Hello! Another in my latest string of questions regarding my recent switch to injections but I have a new question. I read (hopefully correctly) that it can take some time for the body to get used to the nature of injections in order to accurately gauge the levels of estradiol in my blood. I've so far generally enjoyed the switch from sublingual to injections as no more annoying sublingual pills 3x daily however since the 3rd day after the switch I've been noticing progressively increasing massive levels of fatigue and pure exhaustion that's made me on average sleep 12-16 hours a day and even when I'm awake my body has very little energy as well as feelng warm more often (I freezed easily on sublingual). I had my E/T levels tested right before the switch at 185 pg/ml , 24ng/dl respectively so all was good there however it has me thinking if my symptoms could be caused by overall low sex hormones due to maybe an improper injection? It was performed by a nurse and all seemed to go well but after the first few days where my body initially felt the rush it's like it feel off a cliff, nipples 90% of the time were completely insensitive when they were before as well as the above listen symptoms. I'm on Depo Estradiol which is supposed to last longer then Valerate and I inject every other week but I assume this can't be normal reaction to injections can it? I know I shouldn't have but I took a single sublingual pill yesterday after sleeping for ages and completely exhausted and within a couple hours my nipples were super sore again and I had some energy and didn't need to sleep afterwards so it makes me wonder too. It is possible it was accidentally administered subcutaneously and never hit the muscle explaining the quick rush felt followed by the massive and rapid cliff? I did mention in another thread feeling some burning in my thigh for some time afterwards and on and off my knee on that leg has felt sore. Any possible explanations?
I of course messaged my doctor before writing this but it's the weekend so he wont get it until tomorrow at the earliest but I asked him if my E could get tested a few days after my upcoming injection this tuesday and right before the next one afterwards just to make sure my levels/dosage is where they should be. Was so excited at the switch due to the convenience but bleh I can barely function at all currently.
There may be many things going on here. I also found on injections, I felt tired more often and warm all over where I would be able to tolerate cold much better (perhaps due to the increased blood flow and vasodilating properties of estradiol). The tiredness may be due to increasing levels of SHBG (due to higher estrogen) binding more and more testosterone, hence resulting in lower concentrations of free testosterone. But wouldn't the increased levels of E2 compensate for this? Maybe not if T was a better energizer than E2. But then again, I experienced the same as you, when adding some oral E2 to my injections, feeling more energetic and needing less sleep.
Subcutaneously, there is less vascularization so that absorption is slower and more steady. In the muscle, levels will fluctuate more, having more peaks and valleys, dropping faster.
Estradiol cypionate typically results in a slower, steadier release, even intramuscularly (compared to EV) but who knows? You could try and have your levels measured on day 2 and then day 4 or 5. See what is happening in your body or perhaps wait a few more weeks, hoping that your body will adjust and things will improve.
Quote from: KayXo on February 05, 2017, 02:55:12 PM
There may be many things going on here. I also found on injections, I felt tired more often and warm all over where I would be able to tolerate cold much better (perhaps due to the increased blood flow and vasodilating properties of estradiol). The tiredness may be due to increasing levels of SHBG (due to higher estrogen) binding more and more testosterone, hence resulting in lower concentrations of free testosterone. But wouldn't the increased levels of E2 compensate for this? Maybe not if T was a better energizer than E2. But then again, I experienced the same as you, when adding some oral E2 to my injections, feeling more energetic and needing less sleep.
Subcutaneously, there is less vascularization so that absorption is slower and more steady. In the muscle, levels will fluctuate more, having more peaks and valleys, dropping faster.
Estradiol cypionate typically results in a slower, steadier release, even intramuscularly (compared to EV) but who knows? You could try and have your levels measured on day 2 and then day 4 or 5. See what is happening in your body or perhaps wait a few more weeks, hoping that your body will adjust and things will improve.
Thanks for the reply! Surprised to see that my symptoms aren't that unusual and happened to you as well! My doctor sent an order for lab work to test my Estradiol levels right at the end of the 2 week cycle and before my next injection. Just got back from my 2nd injection about 20 minutes ago. On a side note my first injection was with a 21g needle and this time I asked out of curiosity if they had any smaller needles and I had a choice between the 21g or 25g so I tried the latter and my gosh I never knew it was possible for a needle to go in so easily and virtually painless in my life >_< Haha I hate needles but that was the most pleasant needle experience I ever had in my life! I know what I'm asking my doctor to prescribe me once I'm done learning at the doctors office and ready to self inject at home, the longer time to inject easily is worth it with how near painless it is. Also no burning or soreness or anything I experienced with my first injection so so far so good!
