Susan's Place Transgender Resources

Is it true that the hormone shots are more effective than the pills? How often do you most likely have to take the shot?

Like most everything else it is different for everybody. The shots had a profound effect on me when combined with Spiro. That's the ticket for me-Once a week.

Randi

I've not tried E pills so I can't say for sure, however I've been taking E shots for 15months and I'm still an A-cup I suspect it's just another way of getting estrogen.

I will take the other side from Pebbles.  I have been on the pills for the last 39 months and I am a B cup.  But nothing real has happened in the butt/hip area.

It all comes down to YMMV.

They are potentially more effective - I'm sure when taking pills, some gets filtered out by the liver.  However, as long as your levels are correct, I'm sure you will get what you're going to get.  The more important difference is the injections are supposed to be safer because they don't pass through the liver.  Injections are taken either once per week or once every two weeks.

I've definitely heard that patches are 3x more effective than pills (because you lose a lot in the digestive system) - I don't know about shots.

Oral use (swallowing) of estradiol tablets doesn't provide good absorption of your dosage, because of your digestive system and first-pass through the liver.  This is the least effective method of delivery.
Sublingual (beneath the tongue) use of estradiol tablets provides approximately 80% delivery of your dosage.  For most people, it's a very effective method of delivery.
Intramuscular injections are generally more effective, providing almost 100% delivery of your dosage.  Many people don't care for the effort and trouble of weekly injections.  Some people have issues when their weekly dosage runs short a day or two before their next injection.

Sublingual delivery has been good for me, personally.  I'm similar to Janet Lynn in that I've had decent breast development, but no effects whatsoever in the areas of hips or bottom.

Quote from: RoseBlossom on April 17, 2011, 12:08:55 PM
Is it true that the hormone shots are more effective than the pills? How often do you most likely have to take the shot?

There's no way to make such a general, all encompassing, blanket statement without some sort of empirical evidence to back it up. And there isn't any. No long term scientific study to gauge the merits of injectables over oral or transdermal delivery has ever been performed in MTFs. There have been a few which show both oral and injectable routes are more effective than patches, but that's it.

The downside to injections is that your body will experience peaks and valleys (excess and deficits) in your E2 levels, and that's not ideal. They won't remain constant. This can make it hard to accurately gauge your E2 level when testing your blood. Your E2 level will peak right after an injection and fall off halfway thru until your next injection. Now, in an ideal world, daily injections would be the most effective and ideal delivery method.

Quote from: yoxi on April 17, 2011, 01:34:54 PM
I've definitely heard that patches are 3x more effective than pills (because you lose a lot in the digestive system) - I don't know about shots.

This is why if you take the oral delivery route, micronized estradiol is the best option as it's absorbed under the tongue and goes directly into the bloodstream. Taking micronized E2 orally is definitely a more effective delivery route as compared to patches.

And for the record, I've been on oral meds for about 8 months, and have had very good results. So as with all things, your mileage may vary depending on the individual and their physiology.

I have tried pills, patches, gels and shots.
Personaly I think the shots work best. Also I only have to worry about my HRT once every 2 weeks.

QuoteThe downside to injections is that your body will experience peaks and valleys (excess and deficits) in your E2 levels, and that's not ideal. They won't remain constant. This can make it hard to accurately gauge your E2 level when testing your blood. Your E2 level will peak right after an injection and fall off halfway thru until your next injection. Now, in an ideal world, daily injections would be the most effective and ideal delivery method.

The peak when it sustained may cause estrogen receptor to be saturated, and develop resistance to further estrogen absorption. There is cases where injection were taken which result in less effect to the breast than when oral estradial tap is resumed. Oral estradial tap taken sublingually approximate effective absorption rate of injection but less the over saturation effect.

QuoteSublingual (beneath the tongue) use of estradiol tablets provides approximately 80% delivery of your dosage. 
Intramuscular injections are generally more effective, providing almost 100% delivery of your dosage. 

Caith, can you cite reference to your data?

Thanks.

There aren't many clinical studies on effects of cross-sex hormone therapy, and I haven't seen any concerning the effectiveness of different methods of delivery for Estradiol. Doctors prescribe based on opinion and experience.

My doctor, who has quite a bit of experience with transgender HRT and therefore my trust, has the opinion that, given the dosage is right for the person, there is no difference between oral and injectable other than cost. Moreover, he believes the transdermal patch is ineffective for the purpose of transgender HRT, and should only be prescribed when the other methods are deemed unsafe for the patient.

This may or may not be helpful to you but, at my 2-month checkup, my doc assessed my progress as inadequate. Instead of increasing Estradiol or Spironolactone, he added Medroxyprogesterone, to which he believes some people respond better than Estradiol alone. Medroxyprogesterone also has anti-androgenic effects. We'll see in another month and a half if it does the trick.

Quote from: rieko on April 20, 2011, 11:22:04 AMMoreover, he believes the transdermal patch is ineffective for the purpose of transgender HRT, and should only be prescribed when the other methods are deemed unsafe for the patient.

Did your doctor give reasons for this? I'm interested because I've heard the opposite, but that seems to be the case with most anecdotal info about HRT, that people have very differing experiences. I'd heard that patches deliver much more efficiently than pills, for example.

Quote from: yoxi on April 20, 2011, 11:51:31 AM
Did your doctor give reasons for this? I'm interested because I've heard the opposite, but that seems to be the case with most anecdotal info about HRT, that people have very differing experiences. I'd heard that patches deliver much more efficiently than pills, for example.

I know, right? It's so hard to make decisions when there's scarcely any facts upon which to base them. I feel that the best you can do with HRT is pick an experienced doctor and just trust their judgement. My doc didn't give any specific reasons for his opinion on the patch; I'm sure it's based only on his experience, so he could be wrong.

Sure - the folk I know who've been on the patch say it's a nuisance, because they come off easily in the shower or whatever, but that they needed a much higher dose on pills, and that with injections they experienced much bigger swoops of high-to-low, with accompanying emotional switchback. On the other hand, injections are improving all the time - my trans men friends are delighted with more recent injections that have far less swoop factor, for example, so things are moving on all the time. As you say, all we can do is rely on expert opinion and regular monitoring. I can't wait ::) :).

I was on pills for years before I decided to switch over to injections. For me, I had a lot more significant development than I ever did with pills alone. Another effect I had was that I became a little more emotional at times; especially when I watched sappy romance movies. :P

I really hope the injections don't make pills a bad alternative. I'm deathly afraid of needles.

QuoteI'd heard that patches deliver much more efficiently than pills

Let me cite a study from: http://www.maturitas.org/article/PIIS0378512299000213/abstract (http://www.maturitas.org/article/PIIS0378512299000213/abstract)

The bioavailability of oestradiol gel (1.5 mg) is 61% of the tablet (2mg). As the bioavailability of oestradiol tablet (taken orally not Sublingually) is 1%. Thus oestradiol gel is 0.61%.

The bioavailability of oestradiol gel (1.5 mg) is 109% of the oestradiol patch. The bioavailability of oestradiol tablet (taken orally not Sublingually) is 109%+39%=148% of oestradial patch. Hence, bioavailability of oestradial patch is 1/1.48=0.67%

As matter of effectiveness / speed of absorption, the following ranking of methods applied (No.1= fastest):

1. Inhaling
2. Sublingually (8-10%)
3. Rectally
4. Intramascular injection (10%)
5. Skin implant
6. Orally (1%)
7. Skin patch (0.67%)

QuoteMoreover, he believes the transdermal patch is ineffective for the purpose of transgender HRT, and should only be prescribed when the other methods are deemed unsafe for the patient.

The cited study / figures support this view.

Well, this is something that many of us have wondered about.  And I have a decent amount of experience with both forms, intramuscular and sublinqual estrogens.  I have found that I can feel it more in my body and especially breasts when I take orals under the tongue.  When I switched to IM, about 9 or 10 months into transition, I was really disappointed that I could not feel it at all...anywhere.  So for me, I am right now doing a test by experiementing again with pills and seeing what happens, after about 14 months of intramuscular injections.  I do live and work as a woman, but I was beginning to become passable at 5 months.  And at that time, I was taking pills.  It seemed to work pretty well for me.   

