Susan's Place Transgender Resources

Does anyone know if there is a difference and what the differences are between Premarin, Estrace, Estratab, and generic versions. My doctor has me on a somewhat low dose of a generic version of oral Estrace for the first 3 months and may consider injections after that.   

A generic has exactly the same chemical components and will work the same way as the non generic version. I've never really understood that myself but apparently it is the case.

As for the differences between types of estrogens you may want to check the websites of the companies that produce them. It may be that some are bio-identical and others are synthetic. But ask your doctor what they see as they principle benefit of you being on Estrace.

Estrace is the safer, bio-identical estrogen. The other two are slightly riskier due to containing estrogens not native to the human body.

Quote from: Ms Grace on December 13, 2015, 03:57:32 AM
A generic has exactly the same chemical components and will work the same way as the non generic version. I've never really understood that myself but apparently it is the case.

Not necessarily.
Especially with medication for asthma and heart problems this is not the case.
There might be a slightly different list of ingredients. This is why some people are advised to have written " no replacement" on some medication.

With estrogen/estrace it should not matter since its only one ingredient.

Preferable might be uncoated bioidentical micronized estrogen, it should dissolve pretty well under the tongue.
You might think about splitting the daily dose in a few small ones instead of two big ones to avoid spikes and lows which might affect mood.


hugs

Quote from: Laura_7 on December 13, 2015, 06:30:07 PM
Preferable might be uncoated bioidentical micronized estrogen, it should dissolve pretty well under the tongue.
You might think about splitting the daily dose in a few small ones instead of two big ones to avoid spikes and lows which might affect mood.

True... but its generally not the smartest idea to do this right from start. Too high levels too early can cause some more or less severe side effects. After 3 months would be a lot more appropriate time to start taking them sublingually, like her doctor suggested maybe switching to injectables.

Quote from: Lagertha on December 13, 2015, 06:38:07 PM
True... but its generally not the smartest idea to do this right from start. Too high levels too early can cause some more or less severe side effects. After 3 months would be a lot more appropriate time to start taking them sublingually, like her doctor suggested maybe switching to injectables.

She should consult with her doctor...
sublingual use is more efficient and its supposed to be less straining on the liver and less causing clotting factors...
here is a graph:
https://www.susans.org/forums/index.php/topic,186946.msg1665088.html#msg1665088


hugs

Quote from: Laura_7 on December 14, 2015, 06:12:26 AM
She should consult with her doctor...

Definitely! Sublingual use can create peak levels 10 times higher than oral use. Too high levels right from the start can literally cause endocrine shock.. You can read more about it here: http://www.rightdiagnosis.com/s/shock_endocrine/intro.htm

hugs

Premarin is equine Estrogen extracted from pregnant horses placed under substantial stress to create more Estrogen. It's not a bio-identical Estrogen by any stretch of the imagination.

It received bad press in the late 90's where several animal welfare groups were successfully in having bans imposed on its production. Sadly universal acceptance of the bans was never achieved.

Speak to you as soon as I find my slippers.

Huggs
Catherine

Quote from: Lagertha on December 14, 2015, 08:05:26 AM
Definitely! Sublingual use can create peak levels 10 times higher than oral use. Too high levels right from the start can literally cause endocrine shock.. You can read more about it here: http://www.rightdiagnosis.com/s/shock_endocrine/intro.htm

I started right away taking sublingually. No endocrine shock LOL. And I know several people, probably in the hundreds to thousands of transwomen who either began HRT taking estrogen sublingually or injections. Not once did I hear of any shock or complication. This treatment was even initiated on some post-partum ciswomen and proved successful.

I personally know two transwomen who had. One started with medium dose estrofem and full dose androcur, prescribed doses, she just followed internet advice instead of doctors, and took estrofem sublingually. She had severe endocrine complications including problems with thyroid and liver. She had to stop HRT for more than a year, and slowly restart after thyroid and liver functions had been back to normal for more than 6 months. She then started with half the dose orally not sublingually, and one quarter dose of Androcur she was initially prescribed.
Second one bought hormones over the internet.. she took only estrogen, higher dose than what I take after years on HRT, of course sublingually like the internet suggests.. and she ended hospitalized after one week. I dont know much details.. havent seen her or heard from her since.

