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My Endo changed my estrogen and moved me to gel. He is concerned about oral estrogen going through the liver so he switched me to gel. What I was wondering is if any ladies here who are on gel apply it to the breasts ?

If so do your numbers still stay stable ? Does it help you with breast growth? I have only been on the gel for 2 or 3 days and I was told to apply it to the upper arms. When I get my blood tests done again in 2 or 3 months I'll see if my numbers stay fairly stable. I am fairly desperate to get some breast growth so I hope that estrogen directly to the breasts will help with that.

Though if someone here has already tried that and their numbers went down then I will stop before my next blood test.

I've been on gel for almost a decade. My endo at the time took me off the pills due to a high cancer risk in my bloodline. My numbers have been fine. I also saw growth in other areas where there wasn't any before. (Particularly when it came to the hips) The breasts didn't change much. BUT, that is probably just genetics since my mother isn't the most well-endowed woman.

Unsurprisingly there are lots of thoughts regarding transdermal Estrogen products applied directly to the breasts on the internet . One is that it can increase the risk of breast cancer. The minimal research I did suggested this isn't really a big increase in risk, but bare in mind manufacturers don't recommend application here. What I did find is that its apparently not optimal due to skin thickness and fat tissue storing and delaying release which can reduce efficiency.

In reality if E levels are in the correct range then location of application, or higher / lower levels don't affect breast growth. Most important is suppression of T followed by being in range with E.

I'd recommend just applying on the arms or thighs as most instructions suggest.

Quote from: Charlotte Kitty on July 10, 2026, 10:58:22 AM....or thighs as most instructions suggest.

Yeah, I remember reading the instructions once I started using it. I've always stuck with that.

There is information around saying applying it to the scrotum can increase absorbtion (that is if you have one)

I think I read about it in the hormone section

I have not been on the estrogen gel or patches.

The key is to apply to thin skin. So, technically, you could apply it to your eyelids, but I would not recommend it. Here in the U.S., prescription meds come with an information brochure about application sites. In the one that came with patches, there was detailed information about the studies they had done to determine the best site location and the benefits and drawbacks. I would follow the directions exactly.

You don't want to risk your health, then have a problem where you need to explain why you didn't follow the directions. When your lab tests are done, healthcare providers use the results to make adjustments. If you are using a product in a non-standard or non-recommended way, it could skew the results and give the providers misleading information. They can only work with the information they have available.

Don't play games with your health. When in doubt, follow the directions.

Blood-borne hormones are chemical messengers released by endocrine glands into the bloodstream. They travel throughout the body but only exert effects on target cells, which are cells equipped with highly specific receptor sites that recognize and bind to the hormone..   This means that topical application of estrogen has zero effect on the site of application. Think about how it works in a human who produces estrogen from ovaries.. they are releasing it into the bloodstream - that is what you want.

What you need is a quick absorption into your bloodstream to get the greatest effect of the replacement hormone treatment - usually this is your arms or thighs.. exactly as directed in the instructions. Its not magic growth gel!!

I have been on Gels for years, mostly sticking to the manufacturers recommendations, but I read that it was more effective applied to the inner forearms below the wrists, where the skin is thin and there are a lot of blood vessels. I tried it and my levels did not change. I believe it would enter my system more quickly from there, but overall does not make a difference. I still mostly apply it to my thighs, but if I don't have time to sit with my legs bare while it dries, I do apply it to my forearms.

Hugs,

Allie

Quote from: Allie Jayne on July 13, 2026, 10:04:40 PMI have been on Gels for years, mostly sticking to the manufacturers recommendations, but I read that it was more effective applied to the inner forearms below the wrists, where the skin is thin and there are a lot of blood vessels. I tried it and my levels did not change. I believe it would enter my system more quickly from there, but overall does not make a difference. I still mostly apply it to my thighs, but if I don't have time to sit with my legs bare while it dries, I do apply it to my forearms.

