So today I have my doctors appointment with my endo. When I first saw her seven weeks ago, I got a new doctor, she said she wanted to switch me to estrogen injections. She told me in general it is a safer because it is less stress on my liver, and if i remember correctly, correct me if I am wrong, less chance of blood clotting. The only thing I am really timid about is that eventually I will have to do it myself and disposing of said needles. So my question to you ladies who have had experience is whether or not there are any other advantages to injections versus taking pills. I've read in the past, mainly anecdotal accounts of people seeing better feminization but I don't know about that? Honestly I am just really curious if there is anything or if I have basically listed the couple reasons why it is preferred.
Yes injections cause less stress on the liver then taking them sublingually and prolly, though I'm not sure, decrease the risk of DVT, which is infinitesimal to begin with. You'll more likely to hit the lottery then get DVT at your age. It's exceedingly rare. So is any liver disorder. There are zero cases of liver disorder in almost every study on MTFs. None. DVT events are like one in a million. And they all occur in persons over 40.
That being said injections provide are more steady state of E in plasma then pills but less then pellets, which are the gold standard but too costly for most. Pellets prolly provide better femininzation, or faster, but the jury is out on pills v. injections. All in all, injections are prolly better if you can get them. I wouldn't worry about doing it yourself. It is just a fear and you'll get over it. I mean if there was only one way to do this and that way required injections, wouldn't you do it? But you can prolly just go to the clinic ever week. That's what my friend does.
Quote from: Joanna Dark on August 02, 2013, 10:04:59 AM
It is just a fear and you'll get over it. I mean if there was only one way to do this and that way required injections, wouldn't you do it? But you can prolly just go to the clinic ever week. That's what my friend does.
I have a severe aversion to needles, but you're right - if that were the only option - well then I'd get over it. :)
One advantage to them is that you get to stab yourself under medical advisement! How cool would that be?
I've thought about injections, but considering I'm unable to afford one of those doctor people currently, I'm stuck with what I can get for now.
Less chance of clotting / DVT (this increase's with age) if on pills
more "actual" estrogen getting where it needs to go, no 2nd pass unlike pills
I switched and noticed a change.
but there are cons, seems more than the pros actually imo
for me its my insurance doesn't cover injectable's, where as if I go get the pills hey cost me 10 bucks
than of course it can be a pro if insurance doesn't cover for you or you don't have insurance as it cost ( me) 60.00 for 2 months
other cons - chance of bruising yourself via needle, the high and low effect on your mentality, pain in the butt (no pun intended)
I decided to go with injections because, chance of change even after being on pills so long, less chance of clots and dvt (i'm getting older)
don't have to do it everyday (once a week for me)
I was doing injections every other week at the Kaiser Hospital injection clinic in town. It was no problem having someone else to them, but I'm self injecting now and it really isn't bad. No visits to the hospital, no daily pills, no weekly patches that fall off, and once it's done it's over with.
There is a big roller coaster effect from injections because the estrogen falls way low near the end of the two weeks. It takes some getting used to, but gave me weird angry depression in the last two days of the cycle, and then a weird euphoric mood spike a day after the injection. It's been compared to a woman having a period every two weeks instead of monthly, and if that's how my wife felt for all those years I can't apologize enough for not understanding. The roller coaster has flattened out a lot since the doctor ok'd weekly injections, with half the dose. And for me nothing is better, cheaper, safer and less of a problem overall. I love it and won't do anything else now.
Yes, needles are long and a little scary, but once the spot on your thigh is cleaned and the syringe is ready, you just stab it in. Takes a while to push the oily liquid into the muscle and that's the only part I don't like, but when it's done there's no pain or after effect (except the E starts working it's wonders).
There is faster development, and a couple bras no longer fit me well, but when I finally loose weigh maybe they'll fit again.
As for used needles just get a Sharps Container from a pharmacy for a few bucks, and return it when it's full to any pharmacy and sometimes you get a free refill. They're big and will last at least a year.
And there is a very slim chance of hitting the sciatic nerve if you give yourself a shot in the butt. So I don't do it only because I've met one FTM who had that happen him, and he was laid-up in pain for two weeks.
Anyway, so glad to hear the endo offered you injections, and hope it works out.
