Sublingual estrogen monotherapy. I started on 4mg (2mg twice daily) of sublingual tablets.
Sublingual estrogen monotherapy Convenience is a big driver, but also wondering about more stable levels of . 5 mg is equivalent to about 2 mg oral estradiol valerate (). Unfortunately I have not had bloodwork done yet and i suppose that's the next move. 0201), but both were similar to sublingual tablet concentrations (p > 0. Buccal and sublingual give similar results. However, sublingual estradiol is very I'm currently on monotherapy with IM injections of estradiol valerate and very happy with the results. The first five weeks on I was on Estradiol 2mg sublingual daily, then since then it’s been 4mg. Oral estradiol 1. Getting good results and stuff, but a wondering about switching to injections. Monotherapy doesn't appear to be an option with sublingual and oral E, but will patches work? Perhaps Orally administered E2 limits bioavailability to approximately 2% to 10%. The area under the curve (AUC) (0-8 hours) for sublingual E2, measured using LC-MS/MS, was 1. Paired comparisons by t-test or Wilcoxon matched-pairs signed rank test were performed between baseline (filled symbols) and 6 months (empty symbols). If estrone is 4% efficient compared to estradiol It is absolutely fine to start out on estradiol alone (patches, gel, injectible or even sublingual), but starting out on oral estradiol alone is not going to be terribly effective and should only be done if thats in line with the patients desire to go slow and even then youd need to quickly start introducing an anti-androgen or change estrogen Estrogen monotherapy is something a lot of trans women find success with, including myself. On sublingual pills, going above 5mg/day gave me bad headaches. 2023 Dec 13;8(6):485-493. Hey, I’m my first week into hormonal mtf transition. I was taking 1/2 in the am and the other before bed, approx 12 hours apart. The 3 treatment arms include once-daily sublingual 17-β estradiol, twice-daily sublingual 17-β estradiol, and transdermal 17-β estradiol. Looking to hear from people which tried estrogen monotherapy for 3-6 months and had their testosterone levels fall, but stabilised (stop falling) before reaching the female range. I was on 2mg daily sublingual E earlier this year along with Bica 50mg but stopped a while back so my levels should definitely be back to normal male range. [152] is a randomized controlled trial of high-dose transdermal estradiol patches versus gonadotropin-releasing Sublingual E2 peaked at 1 hour and oral E2 peaked at 8 hours, as measured using LC-MS/MS. Reply reply More DIY HRT – Estrogen Monotherapy Purchased 6 x 28 tablets of 2mg Estrofem from Aphrodite Cost: 1 x 28 tablets cost about 11 Euros Day 1 – 3 : 2 x 1mg Estrofem /day Sublingual Day 4 – 7 : 3 x 1mg Estrofem/day Sublingual Day 8 onwards: 4 x 1mg Estrofem (This seems like an appropriate level to suppress my T levels as things begin to change Monotherapy by sublingual pill . We will consider the following comparator interventions. Hey, switching to injections monotherapy soon off of bad levels on 6mg sublingual. ≤200 pg/mL) was associated with higher estrone concentrations among participants taking sublingual 17β-estradiol, but not transdermal or injectable 17β-estradiol. 1, 6–11 This subreddit is intended to be a general forum for transfeminine HRT questions and basic discussion. 25-12. You get more estrogen than estrone with buccal and sublingual than with oral. I was on diy for a year and used two 100mcg patches monotherapy. Starting at 1mg for Month in and I've not really noticed much yet but not tried dividing up my sublingual tablets. As for the other questions, I'm not totally sure. If you take the pills sublingual and through the day as someone else mentioned, it would result in higher E2 levels and therefore could suppress T with less, say 3-5mg. After Objective: To investigate the pharmacokinetics of 17β-estradiol (E2) administered orally versus those of 17β-E2 administered sublingually in transgender women. c Much The point of estrogen monotherapy for me was to block my T by having enough estradiol in my blood. b Based on sublingual estradiol having ~2- to 5-fold greater bioavailability than oral estradiol per studies (Wiki; Sam, 2021). For estradiol, we will also consider bioidentical 17‐beta‐estradiol, as well as synthetic derivatives. The optimal amount of estradiol is usually considered to be the smallest dose that gets the job done; estrogen receptors can get desensitized if exposed to too much too soon. We investigated the effectiveness of oral estradiol therapy in achieving this goal. Does it take a certain amount of time for monotherapy to start working? Or with high estrogen it immediately starts causing you to have atrophy/ less Testosterone? And how long would it take until your levels are Hi! I've just started Oestrogen monotherapy on GenderGP last week! I've started on a 2mg dosage per day taken sublingually and have received conflicting answers on whether this is enough for any proper results or even just to