A Question about Sublingual HRT

[rejennyrated]

I'm going to apologise if this is a silly question. I read in various places about the advantages of taking estrogen sublingually. Despite having taken HRT for nearly 30 years I have never come across this method, and I have been unable to find out much about the system.

I take estradiol hemihydrate orally. Hemihydrate is one of the varients that is used transdermally - you can get it as a nasal spray. I'd like to try taking it sublingually but I can't find any information.

Are there special pills or is it just a case of taking a pill and placing it under the tongue until it disolves and is absorbed. As a one off experiment I tried that this morning and it seemed to work, left no residue and tasted faintly minty and sweet. So I'm wondering if these pills are actually designed to work both ways as I can't think why else they would be flavoured.

I've looked at the various sites that give information about sublingual HRT and they mention two particular brands but looking at the patient notes supplied with those brands they don't actually make any mention of sublingual use - which again makes me think that the pills are probably "dual purpose".

There doesn't seem to be any information in the UK about this at all. Can anyone tell me do I need to get a special formulation, or can I just use my existing tablets, and if I need a special formulation can someone from the UK advise which brand name to ask my GP for (otherwise it gets difficult as I would have to consult an endo, which in turn costs my GP money out of my care budget). So it's a lot easier to justify if the GP and I together can work it out.

Any info that anyone can give (obviously NOT dosage though) would be helpful. Thanks

Post Merge: January 05, 2010, 05:31:56 AM
Ah - funnily enough I've just noticed after posting  - The brands which are recommended for sublingual use all contain Estradiol-Hemihydrate. So it looks as though I may be right. They are dual purpose.

[Janet_Girl]

I have done my Estradiol sublingually for 20 months and have had good results, not outstanding but good.

It helps to bypass the first pass through the liver.  Reducing stress to said organ.  Most pills can be taken this way, just some are horrible in taste.  And they are generally milled finer.

I am not surprised that there is a nasal spray, because most drugs can be taken through the nose.  Think chewing tobacco.  Think Coke.  And not the drink.  Bubbles hurt in the sinuses.

Hope that helps, Sis.
Janet

[rejennyrated]

Thank you Janet

Ali and I are going to try taking it Sublingual for a while and see how we get on.

It sounds like it might be better for us.

J. x.

[Muffin]

I recently read that there is a difference and non-sublingual estrogen can not be absorbed through the mouth. So not sure about the dual action. This is actually one thing I will be asking my doc next visit, I want to try the sublingual.
I really want to be on the safest and most effective program that I can. Being pre-op I cant cycle any of what I need so no needles or patches, sublingual does sound like the safest option, I've heard good things about the nasal method but it's still quite new no? It seems strange... snorting hormones?!?
I wouldn't recommend for anyone to sublingual any ester based estrogen (progynova) or any that have a time release coating. I haven't researched yet to see what is best.. Im looking at estrace (bioidentical) at the moment but Im not sure yet if it's sublingual safe. *click click click*

[MaggieB]

I take sub-lingual estrogen as Estradiol in the form of Estrace. It does well for me and is very inexpensive. It is the way it was prescribed to bypass the liver. Not as good as topical estrogen for that but close.

Maggie

[rejennyrated]

Im looking at estrace (bioidentical) at the moment but Im not sure yet if it's sublingual safe. *click click click*

Estrace contains exactly the same active ingredient as my tabs - namely micronised Estradiol-Hemihydrate which is a bio identical.

Estrace is also one of the two brand names which are specifically referred to in all the data I've found on sublingula dosage (the other is Estrofem).  As far as I can tell from the checks I have made today, it is indeed a dual purpose pill which can be taken either way.

Which of course means by extension that my pills are also dual purpose as they have the exact same formulation, and which presumably is why they flavour them with mint. They disolve quite nicely and taste quite good.

[Janet_Girl]

I go back and forth between Estradiol and Estrofem, and I have always went sublingula.  I want to protect my liver.



Janet

[Hannah]

Estrace contains exactly the same active ingredient as my tabs

I've been thinking about something along these lines lately, but have been too distracted to look it up. (lots of shiny things around in winter) In your research on this did you find anything about the quality variances between brands and generics? At one point I read something about the potency of generics fluctuating as much as 80%, but I think that was premarin-based research. Did you find anything about that while you were looking up Estradiols?

[rejennyrated]

I've been thinking about something along these lines lately, but have been too distracted to look it up. (lots of shiny things around in winter) In your research on this did you find anything about the quality variances between brands and generics? At one point I read something about the potency of generics fluctuating as much as 80%, but I think that was premarin-based research. Did you find anything about that while you were looking up Estradiols?

No but I switched to a brand name estradiol from premarin some years back precisely because of those sorts of issue. I kept getting horrible mood fluctuations and excessive breast tenderness (in excess of those normally caused by my cycling). Also I had suspicions that after 20 years or more the buildup of equine estrogen, which the human body cannot metabolise, was slowly giving me liver toxixity.

- Plus I don't like the potential cruelty to horses involved
(although in fairness I do say "potential" because i understand that Ayerst, which is one of the major product license holders, has now switched their branded Premarin to using synthetically made ingredients.- Which of course presents another problem because now you also have two slightly different types of Premarin according to how it and where was made...  )

[aubrey]

As long as it is micronized it can be taken sublingually. Mouthwash wears away the mucous membranes inside the mouth and is often used to increase absorption of many substances that may be taken sublingually. The alchohol is also a solvent so yeah....

The first brand I ever took was Progynova and tasted like candy but took a few minutes longer to dissolve than Estrace.

[Debra]

I've only recently begun HRT but yes my doctor said to take the estrogen sublingually.

[Muffin]

OMG! I actually researched something for the first time in ages...actually that's not ...what...I'm so happy about.
I just discovered Femoston!!!!!!!!!!! And it's available in Australia and it's covered!!!!!

It's estradiol hemihydrate and it also comes in a form that also contains Dydrogesterone (Duphaston).
You can get it straight or in packs that have so many estradiol and then so many with estradiol and the dydro.. for cycling.

This is the biggest break through I've had all year! SO happy right now.

Now I just have to wait until I see my psychiatrist next month and have him say he can't find it on his computer and say "I can't help you". Just kidding it should be all ok and I can make the switch once my current supply runs out which will take me pretty much all the way up until srs (I've been sneaky and storing them since I flipped out at a GP).

*somewhere over the moon*.
 

[JennX]

As long as it is micronized it can be taken sublingually.

This. Whether or not it is micronized is the important thing. Micronized means it will dissolve easily and be absorbed thru the skin into the blood stream. You need to check with the specific drug manufacturer to find out if the brand of E your taking is or is not micornized. Estrace and Estrofem are the two big name brands of E here in the USA. However, there are plenty of micronized generic brands as well.