Susan's Place Transgender Resources

Hi Susan's Place! I'm new here, I hope I'm posting the right way-

I should preface this by saying: I am NOT looking for medical advice. I already have a doctor appointment scheduled in 2 days as well as bloodwork labs and an appointment with one of the people they allow me to schedule with at FOLX in 3. I'm simply looking for someone, anyone who has experienced the same thing as me so I can feel better knowing at least that my symptoms aren't bewildering.

Recently, something unfortunate has happened to me. I am 18 and I recently was prescribed Estradiol Valerate for the first time— my first HRT dose ever. I was prescribed 5mL with a concentration of 40mg/mL, to take .3mL every week.

However, I am a little stupid, and on the day I injected it, I mistakenly injected 3mL. 3 whole milliliters.

At first I didn't feel too bad. Was a little under the weather for a few days... then, after I got home on Sunday from my dads, I had an extreme panic attack, felt nauseous, couldn't eat dinner, and vomited later that night.

The next morning, (and remember this) I woke up with intense shivering and a high heart rate. I went to the ER and vomited again when I got there. They ran some tests on me including bloodwork and a CT scan, and found nothing of importance other than that I was acutely constipated.

It has been 5 days since this, and the dose of EV was about 11 days ago. Since Monday, I have been consistently waking up every morning with the same issues: shivering, vomiting, and constipation related bowel movements. During the day, the nausea goes away, but I feel dizzy and disoriented. I don't have motivation to do anything, my vision is blurry/dizzy making it hard to read on occasion, and it's often difficult to eat without gagging every time I chew (though this improves spontaneously before regressing again. I have no idea why. It could be related to bowel movements, since I also notice I vomit less if im able to... defecate more).

Some of my symptoms scare me, since they sound similar to a brain tumor (I know irrational but my hormones are making me freak out rn. I wake up every morning with the fear that I am going to die early and lose everything).

Has anyone else experienced this? How long does it usually take for these symptoms to stop? They have continued for 6 days now. Is it unusual that they happened so soon after my dose, or do you think it's normal considering how much I took?

Hello Amber,

I'm Lori Dee. Welcome to Susan's Place!

We strive to make this a safe place to find information and share your thoughts and comments. No matter who you are, you are always welcome at Susan's Place.

I am no doctor, and your doctor is the one to answer these questions best because they know your medical history better than some stranger on the internet. I do not believe your symptoms are related to your hormones. You said they checked your bloodwork and found nothing unusual. When women become pregnant, their hormone levels skyrocket as high as ten times higher than their baseline levels. Don't panic. Talk to your doctor and see what they say.

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~ Lori Dee
Forum Staff

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@AmberRMM
@Sarah B
@Northern Star Girl

Hi Amber — and welcome. I'm glad you posted.

You're not alone in making a dosing mistake; it happens more often than people admit. For context, 0.3 mL of estradiol valerate at 40 mg/mL is a small depot shot. Three milliliters at that concentration is a very large depot (about 120 mg of the valerate ester), and it's delivered in oil that releases slowly. With EV, levels typically rise over several days and then taper across one to a few weeks. Because of that slow release, it's plausible for symptoms to appear a few days after the injection and then wax and wane for a while rather than hitting all at once.

What you're describing - the morning shivering, nausea, vomiting, and digestive issues - could potentially be related to the significant hormonal fluctuation from the overdose. Estrogen can nudge the nausea center, slow gut motility a bit, and affect temperature sensation and heart-rate perception. Anxiety can amplify all of that, especially first thing in the morning when many people feel more keyed-up physiologically. The "morning is worst, improves later" pattern you described is consistent with a systemic reaction and with how a long-acting depot can feel as it peaks and settles.

The ER finding of constipation fits the picture you noticed yourself; when the bowels move, nausea often eases. The fact that your symptoms follow a daily pattern is actually somewhat reassuring - serious conditions typically don't cause such predictable cyclical symptoms. Your anxiety about this is completely understandable, but the timing and pattern you're describing sounds more consistent with how your body is processing the excess hormones.

Two practical thoughts to carry into your upcoming visits: be fully specific about the volume and concentration you injected so they can interpret labs and advise on timing for your next dose, and let them know the daily rhythm of your symptoms. The fact that your tests were otherwise unremarkable is reassuring, and the time-course you've described matches what a large EV depot can do as it gradually clears.

