Quote from: Sophia Sage on November 18, 2016, 08:30:24 AM
Back in the day, I remember on some board (or maybe on Usenet, hah! I've just dated myself) a Russian woman making the argument that injectable EV was more efficacious than EC (or anything else, for that matter). I don't remember the reasoning, though, or whether it was solid.
I think I know who you speak of and her assertion might have been that EV is actually 10 x less potent according to pharmaceutical recommendations and that it might be safer but it was recently discovered through more research that there shouldn't be much difference between EC and EV, both appear as potent and equally safe, relative to each other.
QuoteThe literature certainly suggests that EV yields much higher serum levels, but for shorter periods of time
Exactly that. Higher peaks but shorter duration with a half-life according to some studies of 4.5 days. EC's absorption is more prolonged with slightly lower peak levels, due to its longer ester chain such that it would appear injecting less frequently does not result in lows (i.e. PMS).
Quote from: jentay1367 on November 18, 2016, 08:48:18 AMIsn't the important thing being your personal numbers are where they should be? [I.E.] that your estrogen levels are maintained at a female level of around 200 pg/mol?
Not pg/mol but pg/ml (also in pmol/L outside the US).
Female levels actually fluctuate from as little as 20 pg/ml to up to 650 pg/ml during a single menstrual cycle and up to 75,000 pg/ml during pregnancy so that they are all over the place and even overlap the range of men (10-30). There is no such thing as a normal level, it would seem. Normal levels are arbitrarily set. The right level for one woman might be different for another. Common sense as we all differ in our responses, sensitivities due to genetics, metabolism, weight, age, hormonal environment, what we eat, drink and if we take other medications too.
Aust NZ J ObTtet Gvnaecol 1998. 38: 3: 45"it is difficult to define a therapeutic drug concentration when considering implant therapy because patients may vary in their oestradiol requirements (...) In addition, serum oestradiol levels may not necessarily reflect tissue oestradiol levels."
CLIMACTERIC 2005;8(Suppl 1):3–63"Even though there is a significant correlation between the serum concentrations of estradiol and their clinical effects, e.g. on hot flushes or bone mass, the serum level of an individual woman does not predict the therapeutic effect. As shown in Figure 1, the number of hot flushes differs largely in patients who showed identical estradiol levels during transdermal hormone therapy1.
This casts considerable doubts on the usefulness of regular measurements of hormone levels for the prediction or control of a therapeutic success."
Again, just think for a moment. Does everyone react similarly to the same alcohol concentration in their blood or the same amounts of drugs in their bodies? No. That principle applies to hormone levels too.
Also, hormone levels fluctuate so that taking a measurement might not even be accurate, if there were even such a thing as an ideal level.
Maturitas, 12 (1990) 171-197"When the serum concentrations of natural or synthetic sex steroids are measured at short time-intervals after administration and repeatedly during long-term treatment, it becomes obvious that there are large intra-individual and interindividual variations. This holds true for both the contraceptive steroids and the natural oestrogens and does not apply solely to the oral route. Long-term studies indicate that an important influence is exerted by predisposing factors, particularly the metabolic capacity of the liver, on the pharmacokinetics of sex steroids.
Large variations in oestradiol and oestrone levels can be observed in an individual woman from day to day or from hour to hour, even during transdermal therapy with oestradiol"
I'm not a doctor but this makes sense to me. Discuss it with your doctors, as always and find out what they have to say.