Susan's Place Transgender Resources

Community Conversation => Transitioning => Hormone replacement therapy => Topic started by: KatieP on July 21, 2018, 09:31:18 AM

Title: Estrogen Levels for Older
Post by: KatieP on July 21, 2018, 09:31:18 AM
Hi All,
There is a great thread already talking generally about HRT for older women. Although related, I wanted to ask a more specific question.


For older trans women, what are reasonable, non-transition, estrogen levels?


In my blood tests, the lab says the normal postmenopausal range is 0 - 44.5. And for menstruating women, except for mid-cycle the high range is about 250. (all numbers are pg/mL) I have been on estrogen in some form for 30 years. I don't think I want/need what seems to be called "transition levels" of estrogen, which might be numbers closer to the 250 side.

My estradiol value is running around 46 pg/mL, which on the normal scale for biological women my age would be perfect. However, I am not really a postmenopausal woman.

What is the experience of long-term, older women here?

And, thanks for sharing!!!

Kate
Title: Re: Estrogen Levels for Older
Post by: Jessica on July 21, 2018, 09:57:22 AM
Hi Katie 🌸🌸🌸 I started hrt 1 year ago at 61.  In January I tested at 110 pg/ml
A couple of weeks ago I dropped to 94 pg/ml.  My endo increased my spiro for more T suppression.  He did say that it depends on when the dosage of Estradiol is in relation to the test on how it could read.

Hugs and smiles, Jessica
Title: Re: Estrogen Levels for Older
Post by: KathyLauren on July 21, 2018, 10:35:42 AM
Hi, Kate.

I started HRT a year and a half ago at age 62.  Initially, my levels were all over the place, as my doctor worked out a dosage that worked and I learned to get my levels checked at a consistent time in a dose (patch).  The last couple of checkups, my E has been 133 and 152 pg/ml, both taken at the end of a dose.  My doctor is happy with that and considers it stable stable.
Title: Re: Estrogen Levels for Older
Post by: KatieP on July 21, 2018, 11:33:54 AM
Thanks, Kathy and Jessica!!

My endo keeps saying to worry about how I feel rather than the numbers. I tell her that I don't _feel_ like I did 18 months ago before seeing her and changing to patches. As well, she said this week that the "new" guidelines were to keep the levels below 100 pg/mL. This seems to go against all I have read here, and certainly your actual experience in a very similar situation. My endo is pretty well-known in the local T* community, but I am wondering if she really is up to date...

Thanks again for sharing your experience!

Kate
Title: Re: Estrogen Levels for Older
Post by: warlockmaker on July 21, 2018, 11:55:36 AM
I have been on E for over 6 years. Now 70 and post op 3yrs my E is 243 pg/ml. My mentor and guide has always said its not the E readings but how you feel, mentally and physically. After GRS my E intake was lowered some 40 pct and it didnt feel right. Feeling a little restless, edgy, not sleeping well (I sleep well normally) and a lowering of energy levels. So the dosage was increases to levels of 80 pct of pre surgery amounts. I have kept this dosage for the last 2.5 years with steady readings of 240 to 250 pg/ml.
Title: Re: Estrogen Levels for Older
Post by: KatieP on July 21, 2018, 12:00:11 PM
Quote from: warlockmaker on July 21, 2018, 11:55:36 AM
Feeling a little restless, edgy, not sleeping well (I sleep well normally) and a lowering of energy levels.


This is exactly how I have felt recently. Exactly!


I told my endo that I still don't feel like ME, but I can see ME from here. She counselled patience.
Hearing your story, WarlockMaker, I am feeling a bit less patient...

Thanks for the response!
Title: Re: Estrogen Levels for Older
Post by: epvanbeveren on July 21, 2018, 12:51:17 PM
My E level (post-op GRS) on weekly injections, taken at my low level (right before I inject) was at 120.6 last time.

145.3 was the highest reading, right after GRS.

Doc thinks both are okay readings.

Now one question that pops my mind after reading. Very often, if not always, I feel like doing nothing when I get home form work, just can't get myself to do things around the house, except for the necessary errands. Now I do work 40 to 64 hours a week, pretty active at the railroad in the yard operations.

Could this have anything to do with E levels?
Title: Re: Estrogen Levels for Older
Post by: Tessa James on July 21, 2018, 01:03:18 PM
Good thread and questions, that i share, as well as some familiar sounding responses from my provider.  It would be most excellent if we could know what our optimum levels are yet there are so many factors in our unique make up that cannot be parsed out reliably.  It often does come down to how we feel about the results???

Am i feeling down or less enthused due to little cats in the hat a, b and c, or x, y, z?  And when we are feeling zippty do dah good in mind and body?   I felt a wonderful sense of near euphoria my first month and nearly the first year of transition.  Now going on 6 years in, life is less punctuated by novelty and discovery and a sort of calm assurance prevails. 

