Susan's Place Transgender Resources

Hi everyone using Estrogen. I was interested in how most of us take our Estrogen as there is some research on the effects on the liver, and more recent research on which ones are best for breast growth!

I have an implant and take a daily oral dosage. Noticed my breasts are growing more at the moment, but I have no idea if that's because of how I take E.


Sent from my iPhone using Tapatalk

Thanks Ellement!

Did you start on both together, or one first?
BTW great songwriter, Alicia Keys

From what I have witnessed, patches, injection and implant seem to give some great results with pills being a hit or miss.  There is just so much to how our bodies change with steady inputs, that it is really hard to say.  We are each so different genetically.

My endo told me to look at clinical development instead of chasing numbers.  She had seen great results using patches and I have to say that I have loved the development I have received!  I started a 36A and am now a 36C in 15 months.  For that, my E levels never get above 110.

I just started and I am using the patch. so far I have noticed some nice changes in my chest. The fat accumulation started pretty fast. More recently my nipples have risen and the entire breast has gotten a lot more sensitive. still pretty flat and I would say not enough to fill a cup. So I won't even say I'm an A or anything. As I'm just over a month though I'm pretty happy so far.

I started with gel but after a few months I switched to suppositories. I feel better and also my breast development is more noticeable.

Gesendet von meinem MHA-L29 mit Tapatalk

Quote from: Rikigirl on January 08, 2017, 08:15:33 AM
more recent research on which ones are best for breast growth!

I can't say that I have ever seen research on which method provides best breast growth. Do you have a link?

Quote from: kaitylynn on January 08, 2017, 08:57:38 AM
My endo told me to look at clinical development instead of chasing numbers.  She had seen great results using patches and I have to say that I have loved the development I have received!  I started a 36A and am now a 36C in 15 months.  For that, my E levels never get above 110.

Yup.  I've been on HRT 7 months now, spironolactone pills and estradiol via multiple patches.  I've never had an estradiol reading above 50 pg/mL, the lower limit for sensitivity for the particular lab test involved.

In spite of this, the breasts are aching, areolae puffy, and I'm a solid 34B, lifting the center of the bra well off the sternum now. (I gained width for a while, now I'm getting pointy again. :D )

The E is definitely in my system somewhere, doing it's thing.  I'd like to believe I have hungry, hungry receptors busily sucking down the serum levels. :)



Sent from my iPad using Tapatalk

I keep hearing numbers like 34 and 36... wow you girls are "skinny!". LOL!

Quote from: Rikigirl on January 08, 2017, 08:31:15 AM
Thanks Ellement!

Did you start on both together, or one first?
BTW great songwriter, Alicia Keys

Yes I was on oral dosage only first. With the implant came less mood swings which is great, again I'm not sure if it's the reason why my breasts are growing more.

Good to see another Keys fan. :)

Hi Harley Quinn,

The research was done and published by the European Endocrine society! I have been told I am not at high enough level to post links by the moderators, but the study is "Effects of oral and transdermal estrogen on IGF1, IGFBP3, IGFBP1, serum lipids, and glucose in patients with hypopituitarism during GH treatment: a randomized study". It is heavy reading but it is referenced in good page called "Hormonal Breast enhancement" which is a little easier to read on Wikipedia. A search engine should find them for you.

Yes I would love to be 34 or 36, try 38 or 40 for me! T and genetics hits some of us harder.

I hope this helps!

Hugs Riki

Hi Ellement,

From the research that could be the reason! This is the basics of it;

The research done on oral Estrogen indicates it's not as smooth and even delivery as patches, and it does make the liver do more work! These are not as important as the last issue which is that oral Estrogen can reduce Insulin Growth Factor 1 (IGF-1) by 15-40% which is produced by the liver. The IGF-1 levels are very high in teenage girls going through puberty and their teenage years. Once we reach our 20's it gets lower, and lower again as we get older. This helps the breasts to grow so quickly in cis girls teenage years and researchers now suspect this is why mtf transsexuals have smaller breasts than their cis relatives.

Hugs Riki

Would kill to switch to IM but doctor won't let me due to the shortage and don't believe cypionate is supported where I go so just Sublingual tablets multiple times daily T_T I'll just have to continue to "Harrass" my doctor every month and maybe one day he'll give me the good news >_<

Quote from: Harley Quinn on January 08, 2017, 11:22:12 AM
I keep hearing numbers like 34 and 36... wow you girls are "skinny!". LOL!

