sooo apparently my endo prescribed estrogen to me in a "cream"... I'm just curious as to how this works and i've also read some horror stories in terms of hormones and topical creams... like literally the though of having hormones applied in a gel kinda raises my anxiety levels because the crazy ->-bleeped-<- that i've read.

Just curious if anyone has ever used estrogen cream and exactly how much is supposed to be used? I mean even if it says there to use a certain amount, how do you know you are using that exact amount? >__< I dont plan on using any of my silverware or measuring items to measure the cream... and the fact that i've heard that coming into contact with others on the areas you've applied the gel can have effects on their health... idk maybe i'm just being overly dramatic but when I hear the word "hormones" and "topical cream" put in the same sentence, i freak out. I think the one I was given is called Premarin... I also read that it has very little effect.

Pharmacology of estrogens and progestogens: influence of different routes of administration, CLIMACTERIC 2005;8(Suppl 1):3–63

"The efficacy of transdermally administered progesterone is contested. In a study with postmenopausal women, the daily application of a cream containing progesterone on the skin increased the serum levels of progesterone only slightly" Other studies have found slightly better bioavailability. But, I remain skeptical. 

The same could be said of estrogen cream. Especially when applied on skin vs in vagina, where systemic (general circulation) effects are observed with both Premarin and Estrace cream when applied inside vagina. The skin is not a good site for cream absorption whereas mucosal tissue is a much better site, like scrotal/vulva tissue or vagina.

I also don't understand why she would prescribe Premarin cream when there is a better, safer alternative in Estrace cream that delivers higher levels of bio-identical estradiol relative to estrone and no equine (horse) estrogens that are known to increase clotting risks and affect hepatic parameters more strongly, even if taken non-orally.

Personally, I don't think the cream will be effective if applied on skin and if anything, you should be using Estrace instead. I urge you to further discuss this option with your doctor and consider using another route, like a gel, for example, where better absorption would be obtained. I think it'll be a waste of your money unless used on scrotal tissue (or vulva if you are post-op). I don't think vaginas of post-ops absorb as well as natal vaginas.   

I just called my Endo to do just that, and it turns out that it was the receptionist who made the error of telling me it was a cream; upon calling back they told me that all my medications are in tablet form 

sorry for wasting a post 

Not a waste, at least people got to know a little more about creams, their effectiveness, etc. In case, they consider this option in the future.

Hope you're not taking Premarin...

I take bioidentical tri-est cream as well as bioidentical progesterone cream.  I am over 40 and likely have a somewhat compromised liver.  I've been on it for just over a year and trust me, it works just fine.  I haven't had my levels checked, but everything seems to be in order.  I feel great and that's all that really matters to me.  I'll let the surgeons take care of whatever the HRT doesn't over the next couple of years.

Tri-est contains mostly estriol and small amounts of estrone and estradiol (8:1:1 ratio). This is counterproductive for us since what we most need for our purposes, to feminize and achieve breast growth (and feel good), is estradiol and as much of it unopposed by weaker forms of estrogen such as estrone (12 x weaker) or estriol (80 x weaker). In pre-menopausal women, estriol levels are very low (comparable to men and post-menopausal women) whereas estradiol levels are twice as high as estrone. Wouldn't you want to be closer to that ratio instead?

What you end up getting is a high concentration of estriol that competes with lower concentrations of estradiol and estrone at the receptor level with the net result of very little estradiol actually affecting your body and sub-optimal results unless you take much higher doses but I'd still be worried about estriol competing with estradiol. Estriol levels will only be high during pregnancy, a time when estradiol levels are extremely high anyways and where estrone levels are still lower than estradiol.

http://cebp.aacrjournals.org/cgi/content-nw/full/12/5/452/T1. In pg/ml, estriol levels are still lower (multiply by 1000) than estradiol during pregnancy.

So, while you may be fine with results, I don't quite understand the rationale behind using this cream which is very rarely prescribed to transsexual women given their goals. You may be doing much better, still be safe with just estradiol, which anyways converts to estrone in the body naturally which then converts to estriol...http://alaskadigitalvisions.com/femalehormones/ImagesGeneral/008E1E2E3_576.jpg

I'm also on the fence about cream effectiveness and absorption based on several reports. This route would seem to be the least effective of all routes.

I just thought I should warn you, in case you didn't know all this. I wouldn't want you to waste your time and money on something that is not tailored to our needs and mostly formulated for genetic women who have a different risk profile than us and different needs...they've also already had their puberty

There are far better non-oral alternatives such as patches, gels, injectables that only deliver estradiol.

