So today I started. It is a patch that I am wearing. I think it takes a while to get used to because I am extremely focused on things that sit on my body that should not be there naturally and can get pretty sensitive about it.

But after a few hrs i start to get used to it, but I am very worried about the patch to curl or fall off , so I am pretty stiff att the moment .


Anyways it feels great to be on the right path .

Quote from: Carolina1983 on April 25, 2012, 09:11:54 AM
So today I started. It is a patch that I am wearing. I think it takes a while to get used to because I am extremely focused on things that sit on my body that should not be there naturally and can get pretty sensitive about it.

But after a few hrs i start to get used to it, but I am very worried about the patch to curl or fall off , so I am pretty stiff att the moment .


Anyways it feels great to be on the right path .

Hehe Awesome!

From what I'm aware, its quite durable. My afore-mentioned acquaintance said they end up feeling second nature and you don't realise you have them on. But i'd probably follow you're thinking and treat them carefully incase they fall off.

X

The last I've read about gels was "uneffective", but I don't know if the info was reputable or anything. Patches seem good to me; it's the method that delivers hormones in a way most similar to ovaries - as small dose, continuously. Some doctors, and me too, think that it's quite an advantageous method.

Apart from that, I think pills would be my second choice. Easy, invisible ("hey, Mary, what's that big bandage on your hip?"), cheap and simple. That's what I have.

As for the patch falling, it shouldn't happen in theory... but it does happen to some, depending on skin type. If it comes off, ask your pharmacist for a tip. Maybe just a little medical tape would do the trick. (I don't know if a patch that is held by tape would still deliver its full does, though.)

I'm on the estrodot patch, and work out until I'm as wet as i am in the shower...... it has never fallen off.  I am also a firefighter, so I work hard, and it has never fallen off.  I use two a week.  One for three days, one for four.  There are 8 in the box.

Also, transdermal estrogen has been shown to be less of a clot risk than pills.  Which was a benefit for me.

My endo is fantastic.  His approach is simple... stop the testosterone, and your body won't need high levels of estrogen.  I'm on Lupron Depot, which is expensive  as hell... (I get it from Canada for much less than the US).  Had great results, even at 42 years old.  I read a lot about HRT before starting, and never saw anything about Lupron.  Of course, there's also the orchi surgery... that will also stop your test, which will lower your need for the amount of estrogen.

Health wise, it's a great option.  Stop the testosterone, lowers the amount of estrogen to cause feminization.  Makes sense.

But back to the patch... never had a problem, and I am very, very active.

If there is a problem with the patch falling of, some people put a waterproof bandage on top of it.

I used a once-per-week patch, that got itchy after about 5 days.  So I just peeled it off and moved it.

     Hi,
      My doctor percribed estradiol gel for me// how effected is it, doe's it really work?
     Thanks
     janis

Ok so now I am 2 weeks in. The first patch was a pain to keep on because I did not know where to place it.. But now I have found a spot that is perfect for the patch (finally), I will keep the patch for a while longer but in the future I will switch to something else. It would be nice with a implant to be honest.


Anyway here is the thing that makes me somewhat stunned..... I am just 2 weeks in but my skin already changed to the better a week ago. How is this possible? even my wife noticed because I am smooth like a baby. But I expected it to take atleast 1,5 months or so before I would notice any changes.

Also my sexdrive is zero. And the thing downstairs feels... Hmm I am not sure how to explain it but its like the wires are cut off, my brain doesnt connect to it.. But I am not complaining , it feels good actually.

janis: I PERSONALLY don't think gel is the most effective delivery method; however some have had good experiences with it. But either way, it does have the desired effects; only, if I'm right, not as much as patches or pills.

Carolina1983: It is possible. I noticed the exact same thing (though I wouldn't say I had THAT much of a change with my skin). However, you might be unconsciously seeing more effects than what there actually is through placebo effect / wishful thinking, and it can go for anyone, wife included, as long as they know you're on HRT.

    Hi Carolina,
      Thanks for the information, I do get a little
    headache from it, I hope that's the worst that
    happens.
      Hugs,
      janis

Quote from: janis on May 08, 2012, 01:44:21 PM

    Hi Carolina,
      Thanks for the information, I do get a little
    headache from it, I hope that's the worst that
    happens.
      Hugs,
      janis

I also got a headache but it dissapeared just a few days ago. Sure I can get it for some short periods but it is not like it was the first week .

I wish you all the best ..

Hugs
/C

Gel is a effective method just as patches are. If a guy asks you what is the patch in your butt, tell him it is your chosen birth control method.

     Hi Again,
       A little update on the gel which I am taking, It seems I feel more comer
     and for some reason I am not crying like I was before.
     Hugs,
     janis

More comer?

More calmer? that the only guess that I can come up with .


3 weeks in now and the thing that I have noticed are.