But the truth of the matter is that there is virtually no credible evidence that says IM injections are more effective at feminization.  Nothing exists that can tell us that, unfortunately.  And while I think depot preparations are great, I'm thinking that pills maybe be more effective for me.  I am not sure of that yet, but I suspect that to be the case...  And I also suspect that this is very much an individually based reality; it works better for some, but perhaps not for others...

I effin' love to shoot up. Right between the toes....OHHHH YA...good stuff.

I've been on shots for 6 months, now, and I think I'm doing fairly well. If you can afford it, and don't mind needles, I would earnestly suggest it.

Well in all honesty I have read some studies and reports (although I am much to lazy to look them up) that say no method and no oestrogen is more affective than the next.
All across the spectrum as I have read in the reports I come across say that it is relatively even (although with room for debate as with anything).

I believe this theory and oral is probably the easiest and most sure fire way of taking oestrogen, As I think none has more feminizing effects than another.

I have said the same thing over and over like the school board trustees.

Quote from: Zylphia on February 22, 2012, 12:54:45 AM
Well in all honesty I have read some studies and reports (although I am much to lazy to look them up) that say no method and no oestrogen is more affective than the next.
All across the spectrum as I have read in the reports I come across say that it is relatively even (although with room for debate as with anything).

I believe this theory and oral is probably the easiest and most sure fire way of taking oestrogen, As I think none has more feminizing effects than another.

I have said the same thing over and over like the school board trustees.

You're right, your serum hormone levels are what has the effect, how you get there shouddn't significantly matter.

Quote from: Asfsd4214 on February 22, 2012, 12:59:36 AM
You're right, your serum hormone levels are what has the effect, how you get there shouddn't significantly matter.

This is very true.. Also dividing your oral or sublingual dose also doesn't do much either..

Shots > Pills.

So. Much. Better.

More effective? I think not. Probably a better way to get it in your system though.

Quote from: Caith on April 17, 2011, 08:17:28 PM
Oral use (swallowing) of estradiol tablets doesn't provide good absorption of your dosage, because of your digestive system and first-pass through the liver.  This is the least effective method of delivery.
Sublingual (beneath the tongue) use of estradiol tablets provides approximately 80% delivery of your dosage.  For most people, it's a very effective method of delivery.
Intramuscular injections are generally more effective, providing almost 100% delivery of your dosage.  Many people don't care for the effort and trouble of weekly injections.  Some people have issues when their weekly dosage runs short a day or two before their next injection.

Sublingual delivery has been good for me, personally.  I'm similar to Janet Lynn in that I've had decent breast development, but no effects whatsoever in the areas of hips or bottom.

And if I may add, transdermal (patches) also avoid the filtering effect of the liver.  Their effectiveness is debated but if breast development is used as a barometer, I got to a small B on transdermal patches.  But breast development is such a small part of the overall effect hormones have on a person. 

Looking back, I think the biggest impact hormones had on me happened between my ears.  It's a slippery slope.  So when trying to achieve maximum hormonal effectiveness, consider all the aspects and the impact they may have.

I would love to have the opportunity to find out! but shots are illegal in the U.K  :(

I get really upset with you American girls because you can try shots!

Quote from: Naturally Blonde on February 22, 2012, 02:13:48 PM
I get really upset with you American girls because you can try shots!

I'll drink to that!

Quote from: Julie Marie on February 22, 2012, 02:42:50 PM
I'll drink to that!

Yes, but how do you think I feel?.... pretty pissed about it!

i read on the internet that the injections are better cause they dont really hurt ur liver as much as taking the pill does and i also heard that they make u see changed quicker than u would if u go on pills. you take them every 2 weeks

Quote from: Angelique1994 on February 26, 2012, 02:16:15 AM
i read on the internet that the injections are better cause they dont really hurt ur liver as much as taking the pill does and i also heard that they make u see changed quicker than u would if u go on pills. you take them every 2 weeks

Every week for me.

Quote from: Angelique1994 on February 26, 2012, 02:16:15 AM
i read on the internet that the injections are better cause they dont really hurt ur liver as much as taking the pill does and i also heard that they make u see changed quicker than u would if u go on pills. you take them every 2 weeks

Injection forms have a half life of 5-6 days... so by the 13th / 14th day most are getting pretty low on E. It's best to give yourself a shot every week. If a doctor prescribes you a certain dosage for every 2 weeks, I would say you should half your dosage and take it every week. I'll be doing this on my next shot. Besides... having astronomical estradiol levels is NOT fun...

Quote from: Angelique1994 on February 26, 2012, 02:16:15 AM
i read on the internet that the injections are better cause they dont really hurt ur liver as much as taking the pill does and i also heard that they make u see changed quicker than u would if u go on pills. you take them every 2 weeks

HOW? can I purchase them in the U.K as they are not legal here in the U.K? any reputable on line sources I can purchase them from? keeping in mind I have full medical support from my endo!

I'm getting fed up of being ignored in this forum and everybody from the USA rubbing it in how wonderful shots are knowing I can't get them over here in the U.K!

I go to a very big well known uhmm dr office place (watever sorry im stupid) for my hormones that specializes in it.  Every now and then my endo seems to change.
The first one told me the injections would provide faster results with less risks. 
The second endo "didn't want to say" (thats how she said it) that i should expect any better results by switching to intramuscular from sublingual.  She also told me the risks were the same.
About to be on my third endo so im interested in her view on this..

Just switched in injections so i guess i will see.  I hate needles but so many pills a day is too much for me.

I'm on Neofollin injections once per week. It's 5mg of estradioli valeras (synthetic estradiol identical to estrogen and the rest of the 1ml vial is filled with sunflower oil as a medium). The physical and psychological effects I experienced are way beyond what I've read in a textbook for doctors which discussed pills. However I have to add that I was on Androcur 50 for 5 weeks before Neofollin was added and never had any masculine features besides facial and body hair.

I first noticed breast development after 4 days. Nipple and breast sensitivity spiked up after 8 days. After 3 weeks my sexuality reactivated but it was completely different (female libido, yay :-) ). And my face changed so rapidly in one month and a half that I was no longer talked to as a man by  random people. After 8 weeks I visited my therapist and even though he's normally very professional I could notice a surprised stare. And one funny note: the regular weekly injections gave me a very regular mood cycle. At least the worst day isn't by far as bad as my older sister's PMS :-) .

And from what I've read on local Czech site the general experience is that Neofollin response is very strong when compared to Estrofem or Estrimax (pills). However Neofollin is rarely prescribed for a very good reason: high risk of serious side effects for patients who have history of smoking, drinking or drugs, had circulatory issues like phlebitis, epilepsy and like 50 more items on the list... Nearly perfect health record is required for this stuff to be prescribed.

A dose is  a dose. And we cannot talk about dosage levels here. That said, proper management will put your serum levels where they need to be, regardless of delivery.

there is always a lot of debate over these topics, but I think it all comes down to the individual experience. The key is being happy with whatever method you choose from what is available to you.

For me it would be pellets > patches > injections > pills

general take on pros/cons from my own standpoint (can you guess which one I'm using? ;)) disclaimer: I am not a doctor and not pretending to be one... take this worth a grain of salt

Pellets
+ steady dose release over 3-6 months
+ no peaks/valleys
+ no daily routine
+ cheap on low dose
+ more effective, quicker feminization (as a product of steady release, no valleys)
+ easy on liver
+ very stable mental state (as a product of steady release)
+ very easy on the body (closest possible thing to actual ovaries)
+ no side effects
+ easy to forget about being on HRT
- must be surgically implanted in office by a doctor
- more expensive when starting out (but faster feminization)
- cannot "cancel" a dose
- must keep bandage dry for first 3 days after treatment

Patches
+ easy on liver
+ can be applied at home
+ fast feminization
- can fall off
- can cause rash/allergy to adhesive
- peaks & valleys

Injections
+ easy on liver
+ can be applied at home
+ fast feminization
- involves needles on a weekly basis
- severe peaks & valleys
- possible mental effects due to hormone surges
- testosterone can rebound during valley (impedes feminization)

Orals
+ cheap
+ easy to administer
- slowest feminization
- bad for liver
- bad for mental state
- daily peaks & valleys
- daily routine

Quote from: Jennygirl on June 25, 2014, 07:21:24 AM

Orals
+ cheap
+ easy to administer
- slowest feminization
- bad for liver
- bad for mental state
- daily peaks & valleys
- daily routine

well.. this is a bit discouraging :( my endo seems adamant about keeping me on pills, telling me that injections or other methods are only necessary if I plateau, he doesnt even seem to use patches >_< would I be wrong if I went to my endo and said "I want faster methods please"? 

