Since nobody else here has said it, I use patches. I have two on my butt and I change them twice a week
Congrats! Wishing you the best on your journey!
I switched to subq injections after about 3 months on pills & it was the best decision I ever made for my transition. Felt like the whole process accelerated, within 7 months of switching to injections (10 on HRT) I was stealth at my new job, it was shocking how much of a difference that made.
If you don't mind me asking, what made you decide for going to injections after 3 months on pills?
Hm couple things! My levels after 3 months weren't changing as much as I wanted to. Before I started on HRT I basically had double the average Testosterone (& double the average E) so I figured injections were a guaranteed way to nuke my T levels.
I also had heard from others that injections worked much better than pills, and I figured since I wasn't scared of needles that I'd give it a try. It was also super convenient to switch to only remembering my HRT once a week, I've got ADHD & was struggling a lot to remember taking my pills twice a day.
Damn, double the average T and E? My NelDel really was stealing all the hormone supplies there /lh. But yeah, understandable you made the switch. I think I experienced high T too (but probably no low E), and it wasn't fun.
I'm on spray myself and no regrets, though I feel like the body change might be a bit slow (no orchi yet). Maybe I'll need prog too, but that's not available through the official route here :x
In case you want to get prog (or any other Anti Androgen) for better I highly recommend getting your levels checked beforehand. Ideally you should have T levels in the range of <50 ng/ml. If this isnt the case you can either increase your dose or use an Anti androgen
XD yeah i wasn't super masculine though so idk what my body was doing with all that
Dang! Hope you can get prog soon, honestly the sleep benefits have been the most beneficial thing from it for me. Orchi didn't lead to any additional changes for me, but god was it nice for dysphoria
Oh true! The estrogen helped me sleep so well, it shocked me almost.
Previously I'd take 1-2 hrs to fall asleep, now that's 5-10 min.
Congrats on your HRT appointment! That's super exciting!
As for how I take my estrogen, I used to take pills sublingually for several years. But about two years ago, I switched over to DIY injections. I mostly switched methods because I've heard that injections are much more effective, and they're a lot cheaper than pills.
I'm taking estradiol undecylate subcutaneously. I only have to inject once a month, which is pretty nice. It was kinda scary teaching myself how to inject, but now that I've done it many times, it's not too bad. I just wish I would've started injections much earlier.
Thank you. It's very exciting. I can't wait.
I personally use spray, it's like gel but dries much quickier (2 min dry enough, 1 hr to fully dry). But the 'fully dry' is moreso that in that time you'd best not shower yet, that's it.
Dries in 2 min enough to put clothes over the sprayed spot and do your thing. I have a skin that is drier than the Gobi desert, so that also helps.
You'll need to do it daily, but depending on the person, you can have it 1x a day or twice, and up to three doses per time.
Whether or not you want HRT, it's valid. DIY just means you take the meds without a formal prescription. If your situation allows you to do so safely, without problems with doctors and/or governments, I'd recommend the official path. Otherwise, DIY is also perfectly valid. Stay safe and aware! If you do HRT, always keep a few months' worth of supply in stock, in case.
GUIDE TO CHOOSING YOUR MEDICATION PATH (TL:DR; below)
This guide assumes you already have decided to get HRT. It's not meant to replace official advice from affirming and up-to-date doctors, etc. and all that legal stuff.
The following options consist of injections, pellets, patches, gel, spray, sublingual pills, and oral pills.
The following only applies if you haven't had orchi-/ovariectomy yet! Except for injections and pellets which can work monotherapically, all methods additionally require the hormone blockers for the hormone you want to reduce.
All of the listed HRT methods are safe and work well, it's mainly subtle nuances between them. Which is best, just depends upon your situation and preferences.
If a method, for whatever reason (costs, laws, insurance, transport..), is unavailable for you, then answer as if negative for that method.
1. Do you dislike needles and scars?
Yes -> See question 2
No -> See question 4
2. Do you have sensitive skin?
Yes -> See question 3
No -> See question 5
3. Do you prefer ease of use (although there may be liver/blood issues), or effectiveness?
Ease of use -> Take pills orally (health risk long-term)
Effectiveness -> See question 6
4. Do you want it to be easily available, or for it to be applied less often?
Easily available -> Injections
Apply less often -> Pellet implant
5. Do you want to hide it more easily, or to apply it less often?
Easier to hide -> Gel/Spray; see question 7
Apply less often -> Patches
6. Do you work in a flammable situation (e.g. as a firefighter) and/or is your skin damaged?
Yes -> Take pills sublingually (small health risk)
No -> See question 7
7. Do you prefer it to dry quickly, or for it to possibly yield higher hormone levels?
Dries quickier -> Spray
Higher hormone levels -> Gel
TL:DR; If you still don't know which method to use, or feel indifferent - and it is an option -, then I would recommend injections. WillStealYourUsername below me also has some good explanations.