I use a 22 g to inject and it is virtually painless. I rarely bleed these days. 25 g is a little too thin considering how thick and viscous the solution is, at least I find it is, for me. I'm happy you found it so easy though, great! :) To each their own.
I really don't personally see the point to measuring the levels at any time as they fluctuate (even if to a lesser extent on cypionate) and anyways, what sort of useful information could they provide? There is no optimal range based on evidence based data, it was arbitrarily chosen. Some do indeed do fine within that range, some can even have great results with lower levels while some feel best on higher levels. Studies have also have shown that when bio-identical estradiol is taken parenterally (non-orally), even high levels appear to be quite safe, whether it be men, women, of all ages, up to 91 yrs old. Consider that pregnant women have levels that range from as low as 800 pg/ml to up to 75,000 pg/ml. During a typical menstrual cycle, levels can also go as high as 650 pg/ml.
In only two days, my levels dropped from 2,500 pg/ml to 1,300 pg/ml. I'm on estradiol valerate though where levels fluctuate much more than cypionate.
I will usually engage in conversations like this with my doctors to better understand why they do what they do, ask questions, be curious, challenge assertions. Sometimes, they still insist on doing what they're doing, regardless if it makes sense or not or if not justified because they are following orders and protecting themselves. I can understand this but there are doctors out there that are also open to change if provided good arguments and solid data. They are interested in learning more about the matter, doing what makes the most sense and giving the best treatment possible to their patients.
My 2 cents. I'm not an expert but I think it's important to express such opinions. I hope it all turns out well for you. :)
How can one average 12-16 hours of sleep a day?? I am lucky if I get 6. I am doing something wrong, me thinks.
I use 3cc (3ml) - 20 G x 1.5" Intramuscular Luer-Lock Syringe with Needles and inject Depo Estradiol every other week, too. I run 5k at least 4 times a week and have no fatigue from it after using it for 2 years (I, too, switched from valerate two years ago). So, maybe it just takes time for the body to adjust? In the mean time, enjoy that blissful slumber! LOL
I use a 25 gauge needle 5/8" (16mm) long and inject into the fat layer around the belly. I hardly ever feel anything. It does take a lot of pressure on the plunger though.
My doctor at Howard Brown in Chicago taught me and a few other girls I know to do it this way. It works great. I inject once a week and my levels correspond to what others are getting from injecting into the muscle.
Quote from: ainsley on February 09, 2017, 09:12:14 AM
How can one average 12-16 hours of sleep a day?? I am lucky if I get 6. I am doing something wrong, me thinks.
I use 3cc (3ml) - 20 G x 1.5" Intramuscular Luer-Lock Syringe with Needles and inject Depo Estradiol every other week, too. I run 5k at least 4 times a week and have no fatigue from it after using it for 2 years (I, too, switched from valerate two years ago). So, maybe it just takes time for the body to adjust? In the mean time, enjoy that blissful slumber! LOL
Did you find a difference between taking estradiol valerate and estradiol cypionate? Sense of well-being, energy levels, overall feminization, etc? Doesn't 20 gauge hurt??
Quote from: Charley on February 09, 2017, 01:30:57 PM
I use a 25 gauge needle 5/8" (16mm) long and inject into the fat layer around the belly. I hardly ever feel anything. It does take a lot of pressure on the plunger though.
My doctor at Howard Brown in Chicago taught me and a few other girls I know to do it this way. It works great. I inject once a week and my levels correspond to what others are getting from injecting into the muscle.
It seems weird that pharmacokinetics would be similar for subcutaneous (fatty tissue) and muscle. My feeling, especially from one study I read is that even with a longer needle (1.25 to 1.5 inches) because of the quantity of fat in the buttocks of women, if injected there, it is still injected in the fatty tissue and not the muscle so that it would make no difference. Thigh is a different story but maybe EC is so slow acting that no matter the area, the pharmacokinetics are more or less similar.
Quote from: KayXo on February 09, 2017, 06:32:34 PM
Did you find a difference between taking estradiol valerate and estradiol cypionate? Sense of well-being, energy levels, overall feminization, etc? Doesn't 20 gauge hurt??