Quote from: LittleEmily24 on June 25, 2014, 10:54:41 AM
well.. this is a bit discouraging :( my endo seems adamant about keeping me on pills, telling me that injections or other methods are only necessary if I plateau, he doesnt even seem to use patches >_< would I be wrong if I went to my endo and said "I want faster methods please"?

Absolutely not!  I went right up to my endo and said, "I want patches as my delivery method because I feel it's safer for me."  And he prescribed me a popular name brand patch that sticks on you and doesn't want to let go!  It costs more, that's for sure, but it seems to be really harmonious with me in particular, if that makes any sense.  So just go to your endo and be adamant about it.

yes I agree 100%. You should be adamant and confident about it.

You could even say that the orals are not working out for you. Then you could gauge whether it's a good idea to bring up other methods (you might not want to offend them if they are the only one in your area).

If your endo makes you feel uneasy about asking about other methods though, it sounds like it's not an endo who truly cares and just wants to take your money and send you out of the door. In that case I would start looking for a better endocrinologist.

Quote from: Jennygirl on June 25, 2014, 07:21:24 AM
there is always a lot of debate over these topics, but I think it all comes down to the individual experience. The key is being happy with whatever method you choose from what is available to you.

For me it would be pellets > patches > injections > pills

general take on pros/cons from my own standpoint (can you guess which one I'm using? ;)) disclaimer: I am not a doctor and not pretending to be one... take this worth a grain of salt

Pellets
+ steady dose release over 3-6 months
+ no peaks/valleys
+ no daily routine
+ cheap on low dose
+ more effective, quicker feminization (as a product of steady release, no valleys)
+ easy on liver
+ very stable mental state (as a product of steady release)
+ very easy on the body (closest possible thing to actual ovaries)
+ no side effects
+ easy to forget about being on HRT
- must be surgically implanted in office by a doctor
- more expensive when starting out (but faster feminization)
- cannot "cancel" a dose
- must keep bandage dry for first 3 days after treatment

Patches
+ easy on liver
+ can be applied at home
+ fast feminization
- can fall off
- can cause rash/allergy to adhesive
- peaks & valleys

Injections
+ easy on liver
+ can be applied at home
+ fast feminization
- involves needles on a weekly basis
- severe peaks & valleys
- possible mental effects due to hormone surges
- testosterone can rebound during valley (impedes feminization)

Orals
+ cheap
+ easy to administer
- slowest feminization
- bad for liver
- bad for mental state
- daily peaks & valleys
- daily routine

I do patches I think there good , but sometimes you need to baby them because perspiration will make them fall off. You just need to dry the skin underneath and reapply .

Quote from: cynthialee on April 17, 2011, 08:44:07 PMAlso I only have to worry about my HRT once every 2 weeks.

This is one of the major reasons I'm switching to shots...

It's so annoying carrying the pills in my purse and figuring out how to take them three times daily without looking like I'm taking drugs or something... :(

Once I got my dosage right, pills are working fine for me. I experience none of these emotional changes throughout the day or whatever that these people are saying since I take half my dose in the morning and half at night. The thing I would be concerned about with injections is messing up and killing myself by hitting a vein with E and the peaks and valleys that come with only getting a dose once every one or two weeks as opposed to consistently every day. The thing about pellets is that they're so damned expensive.

I was already used to taking a bunch of daily medication for autoimmune problems, so the extra 8-some-odd pills I take a day for HRT/t blocking don't really bother me :P

Pellets are definitely expensive at first, but not in the long run. Once the T factories are gone, it requires a much smaller dose which is actually very comparable to pills because you really only need a few... I think my endo charges around $75 per pellet and at such a low dose (he mentioned likely around 2-3) will only need to be repeated every 6 months. 3 * 75 * 2 = $450/year. That is super cheap!

Okay I'm gonna stop being a pellet cheerleader. I always do this. Sorry y'all!

I'm using the gel and I can honestly say that after 6 months I do see an obvious change in my breast growth (I'm 60).  It seems to work better for me than the patches I was using.  I haven't tried pills as I believe they go through your liver on the first pass after being digested.  I don't like needles so I haven't gone there yet. 

Quote from: Janet_Girl on April 17, 2011, 01:14:46 PM
I will take other side from Pebbles.  I have been on the pills for the last 39 months and I am a B cup.  But nothing real has happened in the butt/hip area.

It all comes down to YMMV.

This. We are all pre-programmed with the genetic code to be a boy or girl. When T is the predominant hormone, the "boy code" is activated, and when E is the predominant hormone, the "girl code" is activated. When we switch our predominant sex hormone, initiating transition, the dormant genetic code you already have is what you get.

Part of that code may include a better response to one particular delivery method over another, but if your female genetic code is programmed for A-cup breasts then switching delivery methods probably won't magically give you double-D's.

Do all cis-women have double-D's? No. And they get their E internally, directly from the ovarian folllicle and starting at a very young age. At the end of the day, It's all about your DNA and YMMV.

I am on pills and I take E, AA, P and Fin, 10 pills a day in all.  Which is a lot of pills and sometimes I use to forget if I took them and have to think ( I get up at 3:15 A.M. For work) for a while to remember. I now use a nickel heads and tails for am and pm.

My PA said he would cycle me through pills, patched and injections to see how i fair on each method. I started on pills and he did not switch me. I have had good success but who knows how I would respond on injections. I have to admit I was thinking of asking about injections when I go back in December. I am a little nervous to use a needle.

I asked about pellets ( covered by insurance) and wanted them but they do not offer pellets. I go to a LGBT center in Philadelphia. I thought about going to another provider but I really love where I go. I feel very comfortable there.

It seems like those on injections are much happier than those of us on pills.  I'm seriously considering switching for this very reason.  Don't know how to deal with insurance coverage and how to physically get the inejctions (there is no way I'd be able to do it myself) but we'll see.  I'm just tired of feeling like I'm getting less results or moving at a slower rate than everyone else in my age bracket, even at a pretty high dose.  And considering the fact that injections are heavily promoted and endorsed by most who went down that route, there must e something to it. 

I'm with Jenny. Implants, nothing else gets close.

And extra bonus, you don't come off them for SRS.

Quote from: Cindy on June 26, 2014, 08:35:54 AM
I'm with Jenny. Implants, nothing else gets close.

And extra bonus, you don't come off them for SRS.

Implants sound great, but they are quite expensive.  I've been wanting to try it, but it makes saving up for SRS and other things more complicated with that expense on top of everything else.  Not to mention the fact that it doesn't seem to be available through every endo which is especially hard considering how much transcare is lacking in most places.  I'm in NY and wouldn't even know where to go for it.  At the end of the day, as tempting as it seems to go that route, it's just not worth it or possible for me in the long run.  Injections on the otherhand does sound possible and effective.  I don't know.  All I really know is that I want to be more happy with my current presentation and pills aren't doing as much as I'd hope.  But you know me, I complain all the time.  It's sort of my MO, lol.

It really annoys me how we as a community are ripped off. In Australia implants cost me about $120 for six months, I get half of that back from Medicare (our universal medical insurance) . The endo I go to specialises in treating menopause, guess what, menopausal woman don't want pills, patches or injections, why should we?

Our medical concerns deserve the same care as any other woman gets.

So why should we be treated any differently?

OK I've finished my rant!

I just switch to injections for my estrogen this week and had my first session on how to self-inject at the same. Even though my doctor commented on how well HRT is working for me we both agreed that switching to injections will help speed things up. Also after 7 months on HRT (pills) my testosterone was still on the high side ( Total Testosterone: 187 ng/dL, Free Testosterone: 4.8 ng/dL) and she didn't want to up the Spiro any more. (She also increased my Finasteride.)