Why that method?
They're the gold standard for combining safety with effect. Consider the following. If you want pills and consume nicotin, you will have to stop with the latter before starting. Patches are pretty visible and can fall off or cause allergic reactions. Spray/gel has to dry for 2-5 minutes, with a cooldown of one hour before showering.
Like spray/gel, it bypasses the risk for the liver (sublingual reduces the risk to an extent).
Though they need to be applied more often than pellet implants (which are only once every 6-12 months), they are more affordable and like patches, are not on a daily, but weekly basis. Their doses can be more easily finetuned, and they can work on their own, without blockers being necessary.
Does it have downsides compared to other methods? They hurt a bit (obviously), your hormone levels will spike and fall more sharply, it takes more preparation, and administering it isn't as easy. But still, injections are the best widely available method. They're the 'jack of trades, master of some', if you will.
You shouldn't really ever take estradiol pills orally imo. Higher risk of blood clots and cancer for no real benefit other than it being a bit easier than sublingual doesn't seem like a good trade.
I would edit squeamish to say something about phobias instead.
I would also add that many of these paths need blockers which are generally not great for your health in the long run (not so bad that no HRT is better). Injections are the most available path that makes it easy to bypass using blockers all together.
The first things to consider are injections and implants as these can be done without blockers. I don't know much about implants tbh as they are not super available. Injections are very consistent and safe.
The second thing to consider is patches. Patches release hormones continually so there are no lows or highs and it's simply more convenient. Some people have problems getting them to stick, but sometimes medical tape or applying them somewhere else etc help. There can be supply line issues with patches so they might just suddenly be out for a little while. You'll need blockers which can be uncomfortable and have long term side effects.
The third thing to consider is spray/gel. Patches/spray/gel deliver hormones poorly to some people as they simply absorb poorly through their skin, but for others it's a great route. Spray/gel has to be applied two or three times per day and it needs to dry. The area you apply to can also accidentally deliver hormones to animals and people that touch you for a little while, so best to not apply with your hands. Don't apply to the arm you take blood tests from (to check hormone levels). Don't spray while near someone. You'll need blockers which can be uncomfortable and have long term side effects.
The fourth thing to consider is pills sublingually. It's safer than swallowing pills, but you will accidentally swallow some and therefore have slightly elevated risks. Sublingual like the skin can be a bit hit and miss. Some absorb this way better than others. Not all pills can be taken sublingually. You'll need blockers which can be uncomfortable and have long term side effects.
The last thing to consider is swallowing pills. Take this option when you have no others available.
Be aware that often the bad side effects are really only a concern when it's over a long stretch of time. Taking pills orally for a few months or a year isn't a big concern. Taking blockers for a year isn't either. It's an issue when you have to do this for the rest of your life and when there are better options available. Some people also have nasty short term side effects from blockers so avoiding them in the first place is best imo.
Thanks, added some clarifications, I've also added to look at your post.
Thats a pretty handy guide for medication path, thanks for posting it!
Thanks, updated it, by the way!
I'm curious about needles. I don't think I'm squeamish, but does stabbing your skin for years on end have any bad side effects?
You should rotate where you inject. I switch thigh each time and try to not hit the exact same spot. Injecting into the same area too often can lead to scar tissue buildup which makes that part of the skin hard and therefore hard to penetrate with a needle.
I did this as well for spray in the beginning. Had that after administering, it sometimes felt for a few min as if someone was grasping my arm tight. So I rotated and after a week it no longef happened, then I tried going back to administering it on one arm only, and that worked well.
Not really, consider that some people regularly inject their skin for blood donation or checkups, and it goes fine. What WillStealYourUsername said is true, though.
Question 6 is missing ;) - and there doesn’t seem to be a need for question 5?
Yeah, sorry, I forgot. It's updated now, thanks :)
I use injections and I love the freedom! It's nice to not have to think about my hormones several times per day
How often do you have to inject?
Also, what's best? IM or subcutaneous? What do you do?
You go for whichever is the most comfortable/convenient as the differences are so small. Subcutaneous uses a smaller needle so I went with that as it was less scary to me, but some can get allergic reactions on their skin from the injections which intramuscular avoids because it's a deeper injection.
It depends. Doctors typically prescribe estradiol valerate which should be injected every five days. I use estradiol enanthate which is injected every 7 days.