Hugs,

Allie

I just do it while in the bathroom. 😄

I use an Oestrogen gel called Sandrena.

It was recommended by my Dr after taking oral medication for many years.
 
When taking any oral medication, it goes through the kidneys and liver and long term can have adverse effects and long term damage.

I apply the gel to the tops of my thighs and have had no issues whatsoever.

As I am having GRS on 6th August, I will be stopping hormone treatment 2 weeks prior and then recommence on the surgeons instructions, generally 7 days after.

I like the gel application.

Quote from: SoupSarah on July 13, 2026, 09:39:02 PMWhat you need is a quick absorption into your bloodstream to get the greatest effect of the replacement hormone treatment - usually this is your arms or thighs.. exactly as directed in the instructions.

True. Yeah, experimenting with where you apply it isn't a good idea. Gotta follow those directions, yo.

Quote from: Laura Squirrel on July 14, 2026, 10:41:14 AMTrue. Yeah, experimenting with where you apply it isn't a good idea. Gotta follow those directions, yo.

^^^^^ This.

Remember, people... going to the doctor doesn't make you a doctor. Follow the medical advice.

Quote from: VictoriasSecret on July 14, 2026, 04:04:46 AMAs I am having GRS on 6th August, I will be stopping hormone treatment 2 weeks prior and then recommence on the surgeons instructions, generally 7 days after.

I like the gel application.

I prefer gel too.. and good luck with the grs..
On that - this is a WHOLE other bag of kippers.. stopping hrt prior to surgery.. I questioned this and my surgeon agreed (in my case, with my medical history) to not stop my hrt at all during surgery.  Personally, i cam find no medical evidence other than anecdotal advice given out by insurance backed pharmaceutical companies advising stopping it..  Cis-females cannot (on the whole) turn of their estrogen production and even on HRT they are seldom requested to stop taking it before surgery.. Gels and injections now tend to be 'bio-identical' estrodial as opposed to the old animal based/extracted hormone (originally from horse urine,YAY!- glad they stopped that eh?). My experience (YMMV) was there was no adverse effects from stopping hrt and I strongly believe that if I had stopped my hrt I would of suffered the effects of that hormonal withdrawal. The human body is designed to run on these hormones (regardless of chromosomes) and life is generally enhanced with them in our bodies. I would urge everyone facing GRS to talk to their surgeons about not stopping hrt and weighing that up against the downsides of stopping. Obviously follow medical advice, but do not be afraid to question such things.

Quote from: Devlyn on July 14, 2026, 11:03:42 AM^^^^^ This.

Remember, people... going to the doctor doesn't make you a doctor. Follow the medical advice.

THIS! THIS! THIS!!

By the way, this isn't directed toward anyone here. But it is directed at my annoying mother. Ugh. I really wish I could get out of this friggin' state and move as far away as possible.

Before my FFS they told me to stop HRT 2 weeks before. I stopped it 2 days before and restarted 2 days after. Not recommending people ignore advice, but some sources suggest there is no evidence that it makes any difference in outcomes.

For HRT I only have my own medical advice, the NHS aren't interested!

To add to Soup Sarah's post, not stopping hormones in the perioperative period is not just hearsay or kippers, but has support from trans researchers like the University of California San Francisco. The practice of stopping originates from an old study on cis women using synthetic hormones (Women's Health Initiative) but those old hormones had elevated risks not present in modern bio identical hormones.

Study link and excerpt:
https://transcare.ucsf.edu/guidelines/feminizing-hormone-therapy

There is no evidence to suggest that transgender women who lack specific risk factors (smoking, personal or family history, excessive doses or use of synthetic estrogens) must cease estrogen therapy before and after surgical procedures, in particular with appropriate use of prophylaxis and an informed consent discussion of the pros and cons of discontinuing hormone therapy during this time

I had to stop and suffered significant menopausal symptoms during my hospital stay which altered the care I was given. My specialist nurse apologised for putting me through this and forced the surgeon to update his knowledge and practice. More and more surgeons are allowing patients to continue HRT through their operative period, so it is worth being informed and asking your surgeon to update their practice.