As far as the injections go, the nurse showed me the first time. The second time the nurse with do the syringe and watch me self-inject, then the 3rd time they will watch me do it all. Once they are confident I can do it on my own, then I will do it on my own every 2 weeks. With a 21 gauge needle, there was hardly any pain whatsoever (barely felt anything). It goes pretty deep in the thigh muscle, and the stuff is pretty thick. So we'll see how it goes. It could be in my head, but I swear a had a little breast growth on the 2nd day after my injection. (My wife thought so too and that made her happy as well.)

I am on injections, and I am very happy with the results.

Quote from: Jennygirl on June 25, 2014, 06:28:48 PM
Pellets are definitely expensive at first, but not in the long run. Once the T factories are gone, it requires a much smaller dose which is actually very comparable to pills because you really only need a few... I think my endo charges around $75 per pellet and at such a low dose (he mentioned likely around 2-3) will only need to be repeated every 6 months. 3 * 75 * 2 = $450/year. That is super cheap!

Okay I'm gonna stop being a pellet cheerleader. I always do this. Sorry y'all!

That's a great price. Would this be before of after SRS. Like what do you mean by shutting the T factories down. Cause I know some peeps say that as soon as T is suppressed all you need is E.

I'm very happy for all of you girls who've gotten switched from pills to injections. I wish all of you the very best.

I got switched to estradiol cypionate injections but my insurance won't cover them. I've alerted my Endo concerning this, and have asked him to switch me to estradiol valerate injections instead. I'm hoping my insurance will cover the estradiol valerate injections because they are covering my estradiol valerate pills.

If they don't, I'm afraid I'll be stuck with pills as I can't afford $100. per month for syringes and the estradiol cypionate. I just wanna cry..... :icon_cry2:

Ally :icon_cry:

Mine isn't covered at all under insurance. The estradiol valerate is more expensive up front, a 5 month supply costs me about $108, but broken down monthly, it's about $21.60/month. My HRT doctor also switched me from the Propecia dose to the Proscar dose of generic Finasteride (5x the dosage). It's funny that the price of the generic Propecia Finasteride costs me $28 for a 3 month supply (was $158 a year ago), to just $13 for the generic Proscar dose of Finasteride.

I don't get why the insurance would cover some methods but not others. I could see it being all or nothing. Weird.

Rectally?!?!?!?!?!?!!?!?!?

Quote from: Jacelyn on April 20, 2011, 10:13:00 PM
Let me cite a study from: http://www.maturitas.org/article/PIIS0378512299000213/abstract (http://www.maturitas.org/article/PIIS0378512299000213/abstract)

The bioavailability of oestradiol gel (1.5 mg) is 61% of the tablet (2mg). As the bioavailability of oestradiol tablet (taken orally not Sublingually) is 1%. Thus oestradiol gel is 0.61%.

The bioavailability of oestradiol gel (1.5 mg) is 109% of the oestradiol patch. The bioavailability of oestradiol tablet (taken orally not Sublingually) is 109%+39%=148% of oestradial patch. Hence, bioavailability of oestradial patch is 1/1.48=0.67%

As matter of effectiveness / speed of absorption, the following ranking of methods applied (No.1= fastest):

1. Inhaling
2. Sublingually (8-10%)
3. Rectally
4. Intramascular injection (10%)
5. Skin implant
6. Orally (1%)
7. Skin patch (0.67%)

The cited study / figures support this view.

After what I've been hearing, I am getting the pellet implant done two weeks after my orchi for sure.

No more "Jill Pills".  EVER.   ;D

And not having to go through "minipause" before any major surgery is awesome.   I don't think I can handle two weeks without E anymore.

Quote from: Jill F on July 09, 2014, 08:36:32 PM
After what I've been hearing, I am getting the pellet implant done two weeks after my orchi for sure.

No more "Jill Pills".  EVER.   ;D

And not having to go through "minipause" before any major surgery is awesome.   I don't think I can handle two weeks without E anymore.

Congrats, Jill! You probably won't even need that big of a dose since you won't be fighting testosterone after the orchi. Way to go girl, you're gonna love it! Great decision! :)

Quote from: Joanna Dark on July 09, 2014, 12:45:03 PM
That's a great price. Would this be before of after SRS. Like what do you mean by shutting the T factories down. Cause I know some peeps say that as soon as T is suppressed all you need is E.

My endo said for me there are two ways to suppress T... 1) estrogen and/or 2) gonad removal.

When he started me off, he said that 3 pellets would be enough to suppress the T, no AA's. He said I will never need spiro and that hardly anyone ever does. But doing only 3 pellets before gonad removal means a slow transition- which may be good for some... But I wanted to go full steam ahead so I started at 7 and eventually went up to 12 (his max). Also I always like to state the only reason I am posting amounts here is because pellets are administered by endos only ~ it is surgically implanted... A reminder that any other dosages for other methods will not be allowed (sorry for the disclaimer).

After gonad removal (orchi/srs), he said 2 or 3 will be the max and the rate will be down to 5-6 months. He encouraged me to get orchi sooner because it would be drastically cheaper for me... But since I wanted to get SRS I decided to stay on the high dose and wait.

As with anything, the less stuff you put into your body to get the desired effects are probably better. That is why oral is so horrible.. The amount that you would have to eat to comparatively feminize the same amount versus a pellet is just crazy... Pellets are super efficient, much less estrogen going into your body by weight with much greater effect. Win-win

What's the implantation process like and how big are they?
Every 6 months right?

Quote from: awilliams1701 on July 09, 2014, 11:03:30 PM
What's the implantation process like and how big are they?
Every 6 months right?

they are cylindrical and kind of look like those fish food pellets in size, shape, and color. I think each pellet contains 4 doses, probably somewhere around 8mm long and 2-3mm diameter. They are small.

I think this is about as good as I can describe it... he has you get on the table and pull the pant belt area down above your butt, injects a local anesthesia, sanitizes the area, and makes about a 6mm incision in the fatty tissue about 1" over from the very top of your butt crack. Then he inserts the pellets one by one, gently placing them in there. Following the placement, he presses strongly to get them to set deep into the fatty/muscly area of your butt- it just feels like he's pressing it in there, doesn't hurt because the area has been numbed. Then he throws a steristrip on it and some bandages, tells you to not get the area wet for 3-4 days and sends you on your merry way. The whole process would take about 15-20 minutes, but he is a gabber and so am I- so it usually takes about 1-2 hrs :P ;)

Higher dosages have a higher falloff differential, so me for example with a high dose I go back in every 3.5 months. But with a lower dose that also means a lower differential so it can drop to as long as 6 months. Hope that helps.

That doesn't sound too bad. The worst part is the 3-4 days of keeping it dry. I don't know how I would keep my butt dry and still take a shower.

Quote from: Sydney_NYC on July 09, 2014, 08:26:57 PM
Mine isn't covered at all under insurance. The estradiol valerate is more expensive up front, a 5 month supply costs me about $108, but broken down monthly, it's about $21.60/month. My HRT doctor also switched me from the Propecia dose to the Proscar dose of generic Finasteride (5x the dosage). It's funny that the price of the generic Propecia Finasteride costs me $28 for a 3 month supply (was $158 a year ago), to just $13 for the generic Proscar dose of Finasteride.

$21.60 per month for estradiol valerate injections is a lot better than the $90. for the estradiol cypionate. Even if I had to pay out of pocket I can afford this. What I can't afford is $90. per month for estradiol cypionate, plus another $10. for the syringes.

Thanks for posting Sydney. Even though your not in the US I now understand why my insurance isn't covering the estradiol  cypionate -there's a less expensive alternative. This gives me hope they will cover the estradiol valerate injections.

Ally :icon_flower:

This question haunts me!
I just started hormones 3 weeks ago, and I've been taking pills orally.
However, I do believe my estrogen can be taken sublingually, but I've just been swallowing them because my endo didn't really give me clear instruction on what I should do. Although I heard that taking them sublingually will give me better results.
I'm also really curious about the shots, I really want to just do what is going to help me reach my maximum potential, y'know  :(

Quote from: kitty on July 09, 2014, 11:55:57 PM
This question haunts me!
I just started hormones 3 weeks ago, and I've been taking pills orally.
However, I do believe my estrogen can be taken sublingually, but I've just been swallowing them because my endo didn't really give me clear instruction on what I should do. Although I heard that taking them sublingually will give me better results.
I'm also really curious about the shots, I really want to just do what is going to help me reach my maximum potential, y'know  :(

While I await my injections to be straightened out with my insurance I still have to take pills. I put them under my tongue and let them disolve there and be absorbed rather than just swallowing them. Now I'm no Doctor so take this with a grain of salt, but I've heard you get almost 80% of your dose this way as opposed to just swallowing them and only getting 50-60% of your dose.

