Susan's Place Transgender Resources

Hi i have general questions of estradiol levels

I am just curious about peoples opinions and any anecdotal related thoughts.

I started hrt via diy was taking spiro and estradial gel for about two months

Then went in to a nurse practitioner to get on gender affirming care

My first labs were like 20 pg/mol estradiol i think and like 180 for testosterone i think

Then they prescribed 3 mg sublingual estradiol.

I asked for oral vs gel they seem to be willing to prescribe what type you want to take oral etc

My next labs were 120 pg/mol estradiol and like 20 testosterone

They changed my dose from 3mg once a day to 4mg i asked if i could take it twice a twice a day and they said yes

I kinda feel like i should of asked to take it three times a day

Idk if twice a day is normal but since i stopped taking spiro and only estrogen i kinda feel more tired during the day wondering if i should take it more like if i am tired from peaks of estrogen then it dropping down

My next blood labs isnt until February

I also felt tired from just 3mg of estradiol and started taking spiro with it for a bit before my second blood labs to see the difference with or without i def felt better minus the having to pee i didnt tell my nurse practioner as i stopped like 8 days before my second blood labs which it shouldve been out of my system not affecting the test

So this time i am dedicated to not taking spiro in case it affected the blood labs

But still i feel tired before the end of the day my routine is 2mg at 8am and 2mg at 8pm

So is this from peak estrogen and dropping down i need to ask for more to take at noon maybe

Idk just wondering whats normal

Thx

Hello Billie,

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

Thank you for joining us.

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

As you may have learned, DIY rarely produces satisfactory results. The body's hormone system is very complex, and each hormone affects the balance of the others. When first starting, it is wise for your provider to prescribe lower doses. This allows your body to adjust, and for your provider to see how big a dose you might need to achieve the levels necessary. So maintaining a consistent dose is critical for your labs to be accurate.

Your provider needs to know what you are taking, at what dose, and how often. Then they can make adjustments from there. It is very important to work with your provider on this. When you try to manage it yourself, you can cause problems that can affect your development and other hormone levels.

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@Billiefromorygon
@Sarah B
@Northern Star Girl

Your def right about dont use the diy method. Well another few months until the next test. i think ill have to ask her about trying 3x a day dose see what she says. If she agrees hopefully it helps to level out throughout the day

I've never felt tired from adjustments to my E levels so could be something else at play you need to look into with your provider. Maybe you're adjusting to not having so much T, but it's guesses so maybe good to get assistance if you're not sure yourself.

Sublingual does give stronger but more fleeting  results so more sensitive to gaps in doses. I'm upto 6mg with a strong blocker now. I just do 4mg in morning then 2mg later. But everyone is so different in this respect.

Charlotte 😻

Hi Billie

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.

Thanks for sharing your journey so openly.  First of all, well done for moving from DIY to supervised care.  As Lori often reminds us, it really is best to have expert guidance for HRT.  DIY can feel like the only option at first, but having a nurse practitioner involved means your levels, safety and overall health are being looked after properly and that is a big positive step.

From what you have written, it sounds like you are very much on the right track.  Going from very low estradiol to around 120 pg/mL, with testosterone down around 20 pg/mL, is exactly where many people on feminising HRT aim to be.  So seeing your labs move in that direction is encouraging.

It is also great that you are advocating for yourself and asking questions about oral versus gel, dose changes and how often to take it.  That shows you are engaged with your care, which really helps.  Splitting doses can make sense for some people with sublingual estradiol because levels can rise and fall through the day, but this is exactly the sort of thing to work through with your clinician.  If you are thinking about three times a day, bring it up at your next visit, explain how you feel and see what they recommend based on your labs and symptoms.

I have had a similar recent journey in regards to my hormones and I have been on them for neigh on 37 years and the last two years has seen me go from tablets, to gel and finally implants.  It was frustrating to say the least as I wanted to retain an average level of 400pmol/L (Australian units) 120 pg/mL ≈ 440 pmol/L.  Hopefully, my labs will be okay.  I will know in 3 months and 6 months time when I'm due for a replacement implant.

I also want to say, you deserve some praise here.  You recognised that DIY was not ideal, you sought proper care, your levels have improved nicely and you are thinking ahead about how to optimise things safely.  That is a lot of progress in a short time.

Keep doing what you are doing, stay in dialogue with your nurse practitioner and give your body time to adjust.  Everyone responds a bit differently, but from the outside it really does look like you are moving in a good direction.

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.

Wishing you all the best as you continue on HRT and take care and all the best for the future.

Global Moderator
@Devlyn  @Jessica_Rose  @Mariah  @Northern Star Girl  @Lori Dee
@Billiefromorygon