You did the right things—got checked when you felt terrible, scheduled follow-ups, and reached out for community perspective. This rough patch should pass as the depot declines, and your clinicians can help you reset to a safer, steadier regimen. You're going to get through this.

Take care of yourself,
—Susan

Hi Susan!! Thank you so much for this. This was the most reassuring thing I've heard in days, and I cried a little after reading it. This means so much to me.

I do want to ask though; are my symptoms of light headedness, sensitivity to light, and dizzy vision to be expected? I also tend to often gag when trying to eat food. Is this just morning sickness? Also, are you familiar with high levels of systemic estrogen causing constipation?

Hi Amber

My name is Sarah and I would also like to formally, Welcome you to Susan's Place!

I see that other members of Susan's have also welcomed you as well.

You did the right thing by getting checked when you felt unwell and by following up on your care.  Remind your doctors what you took and the timing of your symptoms so they can give you advice that fits your situation.

Susan offered a good reminder that your own doctor is the best person to guide you.  Her message was meant to calm worries.  One tweak is worth adding here.  Very high estradiol from a single large depot can feel quite different from the gradual changes that happen in pregnancy so only your clinicians can judge whether your recent symptoms match a hormonal surge or something unrelated.

It is good to hear that your symptoms have eased.  Many people find mornings harder during a rough patch then notice improvement later in the day.  Keep noting what helps.  Keep hydrated.  Use gentle foods as tolerated and lean on the plan you already set with your care team.

Two other things to consider:

• Late pregnancy estradiol can rise hundreds to about a thousand fold over nonpregnant levels so do not use a tenfold figure to dismiss symptoms.  Keep your appointments. 
• Ask whether the ER measured hormones.  ER panels usually do not include estradiol so normal basic labs cannot rule out a reaction to a large estradiol valerate depot.

Keep your appointments with your doctors and let them know what happened exactly.  Ask when it is safest to resume your regular dosing then follow your doctor's guidance on the next steps.

You are not alone.  Dosing mistakes happen.  You acted promptly and you are doing the right things now.  We are glad you are here.

Once you feel comfortable here, it would be appreciated if you add a little bit more about yourself in the other forums and threads.   I would appreciate it very much as, I'm always interested in learning something new about new members.

In addition members of Susan's will more than likely will discuss problems or issues that are similar to yours as most have experienced these issues as well.

Please keep in mind when posting that this is an ALL AGES PUBLIC Forum and the internet never forgets.   Do not post anything that you do not want to be made public.

Take care and all the best for the future.

Once again, Welcome to Susan's Place!

Best Wishes Always
Sarah B
Global Moderator
@Susan @Northern Star Girl@Devlyn  @Jessica_Rose  @Mariah @Lori Dee
@AmberRMM

Quote from: AmberRMM on Yesterday at 11:50:41 AMHi Susan!! Thank you so much for this. This was the most reassuring thing I've heard in days, and I cried a little after reading it. This means so much to me.

I do want to ask though; are my symptoms of light headedness, sensitivity to light, and dizzy vision to be expected? I also tend to often gag when trying to eat food. Is this just morning sickness? Also, are you familiar with high levels of systemic estrogen causing constipation?

Hi Amber,

I'm so glad that first response helped ease some of your worry. The symptoms you're asking about now - the lightheadedness, light sensitivity, dizzy vision, and gagging when eating - can indeed be part of the picture with a large estradiol depot.

High estrogen levels can affect the vestibular system (your inner ear balance center), which could explain the dizziness and visual disturbances. Light sensitivity can happen when you're already feeling unwell and your nervous system is hypersensitive. The gagging with food is likely connected to the same nausea pathways being activated - your body is still processing this hormonal surge.

Regarding constipation and estrogen - yes, estrogen can slow gut motility (the movement of food through your digestive system), especially at high levels. This is why you've noticed the connection between being able to have bowel movements and feeling less nauseous. When things get backed up, it can worsen nausea significantly.

What you're describing does sound similar to what some people call "morning sickness" - that combination of nausea, food aversion, and digestive issues. The timing and pattern you're experiencing (worse mornings, gradual improvement through the day) is very consistent with how a large, slow-release hormone depot behaves.

Keep staying hydrated, try small frequent meals of bland foods when you can tolerate them, and gentle movement can sometimes help with both the dizziness and constipation. Your upcoming appointments in the next few days will be crucial for getting your levels checked and planning your path forward.

You're handling this with remarkable maturity, and these symptoms should continue to improve as the depot clears your system.

Be well!
— Susan