You can read more here: https://piefed.blahaj.zone/post/24298
First of all: CONGRATS!! Let the girl-ification begin for you too :D
I use pills (oral, not sublingual) actually and it's not that big of a deal at all. It kinda becomes a routine after a while and isn't really annoying, especially if you already have meds to take daily.
From what I've heard (mostly from my mom who uses gel because of menopause) the gel goes into your skin pretty fast so I don't think there's any concern about you playing with your cat.
If you are still to paranoid then you can always try patches.
Thanks :).
I’ve heard that pills can cause blood clots and strokes. Which why I’m a bit reticent to take them. I think the sublingual ones are safe though, but I’m not a doctor
If you take it seriously then nothing is really safe. Taking estrogen could lead to issues with blood sugar levels long term too (am currently part of a study/research for that but it'll take probably still 10-15 years until the papers get published). Not a doctor either but I assume that even pills are safe as long as you don't have specific preexisting condition that puts you at higher risk for blood clots and strokes. I'm also pretty sure that the chance is very low in comparison to things like an unhealthy diet and stuff (assumption!!)
I don’t pretend to know what I’m talking about. I’m sure you’re more clued in than me, so I’ll bow out :)
Main thing to worry about with clots from oral pills is if you smoke! If you don't smoke nicotine then the risk is low like the commenter said above.
Injections work best
do you do subcutaneous or IM? Assuming you do that is.
SubQ, I saw immediate improvements in results vs pill or patch.
You do need to be cautious with your technique every time.
I do injections, especially with subcutaeous the needles are pretty small and I've been able to adjust. I still don't like needles but I got trained on how to use these and I'm able to manage them now.
Yay, congratulations! I'd have gotten impatient and started DIY if I had to wait that long...
I started with gel (massive PITA to apply but works well), did injections for a while (kind of a bother even once a week, and hormone levels going up and down isn't very nice), and now on patches (awesome, no complaints). Probably only implants would be better.
Unless your cat is constantly licking wherever you applied the gel, you don't need to worry. You can wash your hands after applying!
Thank you. I have considered pellets and I’ll probably move to that once I’ve been on oestrogen for a while. In case (the very unlikely chance) that I don’t like oestrogen. Hard to take pellets out once they’re in.
I can recommend patches. I’ve been very happy with them although I do recommend to also apply something like tegaderm over them so they don’t fall off as easily it also helps to not notice them as much on your skin.
I use weekly IM injections in the thigh
I do take a sublingual pill every 8 hours, so morning - afternoon - evening. It's a bit often but you get used to it and it works well for me. I'd like to switch to injections sometime but currently can't be bothered because they're not that easy to get where I'm at. I might tackle that after grs.
Whoa. Three times a day? That’s too much for me lol. I take meds at night to sleep, so something I can take at night would be good. Sublingual, gel, spray would be good. I’d also consider patches. They seem to be little to no fuss
Sublingual doesn't work when you just take them once a day. There's a very high spike 1-2 hours after taking them but the estrogen is absorbed very quickly after that. That's why taking them every 8 hours or at least every 12 is recommended. I think most people who do gel do it in the morning and in the evening. Patches seem like a good alternative though. I don't even know if they're an option where I am, I'll ask my endo the next time I see her.
You can find more information about the different modes of administration here: https://transfemscience.org/articles/e2-equivalent-doses/ and here: https://transfemscience.org/articles/
For spray, I do it once a day, 3 doses; mainly in the evening. I'm not sure if that works or not, given that my boobs grow, but not fast enough imo >:(
Got the same issue with curves. I want wider hips, but raghhh! I sometimes feel pain in my hips though, so is that perhaps an indicator that the bones are widening?
I'm 'only' almost 7 months on E, if that's relevant.
Maybe I need to look at what exercise and diet I could do to improve curves. Do you perhaps have a guide?
I use gel
how often do you need to apply gel? I read once per day, but i'm not sure.
I apply one dose in the morning and one in the evening, but it varies from person to person how much you need. I'm currently waiting for the results of my last blood test to see if the amount I use is enough. The area you apply the gel to should be small, the gel I use takes about one hour to dry.
ah. thanks. That helps a lot. I think I'll go with gel. I doubt I could inject myself, and there are a lot of dangerous taking oestrogen orally, so gel seems like the way to go.
Patches. We tried gel but it's annoying to wait for it to dry and the estrogen levels are kind of spikey.
thanks for the advice everyone. I think I'll go gel to start with, then once I'm sure it's what i want, I will change to pellets. Thank you :)
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