Sitting here at 42 something with about about 15-20 pounds I could lose before going to an unhealthy weight for my frame/height. If I ever break into the 30's I'd cry for joy T_T

Estradiol Cypionate I.M.

Breasts? Hmmmmm.....a 38AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA....and they hurt anyway, thanks Mom. :laugh:

I use implants but top it up a bit with gel towards the end.

When we did an informal comparison at my TG Support group the result was a vast YMMV. Some women went through several types of E and various delivery methods before finding one that worked best all around.

Just proves once again we are not all the same. Every body is different

I started with the injection and got quick results.. I had A cup breasts at 1 month and B cup at 3 months. I also began to feminize quite quickly. After my injections I was moody for a day or so. After my first two or 3 injections I even got some morning sickness. 

After SRS I started with the implants. IT does regulate my e levels better and I am not so moody after my implant is inserted.

I remember this article. I saw it more as a study on IGF1 and HGH, but still quite a good read! Thanks. :)

Thanks everyone for your responses! It has been interesting to see that many endocrinologists are prescribing less pills and more 'automated' delivery systems. I use multiple patches and find it works well for me although occasionally one will not stay on well!

Riki

Implanted pellets for Estrodiol. Biodentical from a compounding pharmacy for progesterone. And pills for spiro. reminds me I'm out of spiro. Crap.

My doc only uses injections.  Estradiol valerate, generic, should be available everywhere in the US by now. 

So I take weekly injections of E and daily pills of Spiro.

Two months and I'm probably an 34A.  I typically wear 34B with room to grow.  Not over flowing, but no filler either.

Sent from my LG-H820 using Tapatalk

Quote from: JoanneB on January 08, 2017, 06:51:23 PM
When we did an informal comparison at my TG Support group the result was a vast YMMV. Some women went through several types of E and various delivery methods before finding one that worked best all around.

Just proves once again we are not all the same. Every body is different

Hi Joanne,

I have also heard that what works well for one person isn't the same for another when it comes to E! It's good to see there are so many options nowadays!

Riki

Tablets.  I tried to dissolve them sublingually but I could never dissolve them completely and ended up swallowing it anyway.  I have some fat redistribution and breasts are starting to grow and skin had changes substantially at 4.5 months.  I would like to try the shot to see if there is a difference.   I had very low body fat for a male and way low body fat for a female when starting.  I have gained weight after being on hrt for a few months so I think it's less redistribution and just new fat with old fat still in its place.

Quote from: Denise on January 09, 2017, 05:12:45 PM
My doc only uses injections.  Estradiol valerate, generic, should be available everywhere in the US by now. 

Sent from my LG-H820 using Tapatalk

Oh how I wish.... Haha

Quote from: DuchessBianca on January 10, 2017, 10:25:31 AM
Oh how I wish.... Haha

Have you asked?  The reason for doc to do that is it's the easiest on the system, patches irritate, oral have clotting issues, gels are a mess.  I'm thinking about asking about subdermal pellets but I'm getting such good results I don't want to rock the boat.

Sent from my LG-H820 using Tapatalk

Quote from: Denise on January 10, 2017, 10:47:26 AM
Have you asked?  The reason for doc to do that is it's the easiest on the system, patches irritate, oral have clotting issues, gels are a mess.  I'm thinking about asking about subdermal pellets but I'm getting such good results I don't want to rock the boat.

Sent from my LG-H820 using Tapatalk

I've been asking (probably annoying my doctor) every couple weeks for months now and he keeps telling me it's on backorder. Asked him for a dosage that he'd prescribe me and other info so I could ask local pharmacies if they could get it in stock but doctor reiterated about the shortage. I see him this friday so I'll ask again but I'm not expected any different answer bleh I do go to a LGBT facility though that has many trans patients and I'm sure many are also on injectables so maybe it's about not adding more people on them until more reliable stock is able to be gotten but I really have no clue other then what he's told me.

The GIC put me straight on the patches. I had the option of gel, but I thought It sounded messy lol.

Quote from: Moomin on January 10, 2017, 02:09:55 PM
The GIC put me straight on the patches. I had the option of gel, but I thought It sounded messy lol.

It's not that messy but I have the impression that over time I could not absorb it in the same good way as in the beginning. 