It seemed like the E was better sustained over the 2 weeks...no drop offs or bottoming out after about ten days. The valerate seemed to give me bottom out periods after the first week. My wife noticed my attitude and disposition was better with the cypionate. I get a ...not sure how to explain it really...but, like a girl rush? I guess it is a sense of well being and just feeling good about myself for several days after injecting with cypionate. But, with no drop off. My energy levels didn't seem to change with either. Feminization is hard to say whether one or the other had a better effect on.
20G only hurt when I started using it, but I got used to it quickly. I alternate thighs, so each only gets the 20G once per month. The cypionate solution is easier to draw in, and inject, with a larger needle, so it is easier and quicker. My wife (cis) had a hysterectomy and oophorectomy and she doesn't like the patches, so she gets the injections, too. She doesn't mind the 20G either. She has me deliver it, though. LOL
Thanks Ainsley. :)
Thank you all for the replies sorry for not responding until now. Thanks for your information Kay! 25g needles are something I don't think I can live without now, I bruise very easily now thanks to HRT (Not diabetic as my doctor regularly checks my glucose along with many other things non sex hormones regularly) and even now 23 days since my first injection on my left thigh with a 21g needle my bruise still hasn't fully healed as the 21g needle caused quite a bruise however with the 25g needle for my 2nd injection on my right thigh there was only a very tiny and it healed in 3 days! Certainly a case of different people different reactions but it's certainly in my best interest to stick with the 25g due to the near painlessness and no bruising.
My doctor isn't really worried about high estrogen levels, but I did mention to him many of the symptoms I have been experiencing and I hit many check lists off the "menopause" list so on my request he ordered a test just to make sure my levels are at least in female ranges at the end of my injection period. Levels may fluctuate but every person is different and I see it said a lot of this forum is that each person will react to doses, methods etc.. differently so having my levels checked is at the very least better then nothing in trying to gauge if this method/dosage is correct/working for me. Mentally it sets in panic a bit because at the time I started injections I was 8 months on pills and hitting that target time were feminizing usually starts to bring more rapid changes and I still struggle to find changes just the thought of possibly having spent the last 28 days with non ideal hormone levels and no further feminization just makes me not very positive >_<
Yeah is a bit crazy Ainsley as with pills I got a good night sleep once a month if I was lucky! But that seems to have been a first injection cycle issue and since my second energy I've slept my for 7-8 hours a night and been able to stay up all day not completely exhausted. Maybe my dark eye bags might finally heal from all the non enough sleep and oversleep >_< Haha
Now that I've been on injections for 23 days and day 9 on my second 14 day injection cycle the absolutely ease of an every other week injection, the ability to sleep, no longer taking pills sublingually 3x daily has been soooooooo nice but bleh have I felt quite icky my entire time on them so far. On pills I used to be freezing every single morning now I wake up with light sweat and constantly feel warm/gross/lightly sweaty throughout the day, my sweat may be orderless but I don't feel any less icky. My blood pressure seems to be super low much more then usual with now pretty much every time I get up I need to hold onto something so I don't fall over due to how dizzy/lightheaded I get, I know estrogen can help raise BP so not sure if it's related. My libodo while very low on pills is now probably lower then that of a corpse >_< Haha Mentally I, (probably irrationally) constantly worry if I even have adequate estrogen levels since the switch. I've lost pretty much all nipple sensitivity whatsoever, I can't really say I've noticed any change whatsoever in femininzation, energy levels while low are a bit more stable throughout the day compared to slight ups and downs with pills. Just some of the things I've been experiencing so far and for as easy as it is with injecting I'm a bit depressed that it seems so far my body just isn't reacting so nicely to injections compared to all the wonderful/positive posts I've seen on them in this forum >_<
Estradiol more so when taken non-orally and if bio-identical tends to actually REDUCE blood pressure as it increase nitric oxide production, dilating blood vessels. Do you feel better the first few days or the same all throughout the 2 weeks? Is the dose high enough or could your estradiol levels have actually gone down? On estradiol cypionate, levels can be quite steady so that desensitization could theoretically occur but who knows? I hope your doctor figures it out.
Feeling cold is not a good sign, in my non-expert opinion, could be a symptom of either bad blood circulation and/or skin that becomes too thin. Estrogen should maintain skin thick to a certain degree although its thinner than what it was on testosterone.
I also noticed on oral/sublingual, I felt cold. That went away on injections and I could tolerate colder temperatures much more easily.
You might also ask doctor if you could stop all anti-androgens as on injections, E will usually be enough on its own to suppress T. Spiro + E, maybe your T is too suppressed leading to tiredness, low libido, etc.
