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After four years on patches and a long struggle with maintaining high enough E levels and suppressed T, I switched to estradiol valerate injections on last week. The way I've been feeling since my first injection on Friday strongly suggests that levels are different than they've been on patches.

I often had a subpar night's sleep on the night I applied my new patches. Occasionally, it was two nights. Since I injected on Friday, each of the five nights since then have been the same: feeling warm all night, waking up several times during the night, recalling my dreams, which seemed more vivid. In addition, my breasts seem more full and sensitive.

I googled "sleep estrogen levels" or similar and here's what came up:

"The combination of warmer body temperature and reduced estrogen levels during the luteal phase can leave you with fragmented sleep. This reduces sleep quality and leads to more frequent awakenings—especially during the REM phase. Since you're waking up more often during dreams, you're likely to remember them vividly"

The luteal phase occurs in women prior to their period and is a time of higher estrogen levels. Basically, I'm PMSing and my body is "preparing for pregnancy." Wild.

The "warmth" is definitely something I can feel. Not a hot flash, but an overall feeling of being warm.

So it seems that my E levels might be higher and be sustained at a higher level than previously on patches. I won't know until my next blood test, which will be several months away.

Has anyone else experienced this? Did you go away after you got used to the injections? Did you lower your dose? I'm happy at this sign that my levels might be up but I can't continue to have poor sleep indefinitely. I'd love to hear from others who had a similar experience. Thanks.

Quote from: Courtney G on January 14, 2026, 08:44:03 AMAfter four years on patches and a long struggle with maintaining high enough E levels and suppressed T, I switched to estradiol valerate injections on last week. The way I've been feeling since my first injection on Friday strongly suggests that levels are different than they've been on patches.

I often had a subpar night's sleep on the night I applied my new patches. Occasionally, it was two nights. Since I injected on Friday, each of the five nights since then have been the same: feeling warm all night, waking up several times during the night, recalling my dreams, which seemed more vivid. In addition, my breasts seem more full and sensitive.

I googled "sleep estrogen levels" or similar and here's what came up:

"The combination of warmer body temperature and reduced estrogen levels during the luteal phase can leave you with fragmented sleep. This reduces sleep quality and leads to more frequent awakenings—especially during the REM phase. Since you're waking up more often during dreams, you're likely to remember them vividly"

The luteal phase occurs in women prior to their period and is a time of higher estrogen levels. Basically, I'm PMSing and my body is "preparing for pregnancy." Wild.

The "warmth" is definitely something I can feel. Not a hot flash, but an overall feeling of being warm.

So it seems that my E levels might be higher and be sustained at a higher level than previously on patches. I won't know until my next blood test, which will be several months away.

Has anyone else experienced this? Did you go away after you got used to the injections? Did you lower your dose? I'm happy at this sign that my levels might be up but I can't continue to have poor sleep indefinitely. I'd love to hear from others who had a similar experience. Thanks.

My hematologist was initially planning on lowering my Eliquis dose when I saw her on Friday. I take estradiol in pill form and would have had to switch to transdermal patches in that case. I had a pulmonary embolism two years ago from too high estrogen levels, so I have to take anticoagulants with my estrogen.

She decided that because of what I've been through it's not safe to lower the Eliquis. Different people are going to react to the hormone differently.

I can't say I have experienced this, but I would say definitely talk to your provider about this. You wouldn't want your levels to be too high.

For me, it was a mild headache. Not bad, just annoying. It would start the evening that I injected and sometimes last into the next day. Over time, that slowly diminished, and I do not get that anymore. Give your body time to adjust. If it continues for several weeks, talk to your doctor about it.

Keep in mind that PMS-like symptoms can happen when hormones are fluctuating up or down. Just maintain a steady dose, give your body time, and it should resolve itself.

Quote from: Lori Dee on January 14, 2026, 10:35:15 AMFor me, it was a mild headache. Not bad, just annoying. It would start the evening that I injected and sometimes last into the next day. Over time, that slowly diminished, and I do not get that anymore. Give your body time to adjust. If it continues for several weeks, talk to your doctor about it.

Keep in mind that PMS-like symptoms can happen when hormones are fluctuating up or down. Just maintain a steady dose, give your body time, and it should resolve itself.

The symptoms do seem to have lessened over the past few weeks. My breasts are experiencing a renewed level of soreness and feel very full, so more growth might be happening.

So glad you're sleeping better, Courtney!

Apparently (and this is from what I've read) because the pills are metabolized by the liver the half life of Estradiol is extremely short, so really you need to take a pill every couple of hours to keep your levels equal.

The patch is better, but the shot is apparently the best way to go. Even with mono therapy 1/2 of what you would take with the pill will give you a higher Estrogen level then the Estradiol pills and a an androgen blocker.

Quote from: Simplycause on January 28, 2026, 11:08:20 AMApparently (and this is from what I've read) because the pills are metabolized by the liver the half life of Estradiol is extremely short, so really you need to take a pill every couple of hours to keep your levels equal.

The patch is better, but the shot is apparently the best way to go. Even with mono therapy 1/2 of what you would take with the pill will give you a higher Estrogen level then the Estradiol pills and a an androgen blocker.

That's only if you swallow the pills.  If you take sublingually under the tongue or in your cheek, the pills bypass the liver and go directly into your bloodstream.

I know when I first was given ev Injections I would have some pretty high and low moods all happen over the course of the week. The day after an injection moody, about 2 days after I seen to level out, the rest of the time till my next injection I could notice a mental change for the negative. In hindsight I def feel I was experiencing PMS like system and even menopausal systems as my levels reached the lower end a day or so before my next dose.

After almost 8 months of this give or take my Endo finally said I could split the dose and try to inject twice a week for more even levels which should help with the extreme mood from high to lows. Once that happened I did notice a more steady mood vs the big swing I experienced before.

At this point all that was left was getting me in range and at the right dose and combo of supporting meds like progesterone.