Hope it helps some.

Ally :icon_flower:

Quote from: kitty on July 09, 2014, 11:55:57 PM
This question haunts me!
I just started hormones 3 weeks ago, and I've been taking pills orally.
However, I do believe my estrogen can be taken sublingually, but I've just been swallowing them because my endo didn't really give me clear instruction on what I should do. Although I heard that taking them sublingually will give me better results.
I'm also really curious about the shots, I really want to just do what is going to help me reach my maximum potential, y'know  :(

The pills definitely work well. However, from everything I've read and experience of others, progress is faster with the injections. One reason I switched is that my T was still to high and going on injections means all the estrogen is going to be used and I don't have worry about certain foods (like broccoli that I love) counteracting some of the swallowed version. Also my doctor didn't want to up my Spiro, but was OK with upping my Estrogen. (Estrogen also lowers T.) My liver levels were perfect, so that isn't an issue and even though I'm over 40, medically I would be fine on pills (some people over 40 are not) since I'm in excellent health and I don't smoke, drink or use any recreational drugs and never have. Long term I think injections are better since they don't have to be processed by your liver. I do have fatty liver disease (hereditary from alcoholic grandfather), but as long as I don't drink are have too much sugar, my liver enzymes are normal and perfectly healthy. Since my liver now has to work less, there is less chance of liver issues down the road. Once I have SRS, the only thing I'll have to take is injections of estradiol valerate and it will be at a much lower level.

Quote from: Jennygirl on July 09, 2014, 10:56:23 PM
As with anything, the less stuff you put into your body to get the desired effects are probably better. That is why oral is so horrible.. The amount that you would have to eat to comparatively feminize the same amount versus a pellet is just crazy... Pellets are super efficient, much less estrogen going into your body by weight with much greater effect. Win-win

The difference in levels between me on pills (SL) and an implant was almost nothing.. It made no difference to my levels of development either. Liver tests were all about the same too..

I don't know that stating implants are better over anything else is entirely true.. I'm suspecting that it depends on the individual...

I take pills and shots, and that seems to work well for me.  I take estradiol daily, and estradiol valerate inj. every other week.




No Dosages Please

Quote from: kelly_aus on July 10, 2014, 09:31:24 PM
The difference in levels between me on pills (SL) and an implant was almost nothing.. It made no difference to my levels of development either. Liver tests were all about the same too..

I don't know that stating implants are better over anything else is entirely true.. I'm suspecting that it depends on the individual...

True, and I am not trying to pretend to be a doctor with all of the answers. However I have just never heard otherwise when it comes to pellets, and if I asked my endo if pills could ever be more effective I have a feeling he would probably give me a really funny look.

When you were on the pellets, how many did your endo prescribe you? I know that some dr's are afraid to do any more than three- mine would likely consider that a minimum dose as he did with me- or a dose for someone who wants to feminize over the course of two or three years (slowly)

Yeah ... They are effective and i'll tell you why from my experience as a transgender. I am transgender person from India suffering from puberphonia  too, which is a great advantage. I'm a medical student  now and had started on self medication on various formulation of oral  estrogens that includes natural estrogen  ie. estradiol valerate  and weakest estrogen  called estriol which is normally seen in pregnancy. I had started all this 5 years back (approximately around early 17 year)s. I'm now 22 yrs. I have experimented with various kinds of anti androgens(Ketconazole,bicalutamide,spironolactone,dutasteride) but not finasteride due to the dangerous side effect of finasteride called post finasteride syndrome. Dutasteride works wonders if you have enough money. And I have taken various synthetic estrogen like ethinyl estradiol  which is highly potent(meaning produces powerful action in small doses compared to estradiol valerate). Ethinyl estradiol increases Sex hormone binding globulin by 10 times compared to normal estradiol valerate equivalent which increases 2 times. Yes there is greater suppression of testosterone but there is excessive shbg which is a protein making the blood thicker and difficult to flow and causing decrease blood flow to brain( meaning -stroke)and clot formation. I have noticed best effects in  Injection and transdermal patch estrogen together, Depot estradiol valerate and transdermal patch to prevent the estrogen coming to low. Dutsteride is optional, but produces best results. Why estradiol injection formulation first it dosn't stress your liver and unlike oral estrogen it keeps the estradiol:estrone high.  estrone is carcinogenic in excess and is less  potent than estradiol. Our liver converts the oral esradiol into estrone. Second it kind of mimics the fluctuating normal menstrual cycle and yeah injection do cause mood swing , anxiety , sweating ( due to super low or super high estrogen that supersaturate and downregulate the estrogen receptor). The hormones need to bind to something  called receptor in the body to produce action. The body produces produces less receptor when  excess hormone is present and thus less action of estrogen and produces more receptor when less. Yes oral estrogen does produce stable concentration thus no side effects like mood swing anxiety but slow result  . But normal woman does suffer the fluctuation. It also improves your intuitive abilities from what i have found. Towards the end  of estradiol injection shot  cycle you may feel low anxiety sweaty so transdermal patch to prevent the estrogen coming to low.  FIve days prior to injection progesterone at high dose. Benefits It converts the estradiol into estrone and then to estriol. These weak estrogen block the receptor thus upregulating them. It normalize the clooting factor. Yeah increased energy and mood is seen with natural progesterone. Progesterone has natural anti dht effects.( Source:ncbi) Both progesterone and estrogen in excess gets converted into testosterone . So STOP  OVERDOSING. MAXIMUM EFFECT IS SEEN IN LOW DOSE . Side effects can like blood clot can be prevented by Vitamin e 800IU/ per day and aspirin. Injection increases prolactin which yeah increases milk but it also enhance the effect of testosterone on body and scalp hair follice and has potency and similarity as that of DHT. So Vitamin B6 for mental concentration(Dopamine)and estrogen dominant symptom and hypothyroid like symptoms that come with high estrogen. Vitamin b12 ,methionine(amino acid), VItamin b6 must be added coz the liver tries to remove the excess estrogen and in the process it uses vitamin b6 , methionine, and vitamin b12.  Thus deficiency can occur. Magnesium to prevent  the side effect seizures. and lot of fibre diet to remove the side effect of increased blood pressure.  Breast tissue requires lot of iodine. So Take Your multivitamin and mineral DAILY. AND also take complete protein. these all help your body to repair itself. Do your research again. Please For heaven sake . I suggest you take this information to your doctor and just show him as he will he will understand this better than you will.  And thus help you better. Last Of all Believe in yourself. Never eat excess in the notion that you will help fat redistribution instead you will be causing more damage and aging. Make your self flexible by doing stretches and exercise you will increase receptor for estrogen and hence action of estrogen. Anxiety (Unwanted pointless  worrying about future ) can be controlled by meditation and  exercise. Restlessness( Walking  excessively without realising )... Remember oral contraceptive have more side effects nd can be countered with just vitamins minerals and exercise alone. Over doing will only cause harm.. Do your research and help your doctor too by giving him this handy information so he/she could help you  better. Since injection do produce high level of estradiol as that of pregnancy it musnot be used for more than a year and preferably can be added  with spironolactone to counter the major side effects. High estradiol inhibits 5 alpha reductase . But progesterone inhibits 5 alpha reductase better. That means both estrogen and progesterone can prevent the formation of dht. I dont prefer anti androgen though it may be useful coz they may affect your cognitive abilites like your mathematical ability and  intelligence and memory. PLEASE  Give  importance to education first then rest will follow. believe me.  Selenium and iodine for proper thyoid functioning and Vitamin b6 ,vitamin c, zinc for adrenal functioning. So i suggested both vitamin mineral and complete protein daily.

*mod edit for dosages

Just started injections last month and can say the mood swings are worse than pills or troches.