My tri-est is custom compounded for my needs at a much different ratio.

I went from flat-chested to a B cup in one year.  Skin is baby-butt smooth, not much body hair left and I have a butt now.  It's working, and enough so that I look female now.

I'm getting an orchi very soon and I will probably end up with pellet implants.

OK. Great to hear, wow!. Really very happy for you. So, what's the ratio like, if I may ask? Now, I'm curious...

But, I still don't see the point in having all three estrogens in a cream. Why not just have estradiol? What's the purpose of having the others? And anyways, some of the estradiol ends up being converted to those weaker estrogens in the body. Did your doctor explain to you his/her reasoning behind having all three?

Quote from: KayXo on February 18, 2014, 06:57:49 PM
OK. Great to hear, wow!. Really very happy for you. So, what's the ratio like, if I may ask? Now, I'm curious...

But, I still don't see the point in having all three estrogens in a cream. Why not just have estradiol? What's the purpose of having the others? And anyways, some of the estradiol ends up being converted to those weaker estrogens in the body. Did your doctor explain to you his/her reasoning behind having all three?

I don't have the formula handy, it's not printed on my clicker and my endo just calls it in to the compounder.  It's mostly E2 (estradiol) and because it goes through the skin, it bypasses that first pass through the liver.   Oral estradiol gets mostly converted to a weaker form immediately by the liver (from my cursory understanding of this) anyway, so the cream only has 10% the potency or so of an oral dose and is easier on the system.  The weaker estrogens are present in cisgirls, and simulating what goes on in a GG's system is what my endo likes to do.  It seems there may be a synergistic effect on nipple and breast development and estrone is noted for positive mental effects.

Once I go sin cojones, one click of the cream I have may be too much for one day, so I think I'm going with the implant for smoother sailing and continue to do a cycle of progesterone cream.   I do a monthly cycle, and believe me, by the end I really don't mind getting off that ride.

Quote from: Jill F on February 18, 2014, 07:22:45 PMOral estradiol gets mostly converted to a weaker form immediately by the liver (from my cursory understanding of this

Yes, estrone and this is the predominant estrogen when estradiol is taken orally.

Quote from: Jill F on February 18, 2014, 07:22:45 PMThe weaker estrogens are present in cisgirls, and simulating what goes on in a GG's system is what my endo likes to do.  It seems there may be a synergistic effect on nipple and breast development and estrone is noted for positive mental effects.

Non-pregnant ciswomen have very low levels of estriol in their bodies (same as genetic men and menopausal women) and 2x as less estrone levels in their bodies than estradiol so that if you only took estradiol in cream base, gel or whatever other non-oral route, estradiol would naturally convert to estrone in the body and estrone would naturally convert to estriol such that you would have all three, in about the same amounts (ratios) as ciswomen. So there is no point in having all three in a formulation if the body can give you all three naturally from just taking estradiol. See my point? It just doesn't make much sense. Would be much simpler to just do it like all other transsexual women do. I think this way, with the triest, you are bringing more estrone and more estriol in your body than you actually need and you might even be paying more (are you?) whereas it could be cheaper if it were just estradiol (?).   

Quote from: Jill F on February 18, 2014, 07:22:45 PMcontinue to do a cycle of progesterone cream.   I do a monthly cycle, and believe me, by the end I really don't mind getting off that ride.

Why cycle? Cycles lead to fluctuations in mood, ciswomen actually complain about them and wish they didn't exist!, frequent fluctuations in cell growth and death (apotopsis) which increases (according to some, is speculated to) the risk of mutations (and breast cancer) because with each new growth and new cell division, there is a chance of a mutation. This may be, some speculate, the reason why genetic women have breast cancer vs us, where no cycles are present in most of us as we take a fairly constant dose in comparison and in whom breast cancer is very low, comparable to genetic men, despite taking estrogen (and progesterone) for several years. There is more to it but I believe I already posted about this before on here.

Cycle is also a recent phenomena in ciswomen. If you look at mammmals (like primates, our closest relatives, especially the apes) and at most our history, one observes that females spent most their time breastfeeding, a time when hormone levels are low and stable or in pregnancy, although to a lesser degree when yes, there is cell growth but only for a short time so that menstrual cycles were much less experienced vs the hundreds of cycles today. There is nothing natural about a cycle...we are the only mammal in which females experience so many menstrual cycles and this could be possibly lead to increased risks. Why even take that chance since you don't have to and why go through ups and down mentally? In my opinion, it's not worth it.