Susan's Place Transgender Resources

Hello peoples, it's been awhile x

I have now been on HRT for just over a year and have been on Evorel Patches for the entirety but I get really bad rashes from them as I am very active, not to mention the fact they don't always stay put, especially after vigorous exercise.

My Doctor has now suggested changing me over to Oral HRT but I am a little concerned with this option as I am 46 years old and have been lead to believe that this could be hazardous for someone in my bracket.

Anyone here have any advice, experiences etc of the pill form at the upper age range?

Love to you all

Naomi

Quote from: Nooms on January 08, 2018, 05:54:57 AMI am
. . . 46 years old and have been lead to believe that this could be hazardous for someone in my bracket.

Seriously?? "Close cover before striking" and "Wear safety glasses" ???

If I heeded every WARNING  :police: these days I'd probably be a paraplegic, totally unable to move!!

Am 62, have been taking diff varieties of estradiol pills on/off for last 40 years, and . . .
We Are Still Here!! (https://www.youtube.com/watch?v=Y7qv0RmYJNg)

Quote from: Nooms on January 08, 2018, 05:54:57 AMMy Doctor has now suggested changing me over to Oral HRT but I am a little concerned with this option as I am 46 years old and have been lead to believe that this could be hazardous for someone in my bracket.

Anyone here have any advice, experiences etc of the pill form at the upper age range?

Those studies that found deleterious effects of pills on women above the age of 40 consisted of non-bio-identical forms of estrogen such as Premarin, ethinyl estradiol and DES.

In studies on women with advanced breast cancer, high doses of bio-identical estrogens, like VERY high doses, resulted in a low rate of complications (only 1 DVT in about 55 women after 6-22 mths of treatment) and that is quite surprising given the ages of these women (up to 92 yrs old) and the fact they were more at risk, not only due to their age but also due their cancer.

Now, there is also another thing to consider and that is that birth control pills contain the equivalent of a very high dose of oral estradiol, far higher than what is typically prescribed to transwomen, in terms of effects on the liver (coagulation) and these birth control pills are routinely prescribed to women all over the world, without much supervision, even after the age of 40 and despite this, the risk of DVT in this population remains very low, around 0.03%.

The above findings and results are reassuring and I tend to agree with your doctor that oral isn't as hazardous as it's made to be, as long as bio-identical estradiol is prescribed.

My 2 cents.

Kay pretty much said it all.

Everything I have read suggests oral bioidenticle is perfectly safe. Safer than most medication for any other medical condition.

Thank you all ever so much for this information, it makes me feel so much better about it. I am fed up of the rashes and the patches coming off during exercise. I workout for about an hour a day and it's a nightmare keeping these wee patches attached 😂

I started on patches at 56 due to possible cirrhosis caused by alcoholism. After monitoring me for six months  while raising the dosage, my doctor decided to switch me to oral estradiol because she didn't see any issues. Your mileage may vary.  :)

Hugs, Devlyn

You could try a different type of patch. Some are worse than others, though I can't say I like any of them.

There's also gel, injections, and implants.

I enjoyed the patch for the ease. I've had quite a few times when I look in my pill case and realize that I missed a dose.

Quote from: AnonyMs on January 08, 2018, 01:15:35 PM
You could try a different type of patch. Some are worse than others, though I can't say I like any of them.

There's also gel, injections, and implants.

I did ask about the estrodot patch but was told there were supply issues, as for the gels, not a good option because of the cross contamination risk with my ftm partner and as far as the other 2 options, these were not even offered x

Quote from: Devlyn Marie on January 08, 2018, 01:23:37 PM
I enjoyed the patch for the ease. I've had quite a few times when I look in my pill case and realize that I missed a dose.

I'm not to worried about missing dosage as I am quite OCD about meds lol

Patches are great, as long as the health plan includes decent ones. My HMO is currently issuing Sandoz patches, which stay MUCH better than their previous brand, that I had to cover with a thin bandage to avoid lifting.

I like having the steady E level. I haven't had my levels checked since GCS, but even with the reduction in dosage (no numbers!) I'm getting stronger feminization effects including more breast growth. They work.

(New levels in a few weeks when I do my annual check up)


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Totally agree about the Sandoz patches, those things STICK!

Quote from: Michelle_P on January 08, 2018, 01:41:03 PM
Patches are great, as long as the health plan includes decent ones. My HMO is currently issuing Sandoz patches, which stay MUCH better than their previous brand, that I had to cover with a thin bandage to avoid lifting.

I like having the steady E level. I haven't had my levels checked since GCS, but even with the reduction in dosage (no numbers!) I'm getting stronger feminization effects including more breast growth. They work.

(New levels in a few weeks when I do my annual check up)


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So is the estrogen less consistent with pills then?

Quote from: Nooms on January 08, 2018, 01:45:42 PM
So is the estrogen less consistent with pills then?