Well, after todays Endo visit I can definitely say injections are much more effective. The most my E would get on tablets was 168 pg/ml, whereas after 3 months on injections my E today was 605 pg/ml. -a vast improvement. I'm happy, my Endo's happy, and finally my E is up where it should be for full transition. My Endo said to just keep doing what I'm doing as my vitamins too look great. My overall health looks fantastic, and I look hea according to my Endo and my bloodwork. So I was a very happy girl after this visit to my Endo.

Happy Holidays!! :icon_bunch:

Ally :icon_flower:

I love the mood swings on injections.

Well, I love to hate them.

My wife laughs at me and says it's karma for all the years I called her crazy:)  she after a hysterectomy, now has a higher testosterone level and I have the higher estrogen.  My son thinks it's awesome.  At least he's in college now!

My mood swings were worst on pills than on injections. I prefer shots over the pills. I gained a small boost in breast growth in my first of month of injections so that was pretty awesome. I really wish I could afford pellets.

I did pills sublingual for 15 months and IM 3 months. IM is more effective for me. My IM schedule is 14 days and I get low on day 10-14. My PA will allow me to go 10 days in march after he sees my blood work. I have consistently very bad dysphoria day 10-14. I hold back tears at work and sometimes I have to close my office door and cry. Going to and from work is emotional. 

Does anyone know a place that compounds pellets or would ship in mail (with a prescription of course).  I've asked compounding places, even my endocrinologist, and they have no clue about pellets.  Wish I could add thyroid to it too..  but just have nobody to send my Dr to talk to?

I've been on HRt for a long number of years and went off the injections a number of years ago and then went on the patches at  my doctors  request. I dont think the patches have a very strong feminizing effect on ones overall appearance, at least in my case. I'm about to see a new doctor and go on injections if  possible or take an estradiol  tablet ever day. I dont think the patches have a very powerful softening effect. I'm more concerned with facial softening for example than breast growth. I don't think the patches have a very potent androgenizing effect. I think the pills are probably more potent and the injections as well. The patches are easy and liver friendly but I hav not noticed them to be very effective in terms of overall androgenization.

As my Dr would say. Patch's, orals, injections or whatever... none of these have a feminising or anti androgenising effect in themselves. What matters and what determines your progress is what your blood levels say. Certainly it may vary from person to person in how a particular delivery method is tolerated etc but in the end it comes down to the blood levels over time. 

My doctor recommended pills instead of shots. I guess it's different for everyone.

Quote from: Cynobyte on December 06, 2014, 10:43:24 PM
Does anyone know a place that compounds pellets or would ship in mail (with a prescription of course).  I've asked compounding places, even my endocrinologist, and they have no clue about pellets.  Wish I could add thyroid to it too..  but just have nobody to send my Dr to talk to?

You could look up compounding pharmacies. There are a few in the us. From other places I'd look for quality, because a quality production is important for a steady dose.
They even deliver international, to medical personnel. 
Available should be estrogen, bioidentical progesterone and different, even very low doses of testosterone.

There is further information online at some of them, like leaflets with some info for endos (mostly for menopausal treatment though) because its not that common.

And, well, there are a few endos who do pellet treatment...

When I was on pills my E wouldn't get above 168 pg/ml. I've been on injections for 7 months now, and my E floats around 450 to 550 pg/ml. So for me injections work much better than the pills ever did or could.

I'm intersex tho and genetically female(female hermaphrodite) so my genetics makes things more complicated for me at least. Having said that, In my observations of friends on this website and others the injections tend to yield better results, and are liver friendly no matter whether your intersex , mtf, etc, etc, etc. As for myself and my well being, I know the injections are a better solution -IMHO that is.

Peace
Ally

For me shot also are better than pills, before on pills+gel ( high dosage ) i was around 200pg/ml, now i'm third week on shots and my E levels are around 800pg/ml ( 4 days after shoot )
Also me and my friends see how fast my body start to change now.

I started off on the pills, then they moved me to patches and that only lasted about a week and a half because they wouldn't stay on and caused a really bad rash. I'm now on the injections and am completely happy with the results.

I was on patches for 15 months and I am not satiesfied. I will now try injections (Neofollin). They hard hard to get here in Germany but I get a prescription from my doc and the pharmacy has ordered them from Czech Republic.

Lara

BTW, higher pg/ml of estrogen levels doesn't equal better feminization, or faster feminization. Efficient level is the highest level one needs, and what is an efficient level for somebody might not be efficient enough for other. And you can only tell if it's working by real life results, not labtest results. How much your body can feminize is much more than E delivery method (and pg/ml levels) dependent on your genetics, and how much damage was caused by testosterone poisoning. If one has good feminizing results while measured 200 pg/ml, having estrogen levels at 800 pg/ml or more will not likely cause better results, but it could that much more likely cause unwanted and potentially dangerous side effects.

I've been on patches for over a year. If I change I'd like a nice pellet implant so there is nothing to do but relax. Shots make me nervous.

I think what comes out of this discussion is that everyone is different. There's no absolute right or wrong as to the best delivery method. some people have more success with one than the other. Estradot patches have worked great for me and the doctors at the GIC are well satisfied. The other thing with transdermals is the much much lower risk of blood clots especially if you are over 40 like I am.  Key to all this is how your blood levels respond which is the ultimate measure if it's getting into your system.  For me that's been Oestrogen of around 550-600 and T of around 1.8   But that may not work for everyone. Some people do get more, or less, feminsation from different levels. We are all different.  Bottom line is see what your blood levels are and what your doctors say!

Quote from: mmmmm on March 27, 2015, 04:02:40 PM
BTW, higher pg/ml of estrogen levels doesn't equal better feminization, or faster feminization. Efficient level is the highest level one needs, and what is an efficient level for somebody might not be efficient enough for other. And you can only tell if it's working by real life results, not labtest results. How much your body can feminize is much more than E delivery method (and pg/ml levels) dependent on your genetics, and how much damage was caused by testosterone poisoning. If one has good feminizing results while measured 200 pg/ml, having estrogen levels at 800 pg/ml or more will not likely cause better results, but it could that much more likely cause unwanted and potentially dangerous side effects.

Yes, thats true.
I got a lot better body feminisation with shots despite my E levels.
I'm on Neofollin too.

Quote from: CB on March 27, 2015, 04:55:05 PM
I think what comes out of this discussion is that everyone is different. There's no absolute right or wrong as to the best delivery method. some people have more success with one than the other. Estradot patches have worked great for me and the doctors at the GIC are well satisfied. The other thing with transdermals is the much much lower risk of blood clots especially if you are over 40 like I am.  Key to all this is how your blood levels respond which is the ultimate measure if it's getting into your system.  For me that's been Oestrogen of around 550-600 and T of around 1.8   But that may not work for everyone. Some people do get more, or less, feminsation from different levels. We are all different.  Bottom line is see what your blood levels are and what your doctors say!

This^^^^^ is so true! I couldn't have said it any better!!

Ally

Really, I am just happy to be on HRT full stop.

Per oral medication is working out just fine for me. I'm very happy with the results.

How much estrogen one has in their system isn't going to make for a successful transition in itself. It's what is up here (*taps her head*) that counts.

I had a good start on the pills and patches and gel all at once ::)  I felt a lot better on gel and patches but that was way too much fuss slathering all the gel on, patches falling off and sucking on the pills... While feminization was good even at a pretty low level of E for all I was taking it was just way too much to deal with every day.... I like taking a shot every five days and forgetting about it and things certainly are moving along nicely on EV injections ;D  So for me they are much better ;)

For me having done both, the pills have a steadier approach, whereas the shots have a noticeable boost that tails off until your next shot. 

Pills = less mood swings for me.

Nationally renowned clinics. for example University of California San Francisco Transhealth Clinic (The Center of Excellence for Transgender Health), do not even test estradiol serum blood levels, only rate of femininization and overall health.  Just spoke with one of their doctors by phone the other day.  Serum levels are far too unpredictable and not considered indicators of any one reproducible, verifiable biological outcome.   Dani

P.S.  UCSF is having a national transgender health summit next month, April 17, 18., and they have downloadable protocols for health care providers.  Oh and yeah, shots work well for me.

why not ask an endo. we are not experts on sex hormones.   

