Being force by insurance to switch from injection to patches. Am wondering what the difference in experience may be. Any help would be appreciated

Injections, topical and sublingual all get absorbed into the body first and avoid the first pass through the liver which only happens if you swallow your tablets.

The real difference is in the half-life of the Estradiol. Sublingual tablets have a very short half-life and should be taken 2 or 3 times a day.

Injectable has the longest half-life and once a week injections are the norm. Some people lower the dose and inject twice a week to reduce side effects. Some people do not feel comfortable being near needles.

Patches are often changed twice a week. Sometimes patches can become loose and fall off the skin, especially when wet through sweat or in the bath. Some people have reported skin irritation with some patches. There are also topical gels available, but if someone comes in contact with your gel site, they may get some rubbed off you and onto them. This may be a problem for some people, especially young children.

There have been many discussions at Susan's Place on which method is best. It really comes down to which method you feel most comfortable with. They are all effective and will achieve blood levels necessary for feminization. Your doctor can monitor blood levels and adjust your dose as needed.

Quote from: Dani on January 31, 2019, 09:51:44 PM

The real difference is in the half-life of the Estradiol. Sublingual tablets have a very short half-life and should be taken 2 or 3 times a day.

But is it important to have a steady level? I'd been taking mine sublingually and twice a day when I got into multiple pill dosage. 
I thought I had seen something that higher initial level from once daily dosing would be more effective than trying to maintain a steady level.

My last blood levels were down, I assumed at least partly from it having been 24 hours since a full dose as opposed to previously having been about 12-14 hours from a half dose.

Can't say I've noticed an increase or decrease in development since going to once a day.



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I have not seen any studies directly comparing the feminization effects of the different methods of administration.

My personal preference is for sublingual twice a day. It works for me. Other people may have a different experience. My opinion is that when someone complains that their method is not working is really a complaint that it is not working fast enough for them to reach their goals in terms of physical changes. Hormone therapy takes time, often two years or more.

Until more research is available, the best advice I can give is get your blood levels into the normal female range and keep it there for several years. Keep in mind that blood levels can vary throughout the day with sublingual administration. To see the lowest level (trough) have the blood drawn before you take your daily dose and to see the highest level (peak) the blood sample should be taken within one hour after you take your daily dose. Injectable and patches being much longer half-lives, do not have this problem as dramatic as sublingual administration.

To summarize, steady state blood levels are not that important for feminization. Even cis women have hormone blood levels that vary throughout their monthly cycle. It seems to work for them. 

Ok, didnt think I'd missed something regarding a steadier blood level for E.

I've always held my morning estradiol until after the blood draws to avoid peak levels showing up.  Trough level would be the one to keep elevated and I want my doses adjusted based on that.

I had some other blood tests that were out of whack do were re tested a month later and were back in range.  Hormone levels I'm getting tested again after 3 months (1 month from now yet). Levels were in the female range still, but testosterone was up a bit and estrogen was down below transition levels. I'll keep going with once a day until then and see how things are.

Sorry to hi-jack your thread Rosey.
Hopefully keeping it fresh so  someone that has switched from injectable to patches will see it and chime in.

My opinion on patches is that they are great for maintenance dosing but I think multiple patches would need to be worn to get transition dosing.  That is the reason I did not switch to them from the tablets when my doctor asked me if I wanted to.

Your doctor may be able to get the insurance to cover the injectable by getting a prior authorization. Insurance might also make you try the  patches before allowing for a prior authorization.

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Quote from: Dani on February 04, 2019, 07:04:44 AM
My personal preference is for sublingual . . .

Well I *gulp* three x's a day have found patches and injections an utter nuisance . . . Rosy ask doc & insure 'bout subdural implants, now that's the way to go!

Im kinda confused about my patch rotation.   I am on a Monday Friday schedule.   But I cant figure out how that equals twice a week.   Monday AM to Friday AM is 5 days     Friday AM to Monday AM is 4 days.    Should I try and figure out the exact time that breaks the week in half?   

Im probably overthinking this again.

Quote from: Jenny1969 on February 04, 2019, 01:31:34 PM
Im probably overthinking this again.

Yes you are! Actually, midpoint would be sometime, what, Monday afternoon? Or prior Thurs late? In alternating the location of patches used to leave old one on an extra day (or 2) just in case . . . but don't confuse which one!

Speaking of nuisance, lol how ya like showering just twice a week?

Quote from: Jenny1969 on February 04, 2019, 01:31:34 PM
Im kinda confused about my patch rotation.   I am on a Monday Friday schedule.   But I cant figure out how that equals twice a week.   Monday AM to Friday AM is 5 days     Friday AM to Monday AM is 4 days.    Should I try and figure out the exact time that breaks the week in half?   

Im probably overthinking this again.

Probably. 

I did mine on Thursday morning and Sunday evening, 3-1/2 days apart.

Quote from: Chloe on February 04, 2019, 11:11:52 AM
Well I *gulp* three x's a day have found patches and injections an utter nuisance . . . Rosy ask doc & insure 'bout subdural implants, now that's the way to go!

Thank you so much for this suggestions just asked insurance and doc just need a prior authorization now

Quote from: Jenny1969 on February 04, 2019, 01:31:34 PM
Im kinda confused about my patch rotation.   I am on a Monday Friday schedule.   But I cant figure out how that equals twice a week.   Monday AM to Friday AM is 5 days     Friday AM to Monday AM is 4 days.    Should I try and figure out the exact time that breaks the week in half?   

Im probably overthinking this again.

If it's a twice a week patch, it should be a 3 day and 4 day interval. If you can keep track you can go every 4 days.

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Quote from: Jenny1969 on February 04, 2019, 01:31:34 PM
Im kinda confused about my patch rotation.   I am on a Monday Friday schedule.   But I cant figure out how that equals twice a week.   Monday AM to Friday AM is 5 days     Friday AM to Monday AM is 4 days.    Should I try and figure out the exact time that breaks the week in half?   

Im probably overthinking this again.

Hello again Jenny

I think the majority of us choose to go 4 days and then 3 days meaning if you start Monday AM, you simply change every Monday AM and Friday AM.

However quite a fair number of us including me prefer to do 84 hours (3.5 days) each meaning if you start Monday AM, you change every Monday AM and every Thursday evening.

Hugs

Pamela  xx