block testosterone? Subject. Another potential route of administration is sublingual, which involves dissolving a specially manufactured tablet under the tongue, where it is quickly absorbed by the blood vessels under the tongue. Always a little bit will go elsewhere in the mouth. Starting levels were 26. the most important thing for breast development is having T levels in the female Yes, I have only ever been on monotherapy and it’s been effective at T suppression and my levels have been good. Sublingual estradiol: 6. Of these, 55 individuals were aged ≥45 years. Spiro usually doesn't lower T but 6 mg sublingual is a high dose, so you probably have T suppressed through the estradiol alone. It really depends on your body and how it reacts to these hormones though, someone with naturally high T will need so much E for Will 2mg sublingual Estradiol monotherapy actually do anything? Question Pretty much as the title says. I'm transitioning super well on 8mg/day sublingual estradiol and 5mg oral finasteride. Estradiol concentrations were higher for injectable versus transdermal preparations (p = 0. 157+815=972. My levels now are 188 pg/mL E and 53 ng/dL for T. Topical, subcutaneous, and intramuscular estrogen all have slightly better absorption since they are immediately available in your blood stream and avoid any break Studies based on either estrogen monotherapy, combined-cyclic, or combined-continuous HRT were included, as well as studies investigating both natural, synthetic, or conjugated equine estrogens. Also varies even when checking at the same time since your last dose, at least in Non-professional experience here. You may struggle with T suppression doing sublingual as monotherapy, and there’s been some stories that intramuscular injections work better as monotherapy. estradiol monotherapy (which is the method she asked about) needs to have high e2 levels on purpose. I take Estrofem Sublingually, think I might be not waiting long enough till I drink water, might have gotten more results if wanted longer, so I drink as soon as the pill starts to crumble & become particles, is that enough time? 2mg is low for estrogen monotherapy, but is a reasonable slow start. And before I lowered my injection dosage to fit better, I literally used to feel high, all warm and fuzzy and falling easily into giggly/sobby fits on the first few days of my cycle. 0001). Treatment naïve adult transgender women ages 18 to 45 years considering an initial course of GAHT presenting to the Washington University Transgender Center in St One frequent question is whether Estradiol Monotherapy (only dosing Estradiol without antiandrogens) is enough to suppress Testosterone without “unnaturally” high dosage. Estradiol patch experience once I added a second patch: As soon as I added the second patch, my reaction to the glue got drastically worse. DIY HRT 20+ years ago (before internet pharmacies were common) tended to not use anti androgens because while you could get syringes of feminizing hormones Doses for Sublingual Estradiol Monotherapy . Girls who switched from aa + estrogen to monotherapy, what has your experience been like? · 1 Is there any reason to change to patches or gel if I can get good levels with sublingual? I’m still titrating to find the right dose for monotherapy but I’m curious when I should consider switching to gel or patches or just keep trying I 17(MtF) have been on 1mg sublingual estradiol every 12 hours (monotherapy) for two weeks and I feel like my body is reacting to it way more than it should? So far I have noticed skin texture change, mood swings (I can cry now!!), "brain fog" cleared, breast buds, nipple size/color change, thinner hair growth, reduced and different body odor Bc my current ratio on sublingual is 157:815 (1:5. 6mg sublingual will be a lot more than 8mg oral in terms of estradiol. Hence, the high to very high doses are indicated for estradiol monotherapy (i. The only down side is you need micronized estrogen to use those two routes. We aimed to compare GAHT with SLE only, to combined oral (CO) estradiol and To investigate the pharmacokinetics of 17β-estradiol (E2) administered orally versus those of 17β-E2 administered sublingually in transgender women. For example, the goal of a classic feminizing gender-affirming hormone My last labs, with estradiol valerate injections alone, was 400ish E and 8 T. To compare serum estrogen profiles of sublingual, transdermal, and injectable estradiol formulations in TGD adults: Total cohort: 92 On injections: 29: Studies have used a combination of anti-androgens and estradiol monotherapy. It would be much easier with Also side note I know the estrogen highs too well lol. The key is that most of it disappears under the tongue. and decided to go on p at a very clear tanner stage 3. 