradiol I take is in a normal range, and my blood levels of estradiol is where she wants it (cis female range), there is no concern.
3: My Endo is very happy to put me on estradiol valerate self injections. However, the Valerate seems to be in short supply so she would put me on MI? injections. The same results as Valerate. In her opinion, there would be no benefit to change over to injections, other than less wear and tear on the liver and kidneys. And since my liver and kidney functions are well within the normal range, she doesn't see the point of putting me through the extra pain of injections. (Valerate and MI is a think oil base and requires a deep muscle injection, which is why the needle is so long.)
So, not being convinced, or at least not sure that the injections would produce a better result, I guess for the time being, I will stay with the oral pill. I have always herd that the injections produce a better result, but as with progesterone, it depend on who you talk to and the fact that YMMV. Wandering through the dark, wanting nothing but the best for myself, I will continue my research and maybe in three months, I'll switch.
Oh ya! My Endo didn't let me get away without a mammogram this time. She just looked at me with this big ear to ear smile and said, "Welcome to the club Donica!".
Warm hugs,
Donica.