Gesendet von meinem MHA-L29 mit Tapatalk

Quote from: DuchessBianca on January 10, 2017, 12:59:27 PM
I've been asking (probably annoying my doctor) every couple weeks for months now and he keeps telling me it's on backorder. Asked him for a dosage that he'd prescribe me and other info so I could ask local pharmacies if they could get it in stock but doctor reiterated about the shortage. I see him this friday so I'll ask again but I'm not expected any different answer bleh I do go to a LGBT facility though that has many trans patients and I'm sure many are also on injectables so maybe it's about not adding more people on them until more reliable stock is able to be gotten but I really have no clue other then what he's told me.

Then tell him you'll happily take Estradiol Cypionate. It's not on back order anywhere for any reason. If he tells you it is, it's time to look at him with a jaundiced eye and consider a new endo. This is your transition, not his. He is not your keeper....he's your Doctor. He works for you, you pay him, not the other way around. You may want to share that tidbit with him.
      I had this issue with a Doctor once....looked him straight in the eye, smiled....an then told him he was fired. He was completely indignant. Arrogant Ass. I wont be lied to or patronized by anyone that works for me.

Hi Thessa and Moomin,

I tried gel too and it dries pretty quickly. I stopped because I kept applying to my breasts which is not recommended as apparently it can cause breast cancer!

Riki

Quote from: jentay1367 on January 10, 2017, 04:09:44 PM
Then tell him you'll happily take Estradiol Cypionate. It's not on back order anywhere for any reason. If he tells you it is, it's time to look at him with a jaundiced eye and consider a new endo. This is your transition, not his. He is not your keeper....he's your Doctor. He works for you, you pay him, not the other way around. You may want to share that tidbit with him.
      I had this issue with a Doctor once....looked him straight in the eye, smiled....an then told him he was fired. He was completely indignant. Arrogant Ass. I wont be lied to or patronized by anyone that works for me.

Thanks for the info! I like my doctor as he's nice and when I asked for Finasteride and questions he's been helpful and willing, plus I've been there for nearly 8 months I'd rather not switch all of a sudden but I see him in a couple days and will ask again. I'll mention Cypionate and I apologize if this is off topic but how does Cypionate compare to Valerate in regards to blocking T? I know all estrogen can lower T but I hear that due to the very high peak levels Valerate can greatly reduce T levels. Along with the ease of once a week or so administering/possibility of better results probably a really big reason why I want to switch to injections is to potentionally have my T reduced enough by them alone so I can lower my spiro dose. While I haven't had many side effects, Spiro is causing me to have very low BP at times and even though I eat lots of salt/stay hydrated If I can lower my Spiro dose while keeping my T where it should be that would be huge so was curious if Cypionate works well there too?

Hey Everybody,

Did we all forget about bio-identical estradiol taken sublingual?

This is my preferred method. It is cheap, safe, readily available, and very effective.

Not every form of estrogen will dissolve sublingual. The estradiol made by Mylan or Teva dissolve in 2 or 3 minutes. Just try not to swallow until several minutes after they are completely dissolved.

Effectiveness is primarily based on blood levels and genetic heritage.

Hi Bianca,
     Cypionate is for all intents and purposes, the same thing as Valerate. The difference is that Cypionate has a longer half life. This means it's released  in a slower manner with lower peaks and requires injection less frequently. I believe it  was 8 days vs. 5 for Valerate. My endo prescribes it for just that reason. The issue with Valerate is that by the end of the week, your levels have dropped sufficiently to have issues. These could include irritability, hot flashes and night sweats as well as mood issues. Cypionate takes longer to be absorbed by the body so your E levels stay stable longer.....less peaks and valleys is the best analogy I can relate.  It is more expensive than valerate, but its efficacy is at a minimum, the equal of Valerate.  I've heard of many Trans Women's experience noting that in the proper dosages, it negates the need for any Anti androgen at all bringing you to a level of <200 pg/ml at a minimum. So this may be just what you seek. If your Endo tells you its availability is not there, he's either ignorant or being insincere at the very best. I have never nor have I ever heard of any kind of shortage, period.  Good luck on your path!....