Kathy
Injections do put less stress on the liver and all, compared to swallowing pills. But you know, there are lots of other delivery methods, and they all put less stress on the liver compared to swallowing pills. Including putting pills under your tongue. So if you're scared of injections, it's not like it's your only option at all.
So just had my appointment with my doctor and got my first injection, woo hoo! It went smoothly, didn't hurt but just felt really weird. Was nervous as all hell to touch the needle the first time so I had her show me and then do it for me. I believe next time I will be a big girl and do it myself. Really wonder how I will feel with these injections.
I strongly suspect the whole thing is nonsense in the way any good convincing nonsense is.
By which I mean, there is some truth to it, but its been dragged out of proportion to the point of being almost a myth.
Allow me to clarify. I am sure it is true that injections have a lower risk of long term complications to your liver. But while that part is true, you have to keep these things in their perspective and context.
If you are a young otherwise healthy person with no outstanding reason to be concerned about hepatic problems, the likeliness of you having any kind of permanent hepatic (liver) complications in the course of oral HRT are pretty unlikely. I mean keep this in mind, the medical community routinely keeps people on oral medications that are specifically indicated as being potentially dangerous above the average to the liver, for years and years. Obviously the reason for this is often that the risk to you from the hepatic complications are not as great or serious as the risks to your health from not getting the medication, which may be unsuitable or cost prohibitive to provide as an injection.
Now keep in mind that bioidentical HRT, and spironolactone (however not cyproterone) is not especially indicated for liver toxicity. Now of course that doesn't rule out the possibility that it can cause liver or other organ damage in the long term or exacerbate damage from other causes, it simply means it is not especially likely to do so compared to other oral medications more broadly.
Now I'm not saying there are never reasons people would be best to use injections over oral medication. Older people and especially older people with existing liver complications or a history of potentially liver damaging behavior (drinking, some drugs, obesity perhaps) may well be serving their health much better to start with and use injections.
But if you're not in one of those higher risk brackets (something you should discuss with your doctor), then despite what you hear, oral HRT is not especially dangerous. It is not risk free either, but risks must be sensibly evaluated with respect to the overall picture.
Using injections when you are have no outstanding risks and injections are costly for your economic status or too mentally distressful for you, simply because oral HRT is supposedly so dangerous, simply doesn't stand up to the science currently available as I've seen it.
Of course by all means you should verify things you read and discuss them with your likely better experienced and trained doctor. Just keep things in perspective.
Then of course there's the question of injected HRT efficacy. Are injections better for your transition goals than oral HRT?
Again I don't think the science stands up. Let me put it this way, ultimately the general point of taking a drug is to have that drug enter your blood stream so your cells can interact with it. So assuming the drug is chemically the same with all delivery methods, or metabolizes into the same drug, and isn't affected by first pass metabolism in a way that would reduce effectiveness. Then provided your blood levels of the drug are the same over a similar course of time, there's no obvious reason one should be more effective than the other.
Ultimately what's required is competent and initially frequent blood tests.
And of course there are many many more subtle factors with all of this, this is only intended to provide a general picture of the situation.
And of course none of this means if you can afford it and injection is your preference that it's not worth using.
Were injections especially expensive? The last time someone told me about that (although it was testosterone he was talking about) it was surprisingly cheap.
It is all a bunch if crap. Funny I used to work in healthcare helping trans people. I myself transitioned years ago. I have NEVER EVER EVER herd of anyone suffering damage from taking an acceptable dosage of hormones.
You want to go on and on about what way to take them is best makes me wonder why? What is the next thing to discuss. What doctor is best..........regardless of the fact that all of the well known doctors do a good job. I mean really people.
The world is filled with those that do and those that don't. Which one are you?
Katie
Quote from: A on August 03, 2013, 10:12:21 AM
Were injections especially expensive? The last time someone told me about that (although it was testosterone he was talking about) it was surprisingly cheap.
not out of pocket without insurance - 1 month of hormones via pill form no insurance is 75.00 usd, 1 vile of hormones is 60 and gives me a 2 month supply, now with insurance it is more expensive.
I get my lady juice via injections. You get use to the injections, and when I started I was afraid of needles..
I got over that, so much I am even planning on getting a tattoo done
My doctor did explain the health benefits, it was pretty much what has been said here, I get mine done weekly, at a clinic. quick and easy.. I do find that I feel more emotional a few hours after the injection, that might be linked to the sudden influx of estrogen.. but that passes.
