Hi there,
Now that I'm post op I have another blood test in a weeks time and I see my clinic in another three weeks. Then I will be discharged from their service. I was thinking of asking to change my estrodial tablets to an estrogen gel that you rub on. The reasoning behind this is because of my age at 50 something and tablets having to go through my liver and kidneys.
So has anyone else had/have any experience of the estrogen gels?
Stardust
No but there are numerous other ways to take it. Ironically I'm now on such a small dose that it becomes almost academic for me...
I always took mine sublingual which bypasses the first liver pass. You can't avoid the liver and kidneys entirely anyway because over several hours they filter 100% of your blood - so if it is in the bloodstream they will eventually have to pass it.
Other alternatives are transdermal patches and a nasal spray called aerodiol (all of which methods I have tried). Sublingual administration is demonstrably the best compromise way to take it. For this you have to be taking either estradiol-hemihydrate or estradiol-valerate. In theory there is a special "micronised" formula to make it easier to absorb in this way but trust me that standard tabs work just fine. They just disolve a little bit slower.
The gel is also a lot more expensive...
I have ussed gel (E and T....long story) I find it to be a pain in the a$$. It is kinda 'tacky' for awhile after you put it on and you have to take time to let it dry before you put clothing on over it. Gel is a time consumer. I would much rather be on pills or injections. (injections is my current method)
However...gel is, like already stated, much easier on the internals.
sleeping single and naked allows me to spread estrogel on my inner thighs so it soaks in pretty slowly.
seems to take quite a while to dry anywhere else.
Have you considered injections? Only once every two weeks..no mess and not as bad on your liver. Plus from what I understand the estrogen is more efficient. I do injections, myself.
Thanks Peps, I hadn't thought of gel and the time it would take to put on and dry. That sounds out of the question as my life is so full I don't have time to fuss around. Thanks Jenny, I do take Estrodiol Valerate so sub may be the answer. Will try that tonight.
Stardust
Just be aware that because of the reduced liver passes you MAY need to lower the dosage after you take sublingual.
Normally dosage for subbing is 30% lower than the equivalent oral dosage (I think I can say that within the rules as I haven't quoted any actual figures)
Best thing is to get you bloods tested after a month of so and see what the levels are
Oh and DONT take one just before the blood test of you will get a false high reading.
Quote from: Dana Lane on September 26, 2010, 11:40:19 AM
Have you considered injections? Only once every two weeks..no mess and not as bad on your liver. Plus from what I understand the estrogen is more efficient. I do injections, myself.
Injectables are not licensed in the UK. Plus the estrogen is no different from that in estradiol-hemihydrate tabs.
Any form of transdermal or sublingual release to blood will have exactky the same effect of reducing the effect on the liver as an injection. It is the point of release into the blood that is important in that. the problem with oral is that blood from the gut goes STRAIGHT to the liver so all of the estrogen gets pumped immediately through it. Not so if you get it into the blood in a different place - like the veins under the tongue.
its a pity that injectable E is not allowed in your country
I do a shot once every three weeks and I am good to go.
Thanks all, I'm trying the sub route for now and started last night with the Estrodiol Valerate seemed to dissolve OK but took about 3/4 mins. I do have a blood test coming up a week today so will see. I'm speaking to my endo in three weeks time.
Just want to say thanks to all and for Susan's its been invaluable during my transition.
Stardust
Quote from: rejennyrated on September 26, 2010, 06:23:17 PM
Injectables are not licensed in the UK. Plus the estrogen is no different from that in estradiol-hemihydrate tabs.
Any form of transdermal or sublingual release to blood will have exactky the same effect of reducing the effect on the liver as an injection. It is the point of release into the blood that is important in that. the problem with oral is that blood from the gut goes STRAIGHT to the liver so all of the estrogen gets pumped immediately through it. Not so if you get it into the blood in a different place - like the veins under the tongue.
I didn't know that the UK banned E-shots. That sucks to say the least!
I tried the gel and it was a pain in the butt,half the time i would sweat it off before it did any good or i would rub it off,so i went to injections every three weeks 3 years ago and have stayed with it,a whole lot less hassle i just mark it on my day planner for every 3rd Saturday!!!
Quote from: Dana Lane on September 27, 2010, 11:51:18 AM
I didn't know that the UK banned E-shots. That sucks to say the least!
They aren't actually banned - its just that NICE (our NHS medicines approval panel) has decided that they aren't cost effective and so they can't be supplied on the NHS - which means you would have to go to a private doc and pay!
Anyway some of us don't care for injections - I for one am moderately needle phobic so injectables may not always be first choice. From My point of view the nasal spray (aerodiol) or sublingual tabs, or transdermal patches remain the best choices.
At least in the UK, you get your meds paid for. I am here in the US and though I am receiving supplies and meds for IM shots, I still have to pay for it all myself.
Quote from: girl_ashley on September 28, 2010, 10:29:36 AM
At least in the UK, you get your meds paid for. I am here in the US and though I am receiving supplies and meds for IM shots, I still have to pay for it all myself.
The right insurance or a doctor who knows how to code to get around the system and your insurance will pay for your HRT.
I am on Medicare/Medicaid and I haven't paid a dime for my HRT since I started.My insurance specificaly say in the coverage book they sent me that they will not cover HRT for transgender clients, yet they do anyways.
Quote from: girl_ashley on September 28, 2010, 10:29:36 AM
At least in the UK, you get your meds paid for. I am here in the US and though I am receiving supplies and meds for IM shots, I still have to pay for it all myself.
That's a misnomer, we do pay for our meds, I have to pay £28/$50 every three months for a pre payment card. Its only if you are on benefits that you don't pay. If you work full time as I do I don't get any state help with this. Granted the NHS did fund my surgery after a battle with the panel. But long term HRT is not totally free as I've said.
Stardust