Quote from: jentay1367 on January 11, 2017, 03:28:55 PM
Hi Bianca,
     Cypionate is for all intents and purposes, the same thing as Valerate. The difference is that Cypionate has a longer half life. This means it's released  in a slower manner with lower peaks and requires injection less frequently. I believe it  was 8 days vs. 5 for Valerate. My endo prescribes it for just that reason. The issue with Valerate is that by the end of the week, your levels have dropped sufficiently to have issues. These could include irritability, hot flashes and night sweats as well as mood issues. Cypionate takes longer to be absorbed by the body so your E levels stay stable longer.....less peaks and valleys is the best analogy I can relate.  It is more expensive than valerate, but its efficacy is at a minimum, the equal of Valerate.  I've heard of many Trans Women's experience noting that in the proper dosages, it negates the need for any Anti androgen at all bringing you to a level of <200 pg/ml at a minimum. So this may be just what you seek. If your Endo tells you its availability is not there, he's either ignorant or being insincere at the very best. I have never nor have I ever heard of any kind of shortage, period.  Good luck on your path!....

Thank you very much for the reply! I did some research on my own and found that Cypionate IS listed along with Valerate as forms of estrogen used for MtF HRT at the LGBT facility I go to AND is listed on my health insurance as something they cover. So when I see my doctor in just over 12 hours I'll ask to be put on that instead while Valerate is on backorder as at the very least I wont need to take pills sublingually 3x a day (something that's driving me insane though I know it's petty of me due to how much better my life has been since starting HRT but bleh) and importantly to try and see if my T levels can stay in female ranges with lowering Spiro while on Cypionate as the less side effects the better. I'll post my results once I'm back home!

When I transitioned the first time my UK doctor had me on Stilboestrol then Premarin pills, but when I was sent out to Australia for work my local doctor was really surprised how little feminisation had been achieved and she moved me onto injections of Primogyn Depot weekly then to fortnightly and on the 16th of every month an additional injection of hydroxy-progesterone hexanoate all intramuscularly. (after only 3 months my feminisation speeded up dramatically, with me getting B Cup breasts rapidly and a much smaller and well defined waist.) Unfortunately when I returned to Great Britain after 6 months in Australia, injections were not available then and my UK doctor put me back on Premarin, but I resumed on injections on emigrating to Australia, 12 months later. Now on my second transition, I am only on Pills, although if my Victorian GP offered it I would prefer implants.
Judith

Quote from: judithlynn on January 12, 2017, 09:24:10 PM
Now on my second transition, I am only on Pills, although if my Victorian GP offered it I would prefer implants.
Judith

I believe Stenlake in Sydney supply implants and a there's a number of doctors will do them. Personally I'd ask the doctor to do it or try to find another one.

I'm on an implant (just got topped up this week in fact!). One usually lasts me about 9 months (although I had to stretch it out to 12 this time due to GRS and supplement with gel between post GRS and being topped up, and even then my levels were alright).

Been on injections over 2 years now. I was on patches for 6 weeks and pills for a few days after SRS to bridge the gap. Hugs
Mariah

Question for the people who use injections instead of tablets.....I know injections can bring your levels up higher than tablets, but what changes did you see if/when you switched from oral to injection? 

I started with patches the first year, then the 2nd year, injections, then the 3rd year, I switched to E pellet implants, just don't have the time to go to get the injections and I'm more even keeled mentally. The MD implants them and I forget about it for the next 6 months. I take a nightly dose of prometrium pills, 3 weeks on, 1 week off. I'm definitely more feminized, I've had a good friend, tell me straight out, "your literally like a lady now, from your back profile" and he repeated it twice. I'm in the closet still, lol, I just look dumbfounded. I don't broach the subject with anyone except my girlfriend.

Quote from: Rikigirl on January 08, 2017, 04:47:46 PM
Hi Ellement,

From the research that could be the reason! This is the basics of it;

The research done on oral Estrogen indicates it's not as smooth and even delivery as patches, and it does make the liver do more work! These are not as important as the last issue which is that oral Estrogen can reduce Insulin Growth Factor 1 (IGF-1) by 15-40% which is produced by the liver. The IGF-1 levels are very high in teenage girls going through puberty and their teenage years. Once we reach our 20's it gets lower, and lower again as we get older. This helps the breasts to grow so quickly in cis girls teenage years and researchers now suspect this is why mtf transsexuals have smaller breasts than their cis relatives.

I'm on injections (non-oral) and my IGF-1 levels are very low, under normal range. My breasts aren't growing and actually, since switching to injections from oral, my breasts have shrunk. In all other respects, I felt better and things improved or so, it seems. Looking into that at the moment.

I find that if I add some oral estrogen to injectables, my breasts start to grow although my IGF-1 levels would further decline. Women with growth hormone deficiency (Laron Syndrome) also seem to have good breast growth. So, I think it's much more complicated than just IGF-1.