I'm bringing this back from the dead. 

Was on patches for nine months.  Levels were great.  E was 363 pg/ml and T was 10ng/dl (my T was 415 when I started).

Switched to injections in February and it's a much higher dosage.  (If the numbers are comparable.. I guess it to be 5x more of a dose weekly).

I'm noticing some problems.

1.  Acne
2.  Hair falling out
3.  Increased growth/darker facial hair
4.   Increased morning wood. (It's happened 3 times this week alone).
5.  Problems sleeping
6.  Stress
7.  Cranky.

I have labs tomorrow.  I've consistently been on 200mg of spiro but from what I'm reading it's either

1.  High DHEA
2.  E dominance
3.  T coming back to life.

It's only been 2 months.  Is this enough time to panic.  Should I lower the dose?  Has all the E in me flared up T that has practically been eliminated?


The increased/darker facial hair drives me nuts.  I've been doing laser and the last two times right before the amount of dark hair on my face/neck has gotten worse and the darker hairs on my chest and I don't want to lose the hair on my head. 

Any ideas/suggestions.   

What kind of estrogen are you on ? Estradiol valerate ?

What is your method of application ? Intramuscular ?


hugs

EV and in the butt.  :)   ;D

Quote from: Laura_7 on April 28, 2016, 11:32:36 AM
What kind of estrogen are you on ? Estradiol valerate ?

What is your method of application ? Intramuscular ?


hugs

Everything points to the injections being less effective and giving you LESS E, not more than when on patches. E dominance is a myth, not scientifically substantiated. DHEA is actually sometimes suppressed due to E. How often do you inject?

E helps with sleep, clears acne due to sebum suppressive effects, is anti-androgenic, is a mood enhancer.

Interesting discussion on this thread. Having posted elsewhere about my recent tests can anyone who takes injections refer me brand names / types of injection? I need some specific info for a clinician in Bangkok.

Mod Edit- leave moderation for the moderators. TOS 7.

 :police:
TOS 7. Leave the moderating up to the moderators. Thank You.
Mariah

Estradiol Valerate - Progynon Depot or Delestrogen
Estradiol Cypionate - Depo Estradiol (less safe, I think)

Hydroxyprogesterone caproate (progestogen) - Proluton Depot

Quote from: KayXo on May 19, 2016, 03:26:32 PM
Estradiol Valerate - Progynon Depot or Delestrogen

Delestrogen is also available as multidose vials so it may be more convenient with traveling.


hugs

Fantastic: thank you ladies.

I'm guessing the valerate version or estradiol is better with an injection because of the slow release?

Quote from: Richenda on May 19, 2016, 06:39:22 PM
Fantastic: thank you ladies.

I'm guessing the valerate version of estradiol is better with an injection because of the slow release?

Yes imo .


hugs

Ok success. I have found a great clinic in Bangkok. They will do me regular tests and the prices are excellent.

The drug regime is interesting. The prescription for the IM hormone injection is two vials. One is estradiol valerate Progynon Depot 10mg/1ml

The other vial is Proluton Depot (hydroxyprogesterone).

Would you advise taking both or just the estradiol?!

Anyone reckon the IM shots make you more drowsy? I've always been a bit dopey on oestrogen but unless it's my imagination the IM has made me more so. I quite like the mellow feel but I slept for 8 hours last night and siesta'd again today.

Could be as you adjust but E should give you energy...perhaps the T is getting lower due to higher E?

Yeah I've always had a more doped out feel on E though. You could be right about the T drop: I'll mention it to the clinician. I'm really noticing with the IM that there are peaks and troughs. Had a hot flash moment last night. I guess when I was on sublinguals I spaced them through the day, so every 8 hours.

Does anyone have a link to the bioavailability of injections? I saw it a few days ago but failed to note the link and can't now find it. I'm specifically after injections of oestrogen, preferably the estradiol valerate version. Thanks in advance if anyone can help. x

I think you have to factor in your lifestyle as well. For example, I'm not sure but in order to take the injections don't you have to visit your endo's office? Like shots have to be taken at the office? Because if that's the case, you'd have to factor in your schedule. Say you have to work the day you are supposed to take your next shot and you don't have time that day to go to your endo. And so it creates inconsistency. Whereas with the pill you can pop it in your mouth on the way out the door for work, school, etc.

I know for me I wouldn't mind the shots. I have Severe Congenital Neutropenia and so I have been taking shots 3 days per week since I was diagnosed in 2005 and will have to take them virtually for the rest of my life. So after like two weeks I just got used to sticking myself regularly. Doesn't phase me at all. Granted subcutaneous is different than intramuscular I still don't fear the needle. I just wonder if insurance covers them differently or something. As some of you say they are more expensive. And so does that really even matter if you're covered by insurance?

The Estrodiol Valerate is the slower release version due to an added chain on the bond.  Delestrogen (Estrodiol Valerate)  is what I have been taking for the past 6 months and I haven't experienced any drowsiness with the IM injections.  A common cycle is about 2 weeks to metablize the injection.

Quote from: SerenaOhSerena on August 07, 2016, 06:25:08 PM
I think you have to factor in your lifestyle as well. For example, I'm not sure but in order to take the injections don't you have to visit your endo's office? Like shots have to be taken at the office?

No.

YouTube search for "estradiol valerate injection".  You will see plenty of videos of cis women doing injections at home for in-vitro fertilization or surrogacy.  It is the same thing for trans women.  The exact same injection procedure, and the exact same estradiol valerate.  There is no need to go to a doctor to do such a simple self-injection (which I do myself, at home, weekly).

The only time I had an injection in my doctor's office was the first time, and I did it myself.  My doctor wanted to teach me how to do self injections and he monitored my first shot. 

After switching back and forth between injections and orals for over ten years, I have no doubt that, for me and my partner, at least, injections are far more effective than orals.  But now the serum seems to be in short supply.

Another thing I have found is that it is hard to find a doctor willing to prescribe injections.  For ten years I had one doctor who was amazing in both his knowledge of treating transwomen and his methods in doing so.  Now that I've moved out of state and my old doctor has retired, I am finding most doctors cannot break themselves of the mindset that transwomen should be treated like natal women.  They cannot seem to fathom we are not the same in physiology.  I am working on that...   

Yes and no why?
Because it depends on the person and how their body responds to certain things
what doesn't work good for one person may work great for another person so to say something works or doesn't without knowing how someones body responds would be invalid. 

Estrogen has been a part of my life since I was about 13. They would place you on oral along with biweekly injections to overcome t in your system because blockers were unknown.   This is just my experience, but all the girls I know that went onto injections saw faster results than with oral alone. By results, I mean feminization in their faces and breast growth along with the 'glow' that only comes from estradiol injections, not to mention that sudden rush or high about 30 minutes to an hour thereafter. I called it my estrogen high -- can't quite describe it,  other than feeling so euphoric and peaceful. Most everyone I know experiences it. I also noticed that it puts out some sort of pheromone or something that attracts guys like flies!! Darn, now I want to go get some e-injections.. 

Quote from: herekitten on January 13, 2017, 01:26:13 PM
Estrogen has been a part of my life since I was about 13. They would place you on oral along with biweekly injections to overcome t in your system because blockers were unknown.   This is just my experience, but all the girls I know that went onto injections saw faster results than with oral alone. By results, I mean feminization in their faces and breast growth along with the 'glow' that only comes from estradiol injections, not to mention that sudden rush or high about 30 minutes to an hour thereafter. I called it my estrogen high -- can't quite describe it,  other than feeling so euphoric and peaceful. Most everyone I know experiences it. I also noticed that it puts out some sort of pheromone or something that attracts guys like flies!! Darn, now I want to go get some e-injections..

so no matter if your on oral or injections everything will end up with the same result just One might take longer than another?

What's most effective is what's safest. I would refuse pills outright cos I'm not into risking my life like that. I'd rather take nothing.

Quote from: Angélique LaCava on January 13, 2017, 02:28:35 PM
so no matter if your on oral or injections everything will end up with the same result just One might take longer than another?

