Susan's Place Transgender Resources

Hi Everyone lets get straight to the point, So my doctor is absolutely wonderful and When I first started HRT he basically let me choose what type. He started me on 2mg however it was my choice and I could have started on more straight away but we decided that checking for reactions was the best bet. When I mentioned pellets, he was unaware of them but was curious and open to the idea. 

Now to my question, how can I, as a patient provide information regarding the sub dermal pellets to help the process along?

I want this type because I don't like the idea of damaging my liver by taking estrogen pills, and lets just say I'm pretty sure injecting myself weekly will be a challenge due to a fear of needles(i can take them just fine if i'm not looking but doing it myself is a different story).

From what I've found obgyn use the pellets to treat menopause but this is all from other transgirls so not exactly formal information. so finding a doctor in my network shouldn't be too hard, It'll just be getting the dosage and recommendation.

Any resources including names of the drug,company,etc would be helpful as well. Thanks!

Regarding suppliers, what ountry are you in?

Quote from: esphoria on September 17, 2017, 05:19:12 PMI want this type because I don't like the idea of damaging my liver by taking estrogen pills

Pills containing *bio-identical estradiol* will NOT damage liver, no study has EVER shown this, even at VERY high doses, much higher than what you'll ever be prescribed. Birth control pills contain the equivalent of very high doses of bio-identical estradiol in terms of the effects on the liver and they are prescribed to tens of millions of women. Your fears are unjustified. Check with your doctor, read studies, see for yourself.

Quoteand lets just say I'm pretty sure injecting myself weekly will be a challenge due to a fear of needles(i can take them just fine if i'm not looking but doing it myself is a different story).

I was like you but slowly overcame my fear and it became a breeze to inject myself. If I can do it, almost anyone can!

Ok I live in the United States Anony

So the sourcing incoming:


Discuss established risks of Estrogen use with patient:
   Impairment of fertility may be permanent
   Breast development is permanent
   Potential risk of hormone sensitive tumors (prolactinoma, prostate, breast)
   Blood clot risk, heart attack, stroke (especially in smokers or age >35)
   Dementia
   Diabetes
   Hypertension
   Liver disease
   Nausea/Vomiting
   Gallstones
   Migraines/Headaches
   Overgrowth of prostate
   Depression/nervousness/anxiety/mood disturbances

source: Informed Consent Document given to me

Regarding the liver and function:

The human adult liver weighs about 1.4 kg (3.1 pounds) and is found in the right upper abdomen, below the diaphragm. It takes up most of the space under the ribs and some space in the left upper abdomen, too. Viewed from the outside, a larger right lobe and smaller left lobe can be distinguished. The two lobes are separated by a band of connective tissue that anchors the liver to the abdominal cavity. The gallbladder, where bile is stored, is found in a small hollow on the underside of the liver.

Liver tissue is made up of lots of smaller units of liver cells called lobules. Many canals carrying blood and bile run between the liver cells. Blood coming from the digestive organs flows through the portal vein to the liver, carrying nutrients, medication and also toxic substances. Once they reach the liver, these substances are processed, stored, altered, detoxified, and passed back into the blood or released in the bowel to be eliminated. In this way the liver can, for example, remove alcohol from your blood and get rid of by-products from the breakdown of medications.

With the help of vitamin K, the liver produces proteins that are important in blood clotting. It is also one of the organs that break down old or damaged blood cells.

The liver plays a central role in all metabolic processes in the body. In fat metabolism the liver cells break down fats and produce energy. They also produce about 800 to 1,000 ml of bile per day. This yellow, brownish or olive green liquid is collected in small ducts and then passed on to the main bile duct, which carries the bile to a part of the small intestine called the duodenum. Bile is important for the breakdown and absorption of fats.

In the metabolism of carbohydrates, the liver helps to ensure that the level of sugar in your blood (blood glucose) stays constant. If your blood sugar levels increase, for example after a meal, the liver removes sugar from blood supplied by the portal vein and stores it in the form of glycogen. If someone's blood sugar levels are too low, the liver breaks down glycogen and releases sugar into the blood. As well as sugar, the liver also stores vitamins and minerals (iron and copper), and releases them into the blood when needed.

The liver also plays an important role in the metabolism of proteins: liver cells change amino acids in foods so that they can be used to produce energy, or make carbohydrates or fats. A toxic substance called ammonia is a by-product of this process. The liver cells convert ammonia to a much less toxic substance called urea, which is released into the blood. Urea is then transported to the kidneys and passes out of the body in urine.

source: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072577/ (https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072577/)

Estradiol Tablet Ingredients:

Each Estradiol Tablet for oral asministration contains x mg micronized estradiol. These tablets contain the following inactive ingredients: anhydrous lactose, magnesium stearate, microcrystalline cellulose, and polacrilin potassium...

source:  http://pi.actavis.com/data_stream.asp?product_group=1233&p=ppi&language=E (http://pi.actavis.com/data_stream.asp?product_group=1233&p=ppi&language=E)

bioidentical- identical on a molecular level

Ok, how I drew my conclusion was based on an assumption I shouldn't have made. I made the assumption based of hearsay that bioidentical pills were unavailable.


You were saying that there are pills that are bioidentical, which a quick google search revealed to me that estradiol is bioidentical. This honestly was my primary concern. I was thinking that my body had to filter out garbage to get to the estrogen combined with the warning with IC is what was raising flags.

The idea that estridol was causing unnecessary damage to my body and that I believed the pellet could provide the most steady level of estrogen (unverified). I think its still worth discussing with my doctor, I just need to be more critical of the treatment.

I'll be the first one to admit biology isn't my forte, but I'm more than happy to dig and get to the bottom of it and will gladly admit when I'm wrong. I sourced everything so the discussion could have a more fruitful impact and to help me understand and grow.

Thank you both for the replies! sorry it took so long to get back to you.

Maybe my knowledge is outdated, but I thought Dr O'Dea was the only US provider doing a feminizing dose of the implants. Remember, we need teenage levels, not menopausal levels.

And if I'm five years behind the times, just disregard!

Hugs, Devlyn

College Pharmacy sells them in the USA

http://www.collegepharmacy.com/index.php?/bhrt_fused_pellet_implant