The level can fluctuate more, yes.  Estradiol has a short biological half-life, a few hours, so the serum level tends to be fairly high shortly after taking the pill and drops after several hours.  That's part of why many split the dosage between morning and evening.  I noticed this in the hospital when I was restarted on Estradiol in pill form once daily.

Quote from: Nooms on January 08, 2018, 01:45:42 PM
So is the estrogen less consistent with pills then?

Yes, if taken sublingual. Taking Estradiol by the oral method is not as variable, but still shows some peaks and valleys.

If you feel more comfortable with a steady blood level, then patches or injectable Estradiol is for you.

Quote from: Dani on January 09, 2018, 05:41:55 AM
Yes, if taken sublingual. Taking Estradiol by the oral method is not as variable, but still shows some peaks and valleys.

If you feel more comfortable with a steady blood level, then patches or injectable Estradiol is for you.

Based on my own research and personal experience, it would seem that implants/pellets, gels, patches and oral (NOT sublingual) estradiol give the steadiest levels. I remember seeing graphs and numbers with the taking of oral estradiol, and levels seemed pretty steady overall, even over the course of 24 hours but results may vary from one study to another and from one individual to another.

On injectable estradiol, my levels weren't steady at all, with numbers being around 2,500 pg/ml on day 3 and then down to 1,300 pg/ml on day 5. My own results seem to be consistent with findings from studies with injectable EV (estradiol valerate) where levels drop relatively quickly over the course of a few days in contrast to Estradiol Cypionate which appears to give steadier levels which drop at a far slower rate.

That being said, you and your doctor need to decide together on the best course of treatment for you based on your own individual responses. Best of luck! :)

I am 64 and have been on Estradiol for almost a month with no problems.
I'll be on it the rest of my life.
With the help of a good doctor who monitors your health as you transition, you will be fine.
I have more problems and concerns with the Spironolactone and plan on an orchie in September when Medicare will pay for it.

Sooo I received my new prescription today "not picked it up yet", I am moving from Evorel patches to Progynova tablets daily.

At 46 I'm worried about the complications still but needs must as the devil drives. I'm not asking for medical advice here just some reassuring from others in my situation...I'm only concerned becaise apart from the 1 hour exercise I do daily, I am working at a desk for most of the day. What's the verdict here lol.

I'm 56, as of yesterday ;D, and have been on oral for just over a year. Labs always great, estrogen stays high and have had no ill effects we can see or measure. I'm feminizing nicely on oral as well.

Quote from: Wanda Jane on January 15, 2018, 12:04:41 PM
I'm 56, as of yesterday ;D, and have been on oral for just over a year. Labs always great, estrogen stays high and have had no ill effects we can see or measure. I'm feminizing nicely on oral as well.

Thanks gorgeous that is very reassuring x

Quote from: Nooms on January 08, 2018, 05:54:57 AM
Hello peoples, it's been awhile x

I have now been on HRT for just over a year and have been on Evorel Patches for the entirety but I get really bad rashes from them as I am very active, not to mention the fact they don't always stay put, especially after vigorous exercise.

My Doctor has now suggested changing me over to Oral HRT but I am a little concerned with this option as I am 46 years old and have been lead to believe that this could be hazardous for someone in my bracket.

Anyone here have any advice, experiences etc of the pill form at the upper age range?

Love to you all

Naomi

Naomi,  I am your age and have been on oral Estradiol for 4 months.  I discussed risks with my Endo when I started and based on my blood work and medical history he felt the risks were very low for me. 

I don't think you should worry, especially if you have a doctor experienced with trans patients. 

Also, we are not "upper age".  LOL

Although younger than you, I took very high doses of oral bio-identical estrogen for several years and everything was fine, blood test results came back normal. My doctor agreed to continue prescribing it as long as it appeared it didn't harm my health in any way. Studies also suggest it might even be relatively safe (as compared to non bio-identical forms) in older individuals so that is indeed reassuring. :)

Thank you all for the many reassurances regarding the change over. I have been on the new regime for a little over 2 weeks now and seem to doing fine. In actual fact, body changes seem to have kicked up a gear. I guess, regarding the patches, with all the exersise I was probably loosing a lot of E through sweating. Oh well, onwards and upwards x

Quote from: Becca Kay on January 16, 2018, 10:20:16 AM

Naomi,  I am your age and have been on oral Estradiol for 4 months.  I discussed risks with my Endo when I started and based on my blood work and medical history he felt the risks were very low for me. 

I don't think you should worry, especially if you have a doctor experienced with trans patients. 

Also, we are not "upper age".  LOL

"Upper Age"? Life is just beginning girls!
I'm 46- and I feel better now than I have in years. I've been on HRT for 6 weeks and when I was running 25mi a week and in the gym every other day, I didn't feel this good.
I was concerned about family health history also- my sister is  abreast cancer survivor and my mother had (self induced) high blood pressure. But I have a clean bill of health and it's full speed ahead. [emoji1380]
-Christyn


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