Hugs,

Allie

Hi Everyone

I started hormone therapy in 1989 with Premarin, yes, the medication made from horse-derived estrogens that is still available today.  I remained on Premarin until it was replaced with Progynova.  I do not remember exactly when that change occurred, but I believe it was around 2012.  During that period I also had hormone implants on a couple of occasions.

About three years ago, when I began seeing my current doctor, she suggested changing to either patches or gel.  I decided against patches because of swimming and other practical issues.  I then tried the gel, but I found it messy and did not like that method of application.

Eventually I returned to hormone implants.  I am now very happy with that method and the levels I'm getting are good.

So after Premarin, Progynova and gel, the implants win by a mile and leave me smiling.

Best Wishes Always
Sarah B
Global Moderator

Sarah, I am also on implanted pellets as they are the most regular dosage available. Australia, like most countries, does not have a commercial supplier, so we get our pellets from a compounding chemist, and they can work out a bit more expensive than other forms of Estrogen. I do love not having to worry about taking hormones for more than a year!

I am currently using Sandrena Gel as a top up as a couple of years ago I started a new drug regime after a health incident, and it messed with my blood levels, so we have gone back to the lower dose pellet and a supplement until my levels are consistent and then it will be all pellets!

Hugs,

Allie

Hi Allie

I should of included what I was using for reference so here goes: Oestradiol 100mg 4.5mm.  You are right its expensive starting from around $100 (US $70) to around $200 ($140), but its worth it in the long run.  No mess no worries.

My last implant was just over 6 months ago and my level was around 350 picomoles per liter (pmol/L) so I was ecstatic about that.  I have the prescription for my next one and I will get it done sometime after August as I other commitments.  As long as I'm around 400 pmol/L.  I will be grinning like a Cheshire Cat.

Best Wishes Always
Sarah B
Global Moderator
@Allie Jayne

Quote from: Sarah B on July 14, 2026, 07:43:28 PMSo after Premarin, Progynova, and gel, the implants win by a mile and leave me smiling.

I think I asked my endo at the time about implants. But, I declined since it would require another out of town doctor visit, and I couldn't deal with that. (Can't drive) It took forever to get 3 of my 4 docs locally. So, I don't know. I already saw my endo, and I didn't think about bringing that up. Until I saw what you read, I hadn't thought about it in several years.

For those using gel, how long does it take to dry and does it wash off with perspiration?

Quote from: Petunia on July 16, 2026, 04:37:23 PMFor those using gel, how long does it take to dry and does it wash off with oerspiration?

Dries in about 1-2 minutes. Wouldn't want to sweat or wash for at least an hour really.

The liver thing is surprising. I mentioned having trouble getting them to dissolve under my tongue and my doctor told me yesterday that the modern Estradiol don't cause liver problems. She said they don't even check liver function anymore. Now I am concerned that she is wrong.

The liver issues are with oral tablets that dissolve in the gut. They are processed by the liver before entering the bloodstream. This is known as "First Pass". The liver metabolizes the hormone, reducing its effectiveness. This process also affects coagulation factors, which underlie issues with blood clots and stroke.

This does not apply to sublingual, transdermal patches or gels, or injectables because they are absorbed into the bloodstream first, do their work, and then are cleared by the liver. High estradiol levels in the blood can still pose a risk, as everything in the bloodstream eventually gets cleared by the liver.

My doctors still monitor my liver enzymes in my lab tests. I haven't taken any oral estradiol tablets since 2021. I was on patches for several years, then switched to injectables. However, the VA likes to test everything.

Your doctor is correct:

Routine monitoring of liver function tests (LFTs) has been removed from both transmasculine and transfeminine Endocrine Society recommendations due to a lack of evidence that hormone therapy causes adverse liver outcomes.

I still have my liver checked for all the other pills I have to take.