The results are amazing on my body..
I took injections for several years for the majority of my time living as a woman. They are abit of a pain... Personally I have no preference between injections and the tablets that I'm now on.
Biggest pain about injections is injection time... It's just hassle and fuss and I hate fuss. You have to prep all sorts of stuff ahead of time to make sure it's done safely And jamming a needle in your leg I'm not scared of it. I've done it hundreds of times but part of you doesn't want to jam a needle in yourself as a natural aversion and the other half just can't be arsed... Really difficult to get motivated for it.
The worst part is if you don't do it, You get depressed and crabby and then you REALLY can't be arsed.
Biggest pain about tablets for me is having to go back to the GP and get more... which takes over 3 weeks given how crap the NHS is.
Part of me just wants to keep stocks of both about the place so I can do whatever I feel like at the time but I know mix and matching like that is not advised for obvious reasons.
GIF MOI IMPLANT NAOW PLIX!!!
What is the pricing of the "pellet implants" that I keep reading about on here like? Something more substantive than "expensive" would be very helpful. I'd probably be willing to pay up to $600 (maybe $1K) for a pellet that would last 6 months.
Joules: That's awful. At this point, with so many states and countries and whatever-you-call-it-territorial-authority's recognizing and covering that sort of treatment, some of them publishing official, government-made recommendations for how doctors should prescribe HRT for trans people... it's really hypocritical for them to be calling this off-label use.
Why about patches? They work for me and are easy and steady.
Quote from: Just Ole Me on August 12, 2013, 09:14:53 PM
Why about patches? They work for me and are easy and steady.
Patches work in theory. But in practice I hear they come off or don't stick enough and so don't always deliver the neccesary dose of estrogen. But if they are working, then that's all that matters. It doesn't matter how you get estrogen in your system, what matters is the E-toPlasma ratio in your blood. A good female ratio and you feminize. Having more E in your system isn't the goal, getting a steady dose that "turns on" the E receptors is. Basically pellets are the best and then injections but pills are good too. I plan to go on patches after a couple years of feminizing. But maybe not. I do like the pills. I like transitioning.
I started my transition with pills, at a very low dose and gradually worked my way up in dosage. Very quick & easy, no mess and you can do it in public if you're out and about all day.
Over a year later, moving to Seattle, a new doctor suggested that I switch to patches. It was one less pill to take a day but that doesn't really matter if you're already taking a multi-vitamin and spironolactone every day anyway, like I was. I didn't mind them at all, at first but then I noticed the patches would often fall off in the shower or while I was out and about in town. I would try to press them back onto my skin but they just didn't want to stay on well for me. I told my doctor about this and we decided to switch brands to see if that would help but it didn't make much of a difference. The best place I found to place them was just below my waistline, just to the left or right and I would rotate from my front side to my back side each application. I couldn't get them to stay on my arms or legs!
After a year of patches I got a new doctor who has worked with many trans patients. I asked her if she would allow me to switch back to pills since I was having such poor luck with patches -- they certainly weren't working any better than the pills were for me, but my account might not be the greatest comparison since they kept falling off. My doctor asked "how do you feel about injections?" I replied, "I fear needles." She explained the process to me and said that she would set up an appointment for me to take a 'class' on administering needle injections and that she would give me a month to think about it before my next appointment and I walked away with a months supply of pills.
I decided what the heck, if they are easier on my liver and there's a chance that injections would work better for me, why not?
I've been doing injections for close to a year now (bi-weekly) and I have to say that I prefer injections over patches or pills but that's only because I don't have to bother with it but once every 2 weeks and it only takes a few minutes to do for me now that I've had practice. Injections worked as good or better than the previous methods, for me. Mood swings are much more noticeable for me on injections but they are mostly manageable and it's not like they surprise me as it usually happens just before or just after injection.
My insurance has me only paying a small co-pay for either method so cost isn't an issue for me really. The injections cost me a little more but they also last for about 12 weeks instead of needing to refill my pills every 3 & 1/2 weeks.
Like Pebbles said, it would be very convenient to have both pills and injections available at home or in my purse and I could just use whatever is convenient depending on the week/day but I'll second that it's definitely not a good idea to "mix and match" like that.
Pellets I can't speak on as I have no experience with them.
My .02 cents.