Thanks for sharing your experience...
Title: Re: Estrogen Levels for Older
Post by: Dani on July 21, 2018, 09:04:51 PM
Estradiol blood levels vary greatly. For sublingual micronized Estradiol, you will peak shortly after taking the tablet and then drop off sharply in just a few hours. Injectable Estradiol and Estradiol patches blood levels remain quite stable for several days.

For injectable and patches, blood levels around 200 pg/ml  (+ or -) are normal for women and just a fraction of that for men. For sublingual, depending on how soon after you take the tablet, blood levels may be many times higher, but they should average the same 200 pg/ml until you take the next tablet.
Title: Re: Estrogen Levels for Older
Post by: KayXo on July 22, 2018, 08:37:34 AM
Quote from: Dani on July 21, 2018, 09:04:51 PMInjectable Estradiol and Estradiol patches blood levels remain quite stable for several days.

For injectable and patches, blood levels around 200 pg/ml  (+ or -) are normal for women

With IM EV injections (in contrast to estradiol cypionate), levels actually tend to be less stable and fluctuate quite a lot. On day 3, my levels were 2,500 pg/ml, day 5, 1,300 pg/ml.

Under 200 pg/ml is a recommendation based on average levels in premenopausal women *after they developed female secondary sexual characteristics*. Whether guaranteed to provide a sense of well-being, good health and maintenance of feminization in transwomen at an older age, who knows?! Individuals vary and their requirements may vary as well. Up to you and your doctor to figure out.
Title: Re: Estrogen Levels for Older
Post by: Virginia on July 22, 2018, 09:35:53 AM
I am 58 and have been on a full transition level HRT regimen for almost 9 years. I am in overall good health and the OBGYN who prescribed my medication had worked with transsexuals for 35+ years. I responded well to standard medical protocol dosages of spironalctotone/estrogen recommended for transgender care so he felt it was pointless to send me to an endo, check my hormone levels or adjust my dosages. I just get my refills from my GP when I get my yearly physical now. He too does not see my actual hormone levels as a great concern and has the philosophy that I would know if there was a problem.

My GP's BIG concern is my potassium level. Many of his older male patients take Spironalactone for their blood pressure. A high potassium level will kill a person in a matter of minutes; it is used for execution by lethal injection. My GP has most of his patients come in for quarterly blood work so he can monitor their potassium levels. My levels have been so stable for so long, he just checks mine one a year at my psychical.
Title: Re: Estrogen Levels for Older
Post by: Antonia J on July 22, 2018, 10:40:20 AM
I'm 47 pre-op and on HRT for a little over a year. My testosterone is 0.11 ng/mL compared to 3.74 ng/mL prior to starting  HRT. My estradiol is 136 pg/mL compared to 26 pg/mL prior.

I feel really good, but also watch my diet, exercise, and monitor my health due to other issues. I am about 5'9" and weigh 152 lbs. I've actually lost weight since starting HRT, but am a solid A cup on one side and an AA on the other. My hips have gained about two inches. My wife says the inches I have lost around my waist have gone right to my butt.

My endo says as long as I feel good, then we can stay here on levels. I get tested annually when I visit him.
Title: Re: Estrogen Levels for Older
Post by: pamelatransuk on July 23, 2018, 07:10:48 AM
Quote from: KatieP on July 21, 2018, 09:31:18 AM
Hi All,
There is a great thread already talking generally about HRT for older women. Although related, I wanted to ask a more specific question.

For older trans women, what are reasonable, non-transition, estrogen levels?

In my blood tests, the lab says the normal postmenopausal range is 0 - 44.5. And for menstruating women, except for mid-cycle the high range is about 250. (all numbers are pg/mL) I have been on estrogen in some form for 30 years. I don't think I want/need what seems to be called "transition levels" of estrogen, which might be numbers closer to the 250 side.

My estradiol value is running around 46 pg/mL, which on the normal scale for biological women my age would be perfect. However, I am not really a postmenopausal woman.

What is the experience of long-term, older women here?

And, thanks for sharing!!!

Kate

Hello Katie

I am an "oldie" and although I agree HRT results are more a matter of how you feel, I am also very interested in Blood Test results for E & T and hence I have a thread (page4 on this Board updated 21June) "Comparison of HRT Blood Test Results after 3/4 Months" in which there are several BT readings of several members of all ages.

However like me you clearly wish to pursue levels for us older girls.

Consequently I want to thank you for starting this thread which I am sure will be most beneficial and informative to many. Thanks also to the respondents to date.

Hugs to all

Pamela

Next month I shall publish my 6 month BT readings on both my thread and on your thread.