Switching to transdermal patches

[Tills]

Another couple of apparent advantages of Oestrogel over Sandrena are that:

- you can apply it to your lower abdomen and therefore
- because it dries so quickly

... it means if you're out with friends you should be able to nip to the loo, lift up your top, put it on, and 3 minutes later come back out.

This may seem a minor thing but I did find it really awkward trying to apply my afternoon dose of Sandrena when I was out with people. I find Sandrena can take anything up to 45-60 minutes to dry, even with rubbing it in. And because the patient leaflet says to apply it only to your lower body or thighs it's a problem if you're out.

https://www.medicines.org.uk/emc/files/pil.1048.pdf 🔗

Oestrogel can be applied to arms or thighs

https://www.medicines.org.uk/emc/files/pil.353.pdf 🔗

https://practice365.co.uk/uploads/sites/1213/2020/05/Oestrogel-A5-tear-off-leaflet-1.pdf 🔗

According to my Gender clinic letter (pasted above) it can also be applied to the lower abdomen e.g. tummy area below the navel but above the genitals.

[Tills]

And finally ... Lenzetto spray.

There are some unverified and anecdotal comments that it delivers a variable amount of estrogen. I really don't know how true these are but my clinic did not take up my suggestion for prescribing it to me. This Dr Louise Newson states that, 'Many women find that the absorption of estradiol from Lenzetto spray is unreliable so dosing can be hard to be optimised':

https://www.drlouisenewson.co.uk/knowledge/oestrogen-only-gel-and-spray-what-you-need-to-know 🔗

It would have been good to know her sources for such a comment. Presumably her own prescribing patients?

[Courtney G]

For those reading along, I'll state what I stated earlier in this thread somewhere: adhesive residue from patches can be easily removed using a 3M Tegaderm, which is applied and left on for about 10 minutes, then removed along with the adhesive from the patches. It took me over 3 years before I'd figured this out.

Having said that, Tills, I'm sorry patches weren't getting your levels to where you needed them. I had the same issue.

[Tills]

I switched to gels a week ago, initially back on the Sandrena whilst I await my new prescription of Oestrogel.

Well I can tell my oestradiol level is rising again because ... my nipples are tingly. Always happens 😀

xx

[Courtney G]

My boobs are sore for two to three days after my weekly estradiol shot. It's an affirming feeling.

[Charlotte Kitty ✅]

Thats intersting as mine stopped being tingly months ago. But my E is in range. Very odd. Maybe my body just  doesn't like E!

[Tills]

Thats intersting as mine stopped being tingly months ago. But my E is in range. Very odd. Maybe my body just  doesn't like E!

Hi Charlotte,

I don't think it's that hon. Don't worry on that score.

I think it's more likely to do with the rising E level. Mine will probably stop tingling too in a few weeks once my body has adjusted to the new level again.

[Charlotte Kitty ✅]

I've always been strangely curious to throw my E level into lower pregnancy levels, get my prolactin up and see what happens. I'm guessing it's risky but still don't stop me wondering!

Charlotte 😻

[Tills]

I've always been strangely curious to throw my E level into lower pregnancy levels, get my prolactin up and see what happens. I'm guessing it's risky but still don't stop me wondering!

Charlotte 😻

It has happened a couple of times to me Charlotte. When I was taking a slightly higher microdose of testosterone my body converted it into estrogen and my level soared.

The other time was when I was on a very very slightly higher dose of estrogen than now and it went really high: over 1000 pmol/L. I kind-of knew. The main side-effect for me was 'morning sickness,' which I had often in the evenings. 

My medics think I'm estrogen sensitive, which might paradoxically explain why the patches didn't work for me: that I went into a quick peak then big drop.

I've lactated before now too but I'm not sure I'd recommend going to those sort of levels. The NHS transgender guideline is broadly speaking to be in therapeutic range of 400-600 pmol/L although that does seem to vary slightly across regions.

xx

[Charlotte Kitty ✅]

It has happened a couple of times to me Charlotte. When I was taking a slightly higher microdose of testosterone my body converted it into estrogen and my level soared.

The other time was when I was on a very very slightly higher dose of estrogen than now and it went really high: over 1000 pmol/L. I kind-of knew. The main side-effect for me was 'morning sickness,' which I had often in the evenings. 

My medics think I'm estrogen sensitive, which might paradoxically explain why the patches didn't work for me: that I went into a quick peak then big drop.

I've lactated before now too but I'm not sure I'd recommend going to those sort of levels. The NHS transgender guideline is broadly speaking to be in therapeutic range of 400-600 pmol/L although that does seem to vary slightly across regions.

xx

Thats quite intersting and only at over 1000pmol/l. I think I'll wait until a few years so i know I'm fully feminised before trying it, as need that to complete first. Risk doesn't bother me too much, I actually enjoy rolling the dice on my life!

Charlotte 😻

[Lori Dee ✅]

Thats quite intersting and only at over 1000pmol/l. I think I'll wait until a few years so i know I'm fully feminised before trying it, as need that to complete first. Risk doesn't bother me too much, I actually enjoy rolling the dice on my life!

