My progress with estradiol injections

[Lorelei]

I started injecting estradiol last month, using estradiol valerate IM once a week (from when I started estradiol up in September to December I was on patches). The first one was tough to draw up the oily estradiol with a 25 gauge needle, but after that I bought 18 gauge needles to draw up the med and changing the needle to the 25 gauge one to inject myself. My estradiol level went from 54pg/dL to 200.5pg/dL and my testosterone level dropped from 369 ng/dL to 2ng/dL. I feel amazing now. My neurologist is concerned about me having too high of a level of estradiol due to having had an ischemic stroke in the past, so I will not likely increase the dose to up my levels any higher. I also had started spiriolactone during this time frame to drop my testosterone, but since I started that the same time as starting injections I have no was of knowing which knocked my testosterone levels down so much. Progress had been going pretty slowly when I was on patches, and now my breasts are getting larger, almost to the point of no longer needing to use silicone inserts to fill the cups of a 40b push-up bra, and my skin is noticeably softer. My emotions have gotten stronger, crying for little things in TV shows and movies, yet I have been the happiest I can remember. Things just feel right now. Estrogen has done more good for my mental health than any of the numerous psychiatric meds I have been on (now off of lithium, my doctor tapered my dose to zero so I could start the spiriolactone), but I am still taking my other mood stabilizers for my bipolar disorder). My wife (she is a registered nurse) did the first two injections to teach me how to inject myself, but after that I have been self injecting. I find myself looking forwards to Saturday evening’s when I do my injections. 

Edited January 25 by Charlize
dosage removed due to rule 13

[Ashley0616]

Congratulations on your injections! I wished I could get them but my doctor is very hesitant putting me on injections. I don't know why. She said it's safer? I don't see how. I could see that it might cost more but the patches coming off are getting really annoying. It's hard to take a shower and it not coming off. 

[Astrid]

Ask your doctor why exactly. A common reason is reducing the chances of blood clots.

 

I followed a tip from @Janion using Optiflex Flexifix, a transparent adhesive film, on top of the patch. Totally solved the problem with showers. 

[Charlize]

Topical E is much safer for any who have or may have heart issues like myself.  I have used sprays and patches but am now using a cream that is compounded at our local pharmacy (one of the few compounding centers). With severe coronary artery disease any potential clotting agent is worrisome.  With time i've received the benefits of E over time.

 

Hugs,

 

Charlize

[KayC]

On 1/24/2024 at 7:40 AM, Theresa said:

Things just feel right now.

This has been my experience also, Theresa.  I am happy for you that you’ve reached that contented, easy plateau.

[Lorelei]

I am very excited that the combination of spiriolactone and estradiol valerate dropped my levels dropped from 738ng/dL to just 2ng/dL. The clinic was a little surprised asking me how I am feeling with it that low. Isn’t the testosterone supposed to be almost zero? I know I am going to resist reducing either dose unless there is some compelling reason for it. Is it possible for a trans woman to have too low levels of testosterone? I know I am going to ask the NP in a few weeks, but I figured I’d ask here. 

[Ashley0616]

It is ok to have some testosterone. Even cis women have it. 

[Lorelei]

Just now, Ashley0616 said:

It is ok to have some testosterone. Even cis women have it. 

I had read it is usually in the range of 15 to 70ng/dL for cis women. At this point in my transition, I  personally think low is better though. 

[KayC]

11 hours ago, Theresa said:

I had read it is usually in the range of 15 to 70ng/dL for cis women.

 

@Theresa - that range you mentioned was similar to what my Dr told me on my last visit.
When I first started estradiol (at lower doses) my testosterone was up around 500 and the E was below 40.  So my Dr upped my estradiol to boost it, and said that would also suppress my T.  On my last lab my T was around 100, and E around 140.  Getting close.

But of course, it’s best to consult the professionals in this case.  Mostly I just FEEL better.  

[Lorelei]

Yesterday I had to open a bunch of manholes and for the first time in my career, I wasn’t able to lift the 32” (the big ones, not the regular 26 3/4” ones) covers. I am assuming this is from the estrogen and lack of testosterone from the HRT. It is going to get used to, as I have always have been exceedingly strong. 

[Ashley0616]

15 hours ago, Lorelei said:

Yesterday I had to open a bunch of manholes and for the first time in my career, I wasn’t able to lift the 32” (the big ones, not the regular 26 3/4” ones) covers. I am assuming this is from the estrogen and lack of testosterone from the HRT. It is going to get used to, as I have always have been exceedingly strong. 

You are correct on that one! It takes more effort to pick up my kids. 

[Lorelei]

This Saturday evening I did my estradiol injection. I misdrew the dose and by the time I realized that I shorted the dose I had already tossed the drawing needle into the sharps bin and put on the injecting needle. I ended up taking about 96% of my prescribed dose (dose not included here). I know I injected myself properly. For some reason (placebo effect?), I feel like I missed the whole shot. Has this happened to anyone else from such a negligible amount off?

[KatieSC]

If you had 96%, you are okay. As for the issue of blood clots, of all of the forms of estrogen, the IM estradiol valerate has the lowest risk of clot development. To avoid blood clots, the usual stuff applies such as being active, avoid prolonged sitting, and most of all, do not smoke. The estradiol will suppress testosterone to some degree. Everybody's response to estradiol and spironolactone varies. As for the estradiol levels, they should check your level about 3-4 days after the injection. If you draw the level too soon after the dose, it will appear abnormally high. Once you are one a stable dose, you will be good to go. You will see consistent results from estradiol valerate. The patches work well for a great number of folks, but it depends on whether you are sensitive to the adhesives. The other issue is whether they stay on, or you have skin that is just not all that great. Other factors can affect the absorption, and then there have been differences reported because of variability in the patches from different vendors.

 

I have been on estradiol valerate for almost 2 1/2 years. As for the spironolactone, one other great benefit is that it will help with your blood pressure if you have a tendency towards high blood pressure. The only other precaution is that you need to get your potassium level checked, and also stay hydrated. The spironolactone excretes sodium (salt) and in the process, causes you to retain potassium. This can result in a higher than normal potassium level that can be lethal if not managed. The other thing to guard against is dizziness as a result of getting dehydrated. You may also experience some muscle cramping when you get dehydrated. Make sure you see your healthcare provider regularly.

[VickySGV]

To quote my Endocrinologist from 2009 when I began my E, "it is not the dose or level in your blood stream that is important, it is what your receptor cells have taken in and allowed the rest of your body to process, and what the body is doing with what is there that is important about the E stuff".  We have since learned that my T receptors have a genetic oddity that has kept them from doing optimal work all my life, and while I fathered three children whom I love dearly, did not feel right as a male.  I had one blood clot  that is still dissolving 8.5 years later and was off of my "outside E" for 6 months, although we found that my normal home grown Adrenal Cortex E was adequate to prevent problems during that time. If you worry about a dose of your medicine call your prescribing doctor to get their opinion as to what to do and what effect they are concerned about from either over or under dosing and if they say do something, do it, or if they say forget about it until next time, then forget about it until the next dose is due to save brain space.