I only speak to my experience. I guess the answer to your question would be a yes. With t-suppressors and estro, you should arrive at the same point. When I began, t-suppressors were unknown to us so maybe that is why we took estrogen and delestrogen along with some progesterone. Studies may indicate differently, but from my view/experience the injections change the physical faster than oral alone. I know some of my friends whom were only on oral for a few years and they looked great. After talking, they went on delestrogen and the changes were noticeable. I wish I knew what it is, but it just feminizes the body in a way that is quite noticeable..... and that 'glow'.  If you decide to add it to your routine, talk with your dr because he would know best.  Good luck  ;)

Quote from: DanaDane on April 28, 2016, 10:10:36 AM
I'm bringing this back from the dead. 

Was on patches for nine months.  Levels were great.  E was 363 pg/ml and T was 10ng/dl (my T was 415 when I started).

Switched to injections in February and it's a much higher dosage.  (If the numbers are comparable.. I guess it to be 5x more of a dose weekly).

I'm noticing some problems.

1.  Acne
2.  Hair falling out
3.  Increased growth/darker facial hair
4.   Increased morning wood. (It's happened 3 times this week alone).
5.  Problems sleeping
6.  Stress
7.  Cranky.

I have labs tomorrow.  I've consistently been on 200mg of spiro but from what I'm reading it's either

1.  High DHEA
2.  E dominance
3.  T coming back to life.

It's only been 2 months.  Is this enough time to panic.  Should I lower the dose?  Has all the E in me flared up T that has practically been eliminated?


The increased/darker facial hair drives me nuts.  I've been doing laser and the last two times right before the amount of dark hair on my face/neck has gotten worse and the darker hairs on my chest and I don't want to lose the hair on my head. 

Any ideas/suggestions.

What were the lab results? T coming back on 200 spiro would be quite surprising....
It almost sounds like too much E or another imbalance, only your blood tests can say. Acne can be caused by many things, stress and anxiety among them but also diet. Your hair grows in cycles, so since it has been a while I would be curious if you are still having this issue. Hopefully you worked it out!

It is such a shot in the dark. Research shows it's important to keep the dosages and time of dosages consistent every day for maximum effect and most stable levels. Then you add in breaking down better orally vs under the tongue vs release times of shots and blah blah blah

I asked my doctor for injections recently and she said there is nothing that suggests it is more effective, but that it is more expensive. I'm deciding at the next visit if I want to switch purely so I'm not taking pills constantly, but the more research I do the less inclined I am to make the switch now. I've been really happy with my progress so far and am not too interested to start experimenting, especially when my interest in switching has only stemmed from uncorroborated 3rd partys

If it's not broken leave it!

Quote from: JMJW on January 13, 2017, 07:06:25 PM
What's most effective is what's safest. I would refuse pills outright cos I'm not into risking my life like that. I'd rather take nothing.

Kind of extreme..

Pills aren't poison unless you are taking them incorrectly... The side effects from Estrogen are far riskier than the side effect of swallowing a pill. The delivery system is by far the least risky part of this process.


I would just compare here :
Has anyone here NOT been in a car accident regardless of whose fault it was?
vs
How many had a health episode caused by pills being processed by your liver?

Safest would be never driving again lol.

Quote from: LShipley on January 14, 2017, 04:02:53 PM
Kind of extreme..

Pills aren't poison unless you are taking them incorrectly... The side effects from Estrogen are far riskier than the side effect of swallowing a pill. The delivery system is by far the least risky part of this process.


I would just compare here :
Has anyone here NOT been in a car accident regardless of whose fault it was?
vs
How many had a health episode caused by pills being processed by your liver?

Safest would be never driving again lol.

I think the problem here is that it's difficult to establish causality with these things, but heart attack and stroke are the leading causes of death in the western world by far.
The reality is, taking oral steroids: testosterone or estrogen or derivatives thereof, in addition to blood clot risk going up  3 or 4x, it can cause bad cholesterol to increase. I think it's unwise to take those risks if there are alternatives available.

It's only an issue if your older. When your young and healthy you don't have to worry much.

Quote from: JMJW on January 14, 2017, 05:28:49 PM
I think the problem here is that it's difficult to establish causality with these things, but heart attack and stroke are the leading causes of death in the western world by far.
The reality is, taking oral steroids: testosterone or estrogen or derivatives thereof, in addition to blood clot risk going up  3 or 4x, it can cause bad cholesterol to increase. I think it's unwise to take those risks if there are alternatives available.

Yeah thats an extreme point of view honestly about the pills like that has more to do with diet than anything else. And us here in the states have some of the worst diets on the planet. Blood clot risk from what I know is only high if you're actually obese, take it orally not sublingually and you're a smoker, including a terrible diet with little to no exercise.

Quote from: Lady_Oracle on January 14, 2017, 06:58:19 PM
including a terrible diet with little to no exercise.

. Well, that includes about 90% of all the people in the country.



It is better to be hated for what you are than to be loved for what you are not.
André Gide, Autumn Leaves

Quote from: Deborah on January 14, 2017, 08:13:39 PM
. Well, that includes about 90% of all the people in the country.



It is better to be hated for what you are than to be loved for what you are not.
André Gide, Autumn Leaves

lol maybe but everyone I know my age at least exercises and we're young so the odds of blood clots for us is like low as can be.

One has to come to a personal decision based on accumulated risk factors.

Dehydration, Inactivity, Weight, Medication, diet, smoking, etc.

I reckon I'm high risk. My cornea has torn twice from dehydration, I don't really move when I'm working and I sleep too much. If I took spironolactone , which is a diruetic so i'd potentially get more dry, and then oral estrogens? I'd be so dead. 

Dehydration is really easy to fix though.  Just drink more water and add salt if you need it.

I find that while on spiro and exercising I need 20 to 24 eight oz glasses of water a day.  Even drinking that much I don't really have to pee too many times a day.


It is better to be hated for what you are than to be loved for what you are not.
André Gide, Autumn Leaves

Exactly, I totally get that. In my case I've always been naturally dry and it got 10x worst when I started hrt but I've managed over the years. I can't stand spiro at this point, due to the increase in dryness. The other aa's arent all that better so spiro is my best bet and I'm sensitive to side effects in general so I really dont wanna go down that road of trying new meds again. I literally spend half my day in the bathroom but its better than dealing with dysphoria like I was before, lesser of two evils. On the bright side I drink tons of water so despite it all, thats a good thing either way. I can't wait to be off it but surgery isn't gonna happen for a long time unfortunately.

Deborah, wow, that's a lot of water.  I'm on a lower dose of Spiro and I've only increased my water intake slightly.  You might want to discuss your dosage with your doctor.

Sent from my LG-H820 using Tapatalk

I had to increase to the max dose to get my T in the right range.  It dropped on a lower dose but not enough. 

As for the water, when I run I sweat a lot; even before HRT.  I once measured it and figured I was sweating around 2 liters an hour running in the summer (in Georgia).  Even at less than 40 degrees I finish with my now longer hair dripping.  I've always thought that was just a sign of a really well developed internal cooling system.

I will mention it to my Dr, but all my blood values are normal and I had a physical to check my blood sugar and cholesterol a few months ago.  Those were normal too.


It is better to be hated for what you are than to be loved for what you are not.
André Gide, Autumn Leaves

Quote from: herekitten on January 14, 2017, 08:29:52 AM
I know some of my friends whom were only on oral for a few years and they looked great. After talking, they went on delestrogen and the changes were noticeable. I wish I knew what it is, but it just feminizes the body in a way that is quite noticeable..... and that 'glow'.

Since being on injections and oral progesterone, I also noticed that 'glow', others have too. My skin glows... :)

Quote from: JMJW on January 14, 2017, 08:22:59 PM
One has to come to a personal decision based on accumulated risk factors.

Dehydration, Inactivity, Weight, Medication, diet, smoking, etc.

I reckon I'm high risk. My cornea has torn twice from dehydration, I don't really move when I'm working and I sleep too much. If I took spironolactone , which is a diruetic so i'd potentially get more dry, and then oral estrogens? I'd be so dead.

The risk of clots so often talked about was noted with estrogens in high doses which were NOT bio-identical. One needs to differentiate between those forms and what is prescribed commonly today. Estradiol taken orally has far less impact on caogulation and as a result, several studies have shown oral estradiol to be quite safe in transwomen.