Questions about E methods

[LaurenA]

My doctors all seem to have this worry that taking E orally puts me at risk for a stroke or a heart attack.  Currently I'm taking it sublingual. My doctor suggested that patches were safer but I have bad reactions to the adhesive.  The only other option I know of is injection.  I'm having a hard time picturing giving myself a shot on a regular basis.  I guess I could learn if necessary.  I've read the reports and understand the dangers but all recent scans and tests show that I have no heart problems.  I'll be talking with my doctors in a couple weeks about it.

Could someone doing injections tell me about what I should expect?  Also, how hard was it to learn?

 

Lauren

[Saoirse 2]

I've been mostly on injections and prefer them. There are pros and cons to any intake method and you should trust your doctors and endocrinologist's advice to guide you.

 

To me the convenience of injections 1 per week (there are some regimens that are every 14 days) is really nice. You do have to be careful to follow directions to prevent infection and administer correct dosages with injections. You also have to be willing to "stick yourself" and not be prone to passing out. It isn't that uncomfortable, but note everyone feels the same way about that.

 

I mention care with dosage not to advise you, but it can be tricky to measure the correct amount. Especially if the pharmacy give you the wrong sized syringe. 

 

Lastly, there may be challenges with your insurance and the costs of the medication in injectable form. 

 

I am happy to share more about my experience, but it might be easier to hear if you have any additional questions. 

 

Saoirse

 

[Guest]

I started with injections of estradiol valerate and continue them each week. The absorption is predictable and the risks of blood clots are reduced. There can be an increased risk with the various forms of estrogen. Taking the estrogen orally, has the worst incidence of blood clots. Find a healthcare provider who is knowledgeable and capable of managing your hormone therapy. If you smoke, stop. If you are obese, lose weight. These are risk factors among others. You should have a very careful evaluation prior to receiving hormone therapy.

[Astrid]

On 8/13/2022 at 8:50 AM, LaurenA said:

My doctor suggested that patches were safer but I have bad reactions to the adhesive

The adhesive used varies vastly between brands of patches.  For me, Vivelle Dot is perfect,  particularly when I cover the patch with Opsite Flexifix adhesive (recommended by @Jani) waterproof film. 

 

Astrid 

[LaurenA]

My appointment is this Thursday.  I'll be sure we talk about all methods.

[KathyLauren]

9 hours ago, Astrid said:

The adhesive used varies vastly between brands of patches. 

 

Yes, that is my experience, too. 

 

The pharmacy gave me the Sandoz generic patches, since the active ingredient is the same and they are cheaper.  But the adhesive is caustic and, after a couple of years, I developed a really painful rash from them.  The Sandoz patches are huge, so there were only a few places on my skin where I could put them, and each spot only got seven days off before being used again.

 

I switched to Estradot patches, and they are totally different.  For one thing, they are much smaller, so I don't have to re-use the same patch of skin for five weeks.  And the adhesive is milder, even though it sticks better in the shower.  It is totally worth the higher cost.  I have a note on my file at the pharmacy to give me the Estradot brand only.

[Charlize]

If you have issues with patches, either because of reactions to adhesive or because they slide off there are creams and even a spray that provide a safe topical route.  Issueas with my heart make topical E the safest method.

 

Hugs,

 

Charlize

 

 

[Ivy]

The VA usually sends the Sandoz patches.  I also had problems with the adhesive rash.  Now I use an Aloe lotion when I peal them off and don't have that problem.

[Kastia]

I have used pills, patches and injections and I think injections are the best. I had a severe needle phobia and it took me a week to do the first time but it's gotten much easier. I think you get a much better effect with injections.

Patches weren't too bad but sweating can make them less effective. I've been told the pills are the riskiest for clotting and heart issues. Your doctor can help you figure out whats best for you.

[Trans22]

I chose to go down the patches (Estradot prescribed) path in combination with Prometrium & Cyproterone Acetate tablets.   Very happy with results so far, no complications that I'm aware of but results of 3 month bloodwork yet to come back.

[Kerry_Autumn]

17 minutes ago, Trans22 said:

I chose to go down the patches (Estradot prescribed) path in combination with Prometrium & Cyproterone Acetate tablets.   Very happy with results so far, no complications that I'm aware of but results of 3 month bloodwork yet to come back.

How easy do you find keeping the patches on for the set amount of time?  The only other time I've had direct experience with a patch based medicine they were supposed to stay on 72 hours and fell off after like 6 hours.

[Kastia]

The estradot branded patches were good except when I'd sweat in summer. My doc said sweat could kinda pause absorption for hours. They left a bit of residue that could be difficult to remove but I'd rather patches instead of pills. @Kerry_Autumn

[Trans22]

1 hour ago, Kerry_Autumn said:

How easy do you find keeping the patches on for the set amount of time? 

I have much the same experience as Kastia.   I've had a patch come off - positioned too low, came off when I removed my lycra after a bicycle ride.  I place  my patches a little higher up now.

[Ivy]

I use the patches as well.  I've not had problems keeping them on.  I have had problems with the adhesive causing a rash.  But I use an aloe lotion when removing them, and that seems to have stopped that problem. 

[LaurenA]

I'm doing sublingual pills.  No problems so far after 2 years.

[Susan R]

6 hours ago, Trans22 said:

I have much the same experience as Kastia.   I've had a patch come off

I use two Sandoz brand patches and would not be able to shower each day if it wasn’t for a solution @Jani gave me a couple years ago. This solution covers my patches with the same transparent tape that my surgeon used to seal the BA surgical site under my arms. It stays on, seals very well, and is waterproof. The stuff is very thin and great at holding on to the skin without any of the caustic affects. The product is Opsite Flexifix Transparent Adhesive and comes in a few sizes but I use the 4” wide rolls. It’s cheaper buying a roll and easy enough to cut to size (I prefer rounding off the edges).

[Astrid]

6 hours ago, Susan R said:

I use two Sandoz brand patches and would not be able to shower each day if it wasn’t for a solution @Jani gave me a couple years ago. This solution covers my patches with the same transparent tape that my surgeon used to seal the BA surgical site under my arms. It stays on, seals very well, and is waterproof. The stuff is very thin and great at holding on to the skin without any of the caustic affects. The product is Opsite Flexifix Transparent Adhesive and comes in a few sizes but I use the 4” wide rolls. It’s cheaper buying a roll and easy enough to cut to size (I prefer rounding off the edges).

 

I, too, adopted @Jani's solution of placing Opsite Flexifix transparent tape over my patches, beginning about 6 months ago. It's been a game changer...and blessedly, a dramatic reduction to the lint that used to surround the edges of my Vivelle Dot patch after a few days.

 

Highly recommended!🙂

 

Astrid 

[Jani]

I'm so happy that has worked for you both!  

[Astrid]

10 hours ago, Jani said:

I'm so happy that has worked for you both!

 

And I'm so grateful for the great ideas that are shared here at TransPulse!  The mutual support and sharing is so important!