My estradiol levels came out to be 1,800. I know this is normal for many that are on injections. I take mine weekly at the standard dose and have been doing so for about a year and a half. Prior to that, i was on pills and had low estradiol at around 60 ng/dl. My testosterone is undetectable (post op) and my progesterone wasn't measured.

I know that women that are estrogen dominant suffer from negative symptoms, so what can I do to counteract these symptoms? I feel like this estrogen dominance explains a lot of the random weight gain and bloating I've been having. I had a very small 24 inch waist before because my skeleton is small but now it's 27 to 28 inches. I feel like all my fat goes to my belly , thighs, and bottom.

My hemoglobin A1c was tested as normal and I'm not a health freak but I'm not a junk food binger either!
Medications include:

Estradiol Valerate (IM)
Progesterone pills
Spiro (discontinued post op a couple months ago)

Any experience with this?

Thanks!

Hello Ash,

When you refer to "estrogen levels", are you referring to E2 levels or total estrogens? Total estrogens are reported as E1 (estrone), E2 (estradiol), and E3 (estriol) levels, although the latter is typically very low except in pregnant women. The reason I ask is I recently had a blood assay that reported only total estrogens, and it was over 1000 pg/mL, which was way higher than I expected (I take my estradiol sublingually and usually get an E2 level of 150-200 pg/mL). A subsequent blood draw reported my E2 levels as 70 pg/mL and E1 levels about ten times higher.

Most clinicians use average luteal phase concentrations of E2 for cis-women as a target (100-250 pg/mL). Your serum levels seem to be much higher, but that is very dependent on when your blood draws are taken in relation to your injections.

That said, peak plasma estrogen levels are probably not a good index of bioavailability due to the pharmacokinetics of estrogen metabolism (see reference below).  A better clinical picture of estradiol levels is the AUC (Area Under the Curve) which is a function of plasma levels over time. 

CLIMACTERIC 2005;8(Suppl 1):3–63
H. Kuhl, Department of Obstetrics and Gynecology, J. W. Goethe University of Frankfurt, Germany

ABSTRACT
This review comprises the pharmacokinetics and pharmacodynamics of natural and synthetic estrogens and progestogens used in contraception and therapy, with special consideration of hormone replacement therapy. The paper describes the mechanisms of action, the relation between structure and hormonal activity, differences in hormonal pattern and potency, peculiarities in the properties of certain steroids, tissue specific effects, and the metabolism of the available estrogens and progestogens. The influence of the route of administration on pharmacokinetics, hormonal activity and metabolism is presented, and the effects of oral and transdermal treatment with estrogens on tissues,
clinical and serum parameters are compared. The effects of oral, transdermal (patch and gel), intranasal, sublingual, buccal, vaginal, subcutaneous and intramuscular administration of estrogens, as well as of oral, vaginal, transdermal, intranasal, buccal, intramuscular and intrauterine application of progestogens are discussed. The various types of progestogens, their receptor interaction, hormonal pattern and the hormonal activity of certain metabolites are described in detail. The structural formulae, serum concentrations, binding affinities to steroid receptors and serum binding globulins, and the relative potencies of the available estrogens and progestins are presented. Differences
in the tissue-specific effects of the various compounds and regimens and their potential implications with the risks and benefits of hormone replacement therapy are discussed.

One member you may want to contact is KayXO.  She is very knowledgeable about these things, and her E2 levels are astronomical, compared to most girls.

With kindness,

Terri

Quote from: Maybebaby56 on April 14, 2018, 09:27:59 PM
Hello Ash,

When you refer to "estrogen levels", are you referring to E2 levels or total estrogens? Total estrogens are reported as E1 (estrone), E2 (estradiol), and E3 (estriol) levels, although the latter is typically very low except in pregnant women. The reason I ask is I recently had a blood assay that reported only total estrogens, and it was over 1000 pg/mL, which was way higher than I expected (I take my estradiol sublingually and usually get an E2 level of 150-200 pg/mL). A subsequent blood draw reported my E2 levels as 70 pg/mL and E1 levels about ten times higher.

Most clinicians use average luteal phase concentrations of E2 for cis-women as a target (100-250 pg/mL). Your serum levels seem to be much higher, but that is very dependent on when your blood draws are taken in relation to your injections.

That said, peak plasma estrogen levels are probably not a good index of bioavailability due to the pharmacokinetics of estrogen metabolism (see reference below).  A better clinical picture of estradiol levels is the AUC (Area Under the Curve) which is a function of plasma levels over time. 

CLIMACTERIC 2005;8(Suppl 1):3–63
H. Kuhl, Department of Obstetrics and Gynecology, J. W. Goethe University of Frankfurt, Germany

ABSTRACT
This review comprises the pharmacokinetics and pharmacodynamics of natural and synthetic estrogens and progestogens used in contraception and therapy, with special consideration of hormone replacement therapy. The paper describes the mechanisms of action, the relation between structure and hormonal activity, differences in hormonal pattern and potency, peculiarities in the properties of certain steroids, tissue specific effects, and the metabolism of the available estrogens and progestogens. The influence of the route of administration on pharmacokinetics, hormonal activity and metabolism is presented, and the effects of oral and transdermal treatment with estrogens on tissues,
clinical and serum parameters are compared. The effects of oral, transdermal (patch and gel), intranasal, sublingual, buccal, vaginal, subcutaneous and intramuscular administration of estrogens, as well as of oral, vaginal, transdermal, intranasal, buccal, intramuscular and intrauterine application of progestogens are discussed. The various types of progestogens, their receptor interaction, hormonal pattern and the hormonal activity of certain metabolites are described in detail. The structural formulae, serum concentrations, binding affinities to steroid receptors and serum binding globulins, and the relative potencies of the available estrogens and progestins are presented. Differences
in the tissue-specific effects of the various compounds and regimens and their potential implications with the risks and benefits of hormone replacement therapy are discussed.