1. Softer skin and the pores are a little smaller now.

2. Much calmer although I can swing from happy to sad in a second

3. My breasts are looking a tad different and I also asked my wife to see if it was only my imagination but no. The have changed shape and the area around the nipples are a bit raised (I dont know any better way to describe it).


So I am happy so far , the paches seem to work and I found a good position for them so that they do not fall of as easy as they did the first week.

The mood swings make life ... interesting
X

Congrats Carolina! I'm very happy for you (and a tad jealous).

I haven't seen an endo yet, but in terms of pills- what variety of estrogen pills should I request when I get to that point? I'm thinking I'll try to get my endo to put me on spiro and estrogen, and pills sound like the cheapest option.

Pills are the second cheapest, actually. Injections supposedly cost next to nothing. But I don't recommend injections.

Anyway~  you don't have to worry about that, really. Your endo should know what they'll prescribe. But in case you do worry, the usual medications are:

-Conjugated estradiol (often sold under the brand name Estrace® for pills, or Estraderm® for patches)
-Spironolactone or cyproterone acetate (often sold under the brand name Androcur®)

  Hi,
   Sorry about the mispelling,more calmer
  Hugs,
  janis

Quote from: A on May 17, 2012, 05:52:39 PM
Pills are the second cheapest, actually. Injections supposedly cost next to nothing. But I don't recommend injections.

Anyway~  you don't have to worry about that, really. Your endo should know what they'll prescribe. But in case you do worry, the usual medications are:

-Conjugated estradiol (often sold under the brand name Estrace® for pills, or Estroderm® for patches)
-Spironolactone or cyproterone acetate (often sold under the brand name Androcur®)

why u dont recommend injections?

Don't take my word as a fact - injections are subject to controversy and debate, and neither side has any actual proof to invalidate the other. So, 1. most of what I say is contestable; 2. even doctors cannot give 100 % certain information. Nevertheless, my opinion can hardly compare to the expertise of one who has experience in the endocrine treatment of transsexuals and has studied medicine. So definitely listen to your doctor.

However, my reasons for believing that injections are not a good idea are (to avoid any confusion, those are merely organisational frames; I am not quoting anyone):

Quote
They consist in a huge dose administered once a week, and count on the injection site (intramuscular, or fatty tissue, I think) to differ the actual diffusion of the product in the blood. But if you don't do it right or -something- goes wrong, there's a slight chance that it might not be really differed, and everything would be released in your blood very quickly, which carries risks. If you do it right, the risk is negligible if not absent, but -I- would personally not trust myself.

Quote
Even though the diffusion of the product is a bit differed, it still spreads hormones around your body much faster than any other delivery method, at a much higher dose, which causes a steep spike in your hormone levels, followed by a large trough until the next dose - since it's administered weekly. So your hormones regularly go both way higher and way lower than the regular levels.

But it has been shown (mentioned here) that in the early pubertal natal female (at the stage when most secondary characteristics develop, actually, such as breasts), oestrogen levels increase very steadily, without spikes: it's before the start of menstruation, in average.

As steady levels of oestrogen is how it works in the natal female, and it seems to work well, it makes sense to me that it should be how it works best in trans females, too.

Quote
And still on the very up-and-down pattern that injectable oestrogen creates... Well, it's just extrapolation, but apart from treatments where shock is what we're looking for (e.g. chemotherapy), in medicine, it's generally common wisdom to research the smoothest curves of serum levels and effects, to try to make them look like a straight line, no?

I just think it feels wiser, safer and most effective to go for a steady approach, too.

Quote
Moreover, since hormone levels go up and down a lot, by the end of the week, your levels should be very low. At that time, you have a significant level of neither estradiol nor testosterone, which is commonly regarded as bad. It's for short periods, but it happens very repeatedly, right? Maybe it has bad effects in the long term.

And also, going up and down so much with hormone levels might cause side effects, such as mood swings. I don't know if it does, but it seems logical to me that it would.

Quote
One of the main theoretical advantages cited for injections is that contrarily to pills, since the product is directly released into the blood stream, it does not have to undergo a first passage through the liver, which, I think, would reduce efficiency (I think it was mentioned somewhere that not all of the product actually made it into the blood stream), and that would mean that maybe depending on the person, when taking pills, very high doses might be required.

Furthermore, pills are supposed to make the liver work especially hard, which is not good. For patients who are older and/or have a lifestyle that already strains their liver, such as drinking or being on other medications, it poses a risk of premature liver dysfunction, which is a very serious thing.

It's also possible (pure non-expert extrapolation) that even in the absence of risk factors, it might wear it out faster, which might affect one's life expectancy, or cause higher cholesterol/etc. levels despite the consumption of fat being all but excessive, for example.
________________________________________________

Those were the potential disadvantages of pills, the most widespread delivery method, and I do not deny them for one second. However, injections are not the only delivery method that has the advantage of direct blood stream spreading.