Charlotte 😻

Just be careful. I had asked my doctors about this.

My Gynecologist warned me that you cannot maintain pregnancy levels indefinitely. And a major complaint from women is that pregnancy levels make the breasts swollen, but then after pregnancy, they become unswollen. So you would gain nothing in the end, possibly become discontent with the results, and then how would you feel?

Just be aware of what you may encounter before experimenting.

[Petunia]

Charlotte, I'm not risk averse either, but you have to remember, if you roll the dice one time too many you may eventually do something dangerous that you can't undo and you may have to live with disaterous consequences for the rest of your life.

[Courtney G]

Yeah. I had a blood clot while on herbals. Honestly, I'd love to experience lactation but I'm wary of the risk at my age.

[Tills]

Prescription for Oestrogel pump pack issued today so I'll be switching over soon. I may as well use up some of my Sandrena gel first though I think. I always like to have a bit of reserve to cover supply issues or, indeed, the kind of trans-attack roadblocking that I experienced from NHS Surrey:

https://www.susans.org/index.php?topic=253232.new#new

[Tills]

Hola.

Well about 5 months ago I was prescribed Oestrogel pump. However, because I still had a load of Sandrena gel left and because I was building up to my Sex Confirming Surgery, I used up all the Sandrena. I've just applied my last Sandrena. This evening I'll begin on the Oestrogel. I'll keep you posted if I have any thoughts!

xx

[Tills]

Just by way of update to this, now that we're permitted to discuss doses can anyone help me with equivalence? Preferably some science and not just AI etc

My current dose is 2.25mg Sandrena applied twice daily as 1.25mg morning and 1 mg evening. Blood results on Sandrena are an excellent steady c. 450 pmol/L.

I've noticed that I've been put on 6 pumps of Oestrogel in the form of 3 pumps morning and 3 pumps evening.

But a quick 20 minute scan of dose equivalence and bioavailability studies suggest that this marks quite a big oestrogen delivery increase. The actual equivalence of 2.25 mg Sandrena ought to be 4.5 pumps of Oestrogel.

I know, I know, that in theory this should all be led by gender specialists / endocrinologists etc but I find that the fine tuning of our lives does definitely need our own input. And it will take months to get an answer.

I'm tempted to go with 5 pumps: 3 in the morning and 2 in the afternoon.

Xx

[Lori Dee ✅]

The difference is the formulation. Different brands mix their products differently, which affects whether they absorb better than others. The equivalents tell you what the starting dose should be until the labs tell you which direction to tweak it. But your skin biology, the formulation, and application site can affect how well it is absorbed.

[Tills]

Yes indeed.

I'm responsive to estrogen. When I was once on 3 mg Sandrena my oestradiol levels went into cis female pregnancy range and I had morning sickness. I also have to be very careful about testosterone. I take a pea-sized amount for energy. When I once took more than that my body converted it into oestradiol via the loop of feeding back.

My hunch is to begin on 5 pumps of the Oestrogel and then have bloods taken in a month or two. Adjusting upwards feels wiser to me at the moment than the other way around, especially bearing in mind that I'm now in my sixties and, in every sense, post op, with 44DD breasts

Xx

xx

[Lori Dee ✅]

Over the years, I have learned how I feel during the highs and lows. I use that to gauge my levels between labs. When they are high (Day of injection), I usually get a slight headache. When they are low (Day before next injection) I start to feel moody or depressed.

Sometimes the high lasts longer than a day, and sometimes the lows hit a day early. But I've learned to listen to what my body is telling me. Then, when labs come around, I check whether I can guess what the levels will be based on how I felt that week. So far, I have been pretty close.

[Stottie Girl]

Just by way of update to this, now that we're permitted to discuss doses can anyone help me with equivalence? Preferably some science and not just AI etc

My current dose is 2.25mg Sandrena applied twice daily as 1.25mg morning and 1 mg evening. Blood results on Sandrena are an excellent steady c. 450 pmol/L.

I've noticed that I've been put on 6 pumps of Oestrogel in the form of 3 pumps morning and 3 pumps evening.

But a quick 20 minute scan of dose equivalence and bioavailability studies suggest that this marks quite a big oestrogen delivery increase. The actual equivalence of 2.25 mg Sandrena ought to be 4.5 pumps of Oestrogel.

I know, I know, that in theory this should all be led by gender specialists / endocrinologists etc but I find that the fine tuning of our lives does definitely need our own input. And it will take months to get an answer.

I'm tempted to go with 5 pumps: 3 in the morning and 2 in the afternoon.

Xx

For what it is worth I am using Estrogel (generic oestrogel) and I am applying 6 pumps daily split into 3 morning and 3 evening. I have been doing this for a month so far. I can't say regarding levels as I have not had a test done since I started but I have noticed a real boost in skin quality and mood compared to my equivallent oral regime. I am overall really positive about the switch. No ill effects so far.