Quote from: iKate on December 14, 2015, 03:40:58 PM

Premarin isn't made from horse pee anymore. It hasn't been in years.

http://www.horsecollaborative.com/premarin-still-needs-horses/

Why Premarin Still Needs Horses

March 11, 2015


hugs

Quote from: iKate on December 14, 2015, 03:40:58 PM

Premarin isn't made ...

I personally would not touch it. There are parts included that are simply not identical with what a human body expects imo.
There are bioidentical estrogens available.

It was different many years ago.


hugs

A friend of mine swears by it. She says it's better than the turquoise pills.

My prescription was written to be taken sublingually, so I haven't deviated, right from the get-go.   No shock issues at all.  Though to be honest, since prescription doses will vary between doctors and patients, I can see where that'd be a concern if I'd started at a higher mark.

My APN said she has a base template she likes to start new patients on and will adjust from that starting point as necessary. 

Quote from: iKate on December 14, 2015, 09:13:28 PM
A friend of mine swears by it. She says it's better than the turquoise pills.

She might try a combination of bioidentical estrogen and bioidentical progesterone... it should be better imo...
its what cis females have...


hugs

I did a bit of research before going to my endo appt. which of coarse impressed my endo because I had an idea of what I was talking about

Anyway, he prescribed a generic bio-identical in sublingual form and I am rather happy with the results

Just a reminder friends, let's be sure to keep the site rules in mind when discussing HRT

Quote
8. The discussion of hormone replacement therapy(HRT) and it's medications are permitted, with the following limitations:
A. You may not advocate for or against a specific medication or combinations of medication for personal gain. This is strictly prohibited.
B. You may not discuss the means to acquire HRT medications without a prescription. The discussion of self medication without a doctor's supervision is prohibited.
C. The posting of recommended, or actual dosages, is strongly discouraged to prevent information obtained on this site from being used to self medicate.

We cannot in good conscience condone the self administering of these medications. Not only may self medication be illegal, but HRT medications can cause serious health problems, and many have the potential for life-threatening side effects that can only be detected and prevented with proper medical supervision.

Hugs

Quote from: Laura_7 on December 15, 2015, 08:29:30 AM
She might try a combination of bioidentical estrogen and bioidentical progesterone... it should be better imo...
its what cis females have...


hugs

I agree, but she is a strange one. Her presentation and medical history is none of my business but she barely has any breast growth and says she is going to get a BA. She has been on a low dose of premarin for a long while, like 10 years. Gee, I wonder why she isn't growing boobs??? Anyway I don't know her full story and I don't mean to tell people how to live. If she's happy and that's what she wants to do, that's fine.

Quote from: iKate on December 15, 2015, 12:37:48 PM
I agree, but she is a strange one. Her presentation and medical history is none of my business but she barely has any breast growth and says she is going to get a BA. She has been on a low dose of premarin for a long while, like 10 years. Gee, I wonder why she isn't growing boobs??? Anyway I don't know her full story and I don't mean to tell people how to live. If she's happy and that's what she wants to do, that's fine.

Well you might at least suggest a change.
She might ask her doc and give it a try...

Of course its all up to her but if there might be a better way why not at least make a suggestion ?


hugs

Quote from: Lagertha on December 14, 2015, 09:42:56 AM
I personally know two transwomen who had. One started with medium dose estrofem and full dose androcur, prescribed doses, she just followed internet advice instead of doctors, and took estrofem sublingually. She had severe endocrine complications including problems with thyroid and liver.

She was taking Androcur as well...and doses may have been too high.

QuoteSecond one bought hormones over the internet.. she took only estrogen, higher dose than what I take after years on HRT, of course sublingually like the internet suggests.. and she ended hospitalized after one week. I dont know much details.. havent seen her or heard from her since.

What type of estrogen, depends on dose as well. One should start low, regardless of sublingual or oral. Of course, with the supervision of a doctor. :)