One member you may want to contact is KayXO.  She is very knowledgeable about these things, and her E2 levels are astronomical, compared to most girls.

With kindness,

Terri

No, I have an even brillianter idea....... she should contact a DOCTOR. 

Quote from: Maybebaby56 on April 14, 2018, 09:27:59 PM
Hello Ash,

When you refer to "estrogen levels", are you referring to E2 levels or total estrogens? Total estrogens are reported as E1 (estrone), E2 (estradiol), and E3 (estriol) levels, although the latter is typically very low except in pregnant women. The reason I ask is I recently had a blood assay that reported only total estrogens, and it was over 1000 pg/mL, which was way higher than I expected (I take my estradiol sublingually and usually get an E2 level of 150-200 pg/mL). A subsequent blood draw reported my E2 levels as 70 pg/mL and E1 levels about ten times higher.

Most clinicians use average luteal phase concentrations of E2 for cis-women as a target (100-250 pg/mL). Your serum levels seem to be much higher, but that is very dependent on when your blood draws are taken in relation to your injections.

That said, peak plasma estrogen levels are probably not a good index of bioavailability due to the pharmacokinetics of estrogen metabolism (see reference below).  A better clinical picture of estradiol levels is the AUC (Area Under the Curve) which is a function of plasma levels over time. 

CLIMACTERIC 2005;8(Suppl 1):3–63
H. Kuhl, Department of Obstetrics and Gynecology, J. W. Goethe University of Frankfurt, Germany

ABSTRACT
This review comprises the pharmacokinetics and pharmacodynamics of natural and synthetic estrogens and progestogens used in contraception and therapy, with special consideration of hormone replacement therapy. The paper describes the mechanisms of action, the relation between structure and hormonal activity, differences in hormonal pattern and potency, peculiarities in the properties of certain steroids, tissue specific effects, and the metabolism of the available estrogens and progestogens. The influence of the route of administration on pharmacokinetics, hormonal activity and metabolism is presented, and the effects of oral and transdermal treatment with estrogens on tissues,
clinical and serum parameters are compared. The effects of oral, transdermal (patch and gel), intranasal, sublingual, buccal, vaginal, subcutaneous and intramuscular administration of estrogens, as well as of oral, vaginal, transdermal, intranasal, buccal, intramuscular and intrauterine application of progestogens are discussed. The various types of progestogens, their receptor interaction, hormonal pattern and the hormonal activity of certain metabolites are described in detail. The structural formulae, serum concentrations, binding affinities to steroid receptors and serum binding globulins, and the relative potencies of the available estrogens and progestins are presented. Differences
in the tissue-specific effects of the various compounds and regimens and their potential implications with the risks and benefits of hormone replacement therapy are discussed.

One member you may want to contact is KayXO.  She is very knowledgeable about these things, and her E2 levels are astronomical, compared to most girls.

With kindness,

Terri

Thanks for the useful info! I asked this because my clinic just doesn't seem to know what they're doing. They typically don't even check estradiol levels in their trans patients and they only checked mine because I kind of asked (well, forced them to, basically).
I'm in the process of finding a new doctor, specifically an endocrinologist, instead of a family practice doctor that just treats trans patients. I just went to that clinic because I was new to everything trans related and wanted hormones with informed consent rather than going through therapy, letters of recommendation, etc. because I knew with 100% certainty that I'm trans.

Quote from: Devlyn Marie on April 14, 2018, 09:34:16 PM
No, I have an even brillianter idea....... she should contact a DOCTOR. 

Haha I love how you said that.  Very true.. my biggest issue is I've contacted doctors.. multiple doctors.  Really a plethora of specialists with a vast array of tests, examines, blood assays, etc... They still are clueless to what makes me tick. Aint life grand?  So then I rely on the internet for opinions.. after all SOMEONE out there might be experiencing what I am.

I do agree insomuch that alot of estrogen levels can depend what type of test, and when you had your last shot.  To be consistent, keep the shots consistent vs when you get your blood labs drawn.

That being said I do agree.. yes... ask a doc.  Barring that, find and research! Especially when answers aren't forthcoming.  Just read into my background you'll know the nightmare I've faced.

Quote from: Devlyn Marie on April 14, 2018, 09:34:16 PM
No, I have an even brillianter idea....... she should contact a DOCTOR. 

I assumed she had, and that's the problem: she wasn't getting good answers and wanted information. I was just trying to be helpful.

~Terri

Precisely! You guys don't know how many times I've heard, "oh, people just react differently to the hormones" from the doctors at my clinic... So we're just going to act like extreme mood swings, unexplained belly fat and constantly being bloated is okay?? Alright then 

Quote from: ashw on April 14, 2018, 07:03:57 PMI know that women that are estrogen dominant suffer from negative symptoms

Several studies show this NOT to be the case and women doing quite well on just estrogen, at high levels.

QuoteI feel like this estrogen dominance explains a lot of the random weight gain and bloating I've been having.

Why couldn't it be from the progesterone? Estrogen makes the body more sensitive to progesterone so at higher levels of E, progesterone is also more potent/stronger.

QuoteI feel like all my fat goes to my belly , thighs, and bottom.

Studies tend to show progesterone promotes fat deposition while estradiol keeps fat away from waistline. Progesterone increases my appetite, estradiol decreases it...this has also been observed in women and across animal species.

QuoteAny experience with this?

Your problems could *perhaps* be due to too low T. I am post-op and take T. It helps.

Discuss those issues with your doctor please, only they can do something about it. We can give you ideas, pointers but in the end, decisions will have to be made in the office with your doctor. Best of luck.