For one, simply taking estradiol pills sublingually (if the pills make it possible; I think it depends on the brand) makes part of the dose go directly into the blood stream (what you don't accidentally swallow with saliva and doesn't stay with the remains of the pill once you swallow, actually, and thatcan't be completely eliminated, right?)

There are also transdermal patches (and gels, but I haven't read a lot of good about those, and in all logic, they're probably not any steadier than pills), which as a bonus give you almost 100 % stable hormone levels, since they release them in real time, second by second, just like ovaries would. Pills are more stable than injections (2 relatively low doses a day), but not nearly as much as patches.

The only disadvantage I can see to patches, apart from the fact that they are, I think, twice the price of pills, is perhaps an allergic reaction to the adhesive (and I think there is more than one brand which don't all use the same, so you can probably get away with an allergy), or perhaps a skin on which stuff just doesn't stick. But even in that case, I'm sure that with a pharmacist, one could find a way to make it work with medical tape and whatnot.

Ah, there's also the fact that the patch could be seen, but since it's put in areas that are generally hidden by clothes, my belief is that if anyone is close enough to you to look there, they're also close enough to see your pills or injectable preparation and syringes.

Quote
On a less medical standpoint, I also find injections to be the least practical delivery method. They're done once a week, so daily routine won't help to remember it. -I-, at least, would very easily forget a weekly thing like that. I have plenty of examples in my life. (Hello, dusty floor!)

Also, some others find it easy and quick, but I would find it really tedious to have to bring out the product into a syringe and inject it, or have to go see a doctor/nurse weekly, or something.

And that's entirely putting aside my fear of needles as well as my very high sensibility to pain - especially that kind of pain. I might just faint whilst trying to do it, which is probably dangerous, and in my fear, I think I could easily make a mistake like injecting myself with an air bubble for instant death, or punctioning the wrong place, or...

Quote
There is also the fact that some countries have not licenced injectable estradiol for prescription and use there, such as the United Kingdom and maybe Canada (I know doctors here don't prescribe it, but I'm not sure if they could if they wanted to). It's a little bit of a sophism to say this and rely on their "authority", but I don't know... if they have no problem whatsoever with pills, despite their proven risks, and transdermal patches, it seems unlikely to me that they wouldn't allow injectables without any valid reason.

There's a chance that it's just because the safeness of injections just haven't been proven enough yet for some governments to permit them; that it's just a precaution. But I haven't heard of such a thing, and it seems unlikely to me, since it's everything but a brand new drug.

Quote
Some people report that upon starting injections, their effects went way up. Here is what I told another member about it, and I don't think I'm wrong:

Quote from: A on May 16, 2012, 04:53:33 PM
[...]
Also, it certainly doesn't fit all cases; maybe not even the majority, but in many cases where people reported having had much better results after starting injections, it was often either:
-They hadn't been on HRT for very long, and it's reasonable to think that the same spike of change could have happened with just any other delivery method. It does happen often, after all, that after a few weeks/months on a steady dose of hormones or after a pill dose increase, eventually levels reach a point where change suddenly starts to happen. It could just be a coincidence.
-Their hormone levels and pill dosage weren't correctly adjusted, so of course, when they started injections of a huge dose, changes appeared. But in those cases, who knows if a higher dosage with another delivery method wouldn't have done the exact same?

I'm not saying that the effects of injections are a fallacy, and that all results were biased, but I still think you should be cautious of what your hear about. It's like that with many things, really.
[...]

Quote
The very low cost of injectable estradiol is a big argument for some. But I think that the vast majority of people can afford pills which, whilst more expensive, are still pretty cheap: on my latest purchase, 0,54 $ per tablet; 32,40 $ for the 60 a month I take, all that, I think, after taxes (not sure though since taxes aren't displayed on medication receipts) and before insurance.

Of course, there are many who live in a poverty I cannot even imagine and try to save every penny they can for other things such as surgery, so I can't entirely rule out cost as a factor. After all, I know little of such money problems, since most prescription drugs are 80 % paid for by the government, and the total cost per month are limited (everything's free past that limit).

Quote
Some claim that since injectables have a much higher maximum in the serum level curve, it could help "kick changes off" by defeating some kind of "resistance" with a high dose, or that a high dose might condition cells to be more receptive to oestrogen. I can't rule that out, since as I said, there is probably at least some basis for testimonies in favour of injections.

But honestly, I think that since the number of receptors is fixed (right?) and I don't really see what sort of "wall" there could be to beat, I don't know. I don't really understand how it could be that way.

...Phew! So... You have a full "essay or my opinion" on HRT delivery methods. The bottom line is:

Why use a relatively controversed delivery method whilst you could be using one of the other methods that are pretty much prescribed everywhere and recognised as safe and effective (outside specific conditions, huh) by all doctors (that I have heard of)?

I hope this was helpful.