Quote from: KayXo on February 18, 2017, 10:59:14 PM
Estradiol more so when taken non-orally and if bio-identical tends to actually REDUCE blood pressure as it increase nitric oxide production, dilating blood vessels. Do you feel better the first few days or the same all throughout the 2 weeks? Is the dose high enough or could your estradiol levels have actually gone down? On estradiol cypionate, levels can be quite steady so that desensitization could theoretically occur but who knows? I hope your doctor figures it out.
Feeling cold is not a good sign, in my non-expert opinion, could be a symptom of either bad blood circulation and/or skin that becomes too thin. Estrogen should maintain skin thick to a certain degree although its thinner than what it was on testosterone.
I also noticed on oral/sublingual, I felt cold. That went away on injections and I could tolerate colder temperatures much more easily.
You might also ask doctor if you could stop all anti-androgens as on injections, E will usually be enough on its own to suppress T. Spiro + E, maybe your T is too suppressed leading to tiredness, low libido, etc.
That would probably explain my blood pressure being lower/me being dizzy more often. The first day of the very first injection within a few hours my nipples because extremely sensitive and achy and my chest felt really strangely tight for a couple hours, wasn't wearing anything out of the ordinary so it was certainly a strange initial reaction, by the very next day both the nipple sensitivity and chest pain was gone and just felt slightly sluggish the first 3 days after my first injection. The 4th day all the way until my 2nd injection I had extreme levels of fatigue and thats what I talked about earlier in this thread about sleeping 12-16 hours a day and still feeling completely exhausted. Since my 2nd injection on February 8th however I didn't experience any strange reaction hours after my injection and pretty much this entire 2 week injection period which ends wednesday I've just felt the same, not bursting with energy but no real fatigue/exhaustion and no urges to sleep at all during the day, every day so far has felt exactly like the previous but with feeling all the bleh I posted earlier in the thread.
I'm not sure how standard my dose is and I can't post it here due to the site rules but I guess it's a standard dose not sure. That's what I'll be finding out wednesday when I get my blood work taken for the first time since switching to this method before I head to get my 3rd injection. My estradiol levels at various stages while previously on sublingual pills was always between 150-185 pg/ml. Won't know my peak levels come Wednesday but will see what it is as the very end of my injection cycle, hopefully it can tell if my levels are where they should typically be at the end or if they are much lower then should be either increase the dosage and/or shorten length between injections to 7/10days. I'll be sure to post my results/doctors plans once I find out. truth be told though if they turn back perfect I might think about switching back to pills as for how nice it is taking an injection once every over week and not daily pills I just feel bleh with Cypionate so far. Pills were annoying and sleeping was harder but I the peaks and sensitivity I felt was nice.
My skin is really quite thin maybe even more then it should be with estrogen. I'm still a bit overweight with about 15-20 pounds more to lose but my skin is near see through, also quite pale plus I scratched my thight 2 days ago not super hard but it caused a large red mark nearly bleeding from a itch I didn't use too much force scratch, just figured it was the effects of estrogen/my biology.
That was actually one of the main reasons I wanted to get on injections because spiro is causing so many bleh side effects. In late december though my sprio was increased to not and outrageous dosage but higher then the "typical" dosage most people are on due to my mentioning to my doctor about morning erections happening all the time for a month (so far at the time) and it was causing major dysphoria, thankfully since the increase I haven't had a since incident. I just want to make sure injections are doing what they should be before I mess with my spiro and I'm afraid with having to go through that again with a lower dose >_<
Had my 3rd injection at the doctors office today, back in the left thigh that started off the injections, once again with the 25g needle and this time I actually self injected! (Nurse said she'd guide my hand and would push with me but when I went to push it in she took her hands away and at the end of the day I technically did the injection) Hardest part just seems the general fear of needles but once again it was very light on pain and I'm starting to get pretty comfortable with injecting. Have one more office guided injection in 2 weeks where I'll do it 100% by myself then I'll get the okay/prescription for needles to inject at home. I love my doctors office its so fancy and pretty but I deal with extreme nausia/carsickness and the 60-90 minutes stuck in the car going to Boston is hell >_< My biggest fear aka needles is becoming something I don't mind at all, so simple and virtually pain free! Stupid noobie me though was trying to suck up my prescribed dose from the vial with a 25g needle and was taking forever then I remembered I was an idiot and swapped it out for a 21g which was so much easier and then replaced it with a new 25g needle when I was finally ready to inject. Next time I'll remember to impress the office~ >_< Haha
My left thigh really hates injections though so far, no burning like my first injection but my thigh is super sore like the first time on that thigh and the entire muscle right in the middle of my thigh feels pretty tight and feels very close to the surface of the skin bleh Maybe I'll just only ever inject in my right thigh starting next time, my right thigh surfacewise at least healed in just a few days.