Some older women with much lower levels of IGF-1 have significantly better results than their younger counterparts, in their late teens or early 20's.

Quote from: Rikigirl on January 11, 2017, 08:14:12 AMI tried gel too and it dries pretty quickly. I stopped because I kept applying to my breasts which is not recommended as apparently it can cause breast cancer

Indeed, it is recommended not to do so but when one digs deeper into the subject matter, one realizes this recommendation is not evidence based as there no study showing applying it this way increases the risk of breast cancer nor has there been any cause and effect established with respect to estrogen and breast cancer. The results are MIXED and a recent study showed HRT in transwomen did not increase the risk in our population.

Still, one should follow the doctor's directives. If they advise against doing it this way, follow orders.

Quote from: Dani on January 11, 2017, 03:14:25 PM
Effectiveness is primarily based on blood levels and genetic heritage.

And many more things. Just to illustrate. All the women, on both sides, in my family have large breasts. My blood levels of estrogens are very high, typical of pregnancy levels. I also take progesterone. Despite all this, my breasts are very small, AA to A. On oral, I get better breast growth with lower levels of estrogen.

Some things will just remain a mystery. Such is life!

Quote from: judithlynn on January 12, 2017, 09:24:10 PM
she moved me onto injections of Primogyn Depot weekly then to fortnightly and on the 16th of every month an additional injection of hydroxy-progesterone hexanoate all intramuscularly. (after only 3 months my feminisation speeded up dramatically, with me getting B Cup breasts rapidly and a much smaller and well defined waist.)

Primogyn is estradiol valerate, I believe and hydroxyprogesterone hexanoate is the same as hydroxyprogesterone caproate. Both are still available, I think, in some countries. I know a transwoman taking both with phenomenal breast growth but she took VERY high doses of the progestin, hydroxyprogesterone caproate to the point where she was lactating A LOT.

Sublingual Estradiol here. It seems to be working just fine. My boobs are constantly sore and my nipples are erect way more than anything else  :)

Quote from: Dani on January 11, 2017, 03:14:25 PM
Hey Everybody,

Did we all forget about bio-identical estradiol taken sublingual?

This is my preferred method. It is cheap, safe, readily available, and very effective.

Not every form of estrogen will dissolve sublingual. The estradiol made by Mylan or Teva dissolve in 2 or 3 minutes. Just try not to swallow until several minutes after they are completely dissolved.

Effectiveness is primarily based on blood levels and genetic heritage.

Mines Teva! Gone in minutes =D This is by far my preferred method now.  Tablets > Pills

My doc started me on patches, due to my age, worried about liver effects.  She prescribes pills for her younger patients.  It's only been a week and a half, so too early to see significant changes, but my nipples have definitely woken up.  They are standing taller and getting wider, and get irritated runnbing against my shirt when I walk the dog.

Patches, as of this afternoon!  ;D ;D :-*

Hugs, Devlyn

I'm on injections (non-oral) and my IGF-1 levels are very low, under normal range. My breasts aren't growing and actually, since switching to injections from oral, my breasts have shrunk. In all other respects, I felt better and things improved or so, it seems. Looking into that at the moment.

I find that if I add some oral estrogen to injectables, my breasts start to grow although my IGF-1 levels would further decline. Women with growth hormone deficiency (Laron Syndrome) also seem to have good breast growth. So, I think it's much more complicated than just IGF-1.

Some older women with much lower levels of IGF-1 have significantly better results than their younger counterparts, in their late teens or early 20's.

Hi KayXo,

Yes it is not as simple as IGF-1 levels or HGH levels. There is general health, Vitamin D levels not too low or too high, exercise, amino acid levels, and many other things known, and I am sure many still not known. The point is that oral Estrogen does lower IGF-1 levels due to the liver having extra work. Lower IGF-1 levels do not support higher GH levels which does can restrict breast growth and feminising changes. This has been documented in controlled experiments on Cis women. Higher Estrogen levels usually increase GH levels too.

Laron Syndrome is not low GH, it is a GH insensitivity disorder where the GH receptors are often faulty. Yes many Cis women with Laron have normal breast growth so there is very much more to breast growth as you say. I always try to maximise my chances!

Riki

Quote from: Rikigirl on February 11, 2017, 09:02:02 AMLaron Syndrome is not low GH, it is a GH insensitivity disorder where the GH receptors are often faulty.

Indeed. Thank you for correcting. :)