Optimal Estradiol test levels for pre-ops?

[Tippe]

Hello there,

I wonder what you consider optimal estradiol levels for pre-op women? Sources appreciated!

I've been on orals for almost four months now and psychologically it's been very good, but from the blood work I think my E is on the low end.
During the first three months T went from 15 -> 0.75 nmol/l, which compares well to the lower female range and I only take a small amount of androcur. On the other hand E only went from 0.09 -> 0.16 nmol/l on a normal dose of Estradiol aka Estrofem.

1. The pharmacy told me there was no specific time of the day to take the pills if I just made sure to do it the same time every day. For practical reasons I take them at night, but the tests are usually run around noon.
On orals how much will my levels vary during the day? I can't find information about their half-life.

2. From various sources - none of them authoritative - I gather 0.5 nmol/l i.e. 500 pmol/l should be a good estradiol level. What do you think it should be?
It's quite difficult to find any official recommendations I think.

3. How many months should I expect to wait before reaching the final / steady-state levels on oral estradiol?

My next checkup is six months away, but I think that's quite a long time to wait since I consider myself in the beginning of the process.



Tippe

[Tippe]

I found some more information regarding the half-life, but I still miss reliable information about optimal estradiol test levels?

Anyone?

1. The pharmacy told me there was no specific time of the day to take the pills if I just made sure to do it the same time every day. For practical reasons I take them at night, but the tests are usually run around noon.
On orals how much will my levels vary during the day? I can't find information about their half-life.

Okay, I found an informative summary of product characteristics here:
http://www.medicines.ie/medicine/6181/SPC/Estrofem+2+mg/

Apparently maximum is reached in six hours and half-life is 18 hours on oral medications. That means, if I take the pill at night I start out with maximum in the morning. But then I'll be low from 4 pm to 10 pm. Hmm, I'm gone experiment with when it suits me best to take it then.

3. How many months should I expect to wait before reaching the final / steady-state levels on oral estradiol?

With a half-life of 18 hours steady-state should be reached within a week, but this obviously depends on how soon androgen suppression is completed as well.



Tippe

[Janet_Girl]

From most for what I have been told by my doctor, most look for normal levels and adjust accordingly.  One of my old doctors would check only my liver, and would go by how I felt things were going.

[Tippe]

But the normal varies during the period in genetic girls so where does that put our goal? And why is it so difficult to find sources about the optimum?

With hundreds of thousands of people on HRT in the world it realy amazes me that I cannot find any studies on this or even a controlled trial on whether progesterone is beneficial or not.

[Julie Marie]

My doctor is happy when he sees E levels in the 350-450 range.

[Tippe]

My doctor is happy when he sees E levels in the 350-450 range.

Thanks Julie, in which units - pmol/l or ng/dl?



Tippe