Estradiol Dose Increase *After* Orchi ??

[KindOfBlue]

Well, that wasn't my intention.

I had my orchi on 2/18. I was off estradiol for two weeks before and one week after.  My doctor cut my dose by a third.

A month after resuming my levels my blood test showed my blood estradiol levels were around 60 — menopausal.  My doctor increased my estradiol dosage — I am now taking "more" estradiol than I did before surgery.

I was under the strong impression that an orchi would allow me to lower my estradiol dose, along with the risk of side effects.  That was my main motivation for the surgery — it seems, however, I may have shot myself in the foot.

The only other explanation of which I can think is  I forgot to take my estradiol (sublingual) the morning of the blood test, and perhaps a couple of other times in the month before.  But could doing that drop my level all the way to 60?

Has anyone else had a similar experience?  Did you have to maintain a higher dose long term?

Thank you!

[GordonG]

Same here. My E was increased by 50% after my orchi. We'll wait 2 months and check it again.

[Dani]

I was under the strong impression that an orchi would allow me to lower my estradiol dose, ...

Not really, an orchi will allow you to completely stop taking the Testosterone blockers.

The only other explanation of which I can think is  I forgot to take my estradiol (sublingual) the morning of the blood test, and perhaps a couple of other times in the month before.  But could doing that drop my level all the way to 60?

This is not the reason for your low blood level. You should really NOT be taking sublingual Estradiol on the morning of your blood test. Take your Estradiol right after your blood test. You want your doctor to see the low point of your daily Estradiol cycle. Sublingual has the shortest half-life of all the available methods of administration. The peaks and valleys fluctuate throughout the day. 

Has anyone else had a similar experience?  Did you have to maintain a higher dose long term?

Without mentioning doses here, before GCS, I was on a higher transition dose, near maximum recommended by my Endocrinologist. After GCS, I was reduced to a maintenance Estradiol dose, similar to what a post-menopause cis-female would be taking.

Since you have been off Estradiol for a month or so, your blood levels have not had time to get back to normal yet. I would just keep taking your Estradiol as your doctor recommended and let the next blood level determine what your next dose should be.

Also, and be sure to hold taking your Estradiol on the morning of your blood draw until after your blood sample is in the lab.

[Linde]

My endo doubled my dose after my orchi.  Nobody, neither the surgeon nor the endo asked me to stop estrogen for the surgery.  I specifically asked about it, and the answer was no.

I Just posted my blodd vlues taken a month after the orchi, and I am on good female level with E139.9 pg/mL and on the lower side for testosterone 5ng/dl.  I feel pretty well on this amount of estrogen, and will see my endo on Thursday.

On the test day I took my E pill sublingual around 9 am, and had my test done around 5 pm.  I think the time in between taking the blood sample and having had E is long enough to show a pretty realistic test result.

[pamelatransuk]

The only other explanation of which I can think is  I forgot to take my estradiol (sublingual) the morning of the blood test, and perhaps a couple of other times in the month before.  But could doing that drop my level all the way to 60?

Thank you!

Hello KindOfBlue

As you suspect and as others have confirmed, Blood Test results for E (&T) can vary significantly depending on timing of the BT. Some doctors/endos advise taking the BT shortly after the dosage (perhaps 4 hours), some advise waiting till next day meaning minimum of 24 hours and some say wait longer.

It is however generally accepted that consistency of timing is necessary such that when you compare BT with previous BT, you are comparing like with like. I have my BT in the afternoon of the day after I change my E Patch which I change in the morning meaning my BT is around 30/32 hours afterwards.

Hugs

Pamela

[Quinn]

I had my orchi march 11  I was not required to stop E at all and actually was able to take it the morning of surgery. Endo had me cut my dose by 75% after, which I personally believe was way to much but I did what the endo asked. I will have a blood test in about two weeks to see what my levels are and adjust from there.
Been on pill form and no blockers.

[KindOfBlue]

Thanks, everyone!  It sounds like my experience isn't singular. It's just different than what most of the online literature seems to suggest — that having an orchi is metabolically protective from the point of reduced estradiol dosages. It's disappointing — my main reason for going through with surgery was to reduce estradiol dose-related stroke risk, and I seem to have done just the opposite.