Had to postpone my lab work though as once again I didn't feel right and cheated with some spare sublingual pills the last few days and that would have skewed the test, this time I'm determined to make it the 2 week period no matter of off I may feel the entire period just so I can have some sort of baseline for my doctor to see if my dose/frequency needs to be adjusted.
You could inject in the buttocks where it's usually less likely to result in soreness, the upper outer quadrant. I do them myself, have done so for more than a year, at least 50 injections and no problems. Ask your nurse if she can show you to do it that way, my nurse did, it was a breeze.
I recently added oral Estrace to my injections and finally, I have some breast growth, feel more energetic and my mood has improved somewhat. Only downside is I don't sleep as much and my skin/hair are drier.
Quote from: KayXo on February 24, 2017, 03:57:44 PM
You could inject in the buttocks where it's usually less likely to result in soreness, the upper outer quadrant. I do them myself, have done so for more than a year, at least 50 injections and no problems. Ask your nurse if she can show you to do it that way, my nurse did, it was a breeze.
I recently added oral Estrace to my injections and finally, I have some breast growth, feel more energetic and my mood has improved somewhat. Only downside is I don't sleep as much and my skin/hair are drier.
Thanks for the reply! I'll certainly think about it. What I like about injecting in my thigh is that thanks to estrogen I've gained at least afew hundred freckles all over my body (No exaggeration) and I have them at the perfect spot on each thigh so theres never any guesswork needed on where to inject so no chance of accidentally ever hitting anything bad or missing muscle, very convenient couple of freckles!
I know in my brief experience when I've taken some of my spare pills at the end of my injection cycle I did feel quite nice too but it's not something I plan to do without doctor approval as I shouldn't be taking 2 forms on my own so just going to do my best to get to the end of my cycle to finally get that bloodwork done to see if anything needs to be adjusted as the injections are way too convenient and super easy.
If you are sleeping 12-16 hours a day that is probably too much sleep. That alone will cause fatigue. It's also a red flag for depression. Try sleeping less. No more that 9 hours. Set the alarm if you have to. And exercise.
Also, the quality of your sleep is important as well. More Delta wave sleep equals more energy. Human growth hormone is released during the deepest level of sleep. Which can be measured and identified by the delta waves that show up on the EEG of a sleeper who is in the deepest level of sleep (delta wave sleep). Increased Delta sleep can be achieve with medication. I was prescribed medications (anti-depressants) and natural diet supplements to increase delta sleep. Also, I used auto-hypnosis to to increase Delta sleep. Hope this helps.
Quote from: Jane Emily on February 25, 2017, 04:22:33 PM
If you are sleeping 12-16 hours a day that is probably too much sleep. That alone will cause fatigue. It's also a red flag for depression. Try sleeping less. No more that 9 hours. Set the alarm if you have to. And exercise.
Also, the quality of your sleep is important as well. More Delta wave sleep equals more energy. Human growth hormone is released during the deepest level of sleep. Which can be measured and identified by the delta waves that show up on the EEG of a sleeper who is in the deepest level of sleep (delta wave sleep). Increased Delta sleep can be achieve with medication. I was prescribed medications (anti-depressants) and natural diet supplements to increase delta sleep. Also, I used auto-hypnosis to to increase Delta sleep. Hope this helps.
Hello Jane Emily! Thankfully the 12-16 hours of sleep and extreme fatigue felt during my first 14 day injection cycle seemed to went away with my 2nd cycle and current 3rd cycle. Maybe my body just didn't know what to do with it after being on pills for so long and took 2 weeks to properly utilize it and such and that's why I have my usual HRT energy levels since my 2nd cycle. As for depression outside of the normal dysphoria/daily issues my moods been pretty good on average since begining HRT so I don't believe that's the cause though the 2 months from seeking therapy to starting HRT I tried 3 different Anti-depressants and all 3 caused my to have very serious reactions and I have no interest in dealing with those serious issues again plus HRT has been the best anti depressant I could ever ask for ^_^ Haha
Thanks for the breakdown of sleep though as I didn't know that and it's interesting!