5mg/day) Estradiol Patches: 100μg estradiol patch, changed weekly; Estradiol gel: I've been on 8 mg sublingual and I am tired, but I'm also doing monotherapy and presumed I'm tired because both my e and t levels are low. As each Background: A goal of gender-affirming hormone therapy (GAHT) for transgender women is to use estradiol to suppress endogenous production of testosterone. I'd like to educate myself more before I talk to my NP about switching. we don’t have a study that says um. 05 Sublingual pills are more effective than oral pills (for some people monotherapy is possible with sublingual pills), and transdermal gel is more effective than sublingual pills, so that monotherapy is easily possible. . I started with monotherapy with my endocrynologist, I take 2mg estrogen sublingual three times a day every six hours, do you think its enough to get some effects? Or should I go for spiro? I have consultation in three weeks when we will check my levels, but Sublingual Estrogen . I was thinking about LSH and gonadol suppression. Oral estradiol tablets can be taken sublingually instead of orally. I want to end up doing injectable monotherapy, but I have read that increasing dosage slowly is better for breast development. In the past, feminising therapy in this group was done using high dose estrogen monotherapy with parenteral esters of estradiol such as estradiol valerate or estradiol undecylate (Benjamin, 1967; Estradiol pills may also be Taking oral or sublingual estradiol, that can happen within hours of a dose. Reply reply More replies More replies ErosDarlingAlt This is particularly true in the case of estradiol monotherapy, a therapeutic approach in which an antiandrogen isn’t employed. The compounds are fine, you probably just need a much much higher dose. I've successfully suppressed T by sublingual tablets. It worked really well but other women use spiro and sublingual e and it works really well for them. Studies based on either estrogen monotherapy, combined-cyclic, or combined-continuous HRT were included, Estradiol alone. it’s off label also there’s. I've never taken an anti-androgen in my life, I was able to squash my T to within target levels just with sublingual estrogen (8mg per day). However on injections it was only about a month and I Transdermal estrogen has a lower risk of adverse events than oral estrogen but has limited dosing options, which often require transgender women to wear multiple patches in order to achieve the desired E2 levels. Very simple and streamlined HRT method. I started on 4mg (2mg twice daily) of sublingual tablets. Know your body and, if you can, maintain Estradiol alone. sublingual estradiol is After a dose of sublingual estradiol, levels of estrone start to slowly but progressively rise within 10 minutes. However, the effects of different estradiol regimens and route of administration on testosterone suppression is unknown. 5 mg four times daily) And to answer your second question, monotherapy can be done with any route of administration. I became itchy, the marks on my skin lasted longer, etc. I'm sorry you had experienced it too. I did that from 6 months to 18 months and my levels were really good. Monotherapy used to be fairly common, 30+ years ago. We aimed to compare GAHT with SLE only, to combined oral (CO) estradiol and cyproterone acetate, in treatment-naive trans women. There's not a big difference in effectiveness but sublingual skips first pass metabolism For my first 3 months I was on 4mg sublingual estradiol daily and 100 mg spironolactone daily, then I got my E bumped up to 6mg daily (split 2 in morning 1 in evening as that's more convenient for me to be consistent with) while keeping spiro the same. Due to the half-life of estradiol, that major of a swing was severely impacting me. In that first category, while you're running at higher levels then cis women it's needed for testosterone suppression and the overall increase in risk of I've been taking it sublingual for over a year and a half. a For oral estradiol. 4mg sublingual worked for suppressing my T and feminizing me. Most of the time it used ethinyl estradiol or premarin, both of which have some significant issues in high enough doses to suppress T. I'm on 8mg sublingual E and I'm guessing around 150ng/L now - which is usually not enough for mono. 2023. 25 spiro 4 mg sublingual e, just starting third week physical - My nips are sore but haven't really changed otherwise - I have more energy Estradiol Monotherapy - $100-$200 per year. Monotherapy is tricky, although it will probably be easier for you. I'm lucky enough that my T has never been very high so I was able to do it, YMMV. At 6 months, my doctor told me to go down to 3mg because my estrone was dangerously high. For context, I started at 2mg/day sublingual for my first month. It also has a higher peak but your e level goes down faster. I've messaged my doctor early and said I was concerned my T levels were rising after switching some dosing and she had me do the labs early, so just ask your doctor. I am currently taking 2mg estradiol and 5mg finasteride daily. I didn’t get any bloodwork done, and YMMV, though. If your Estradiol is the little teal color pill like mine, it's micronized and thus made to be taken sublingual, it even has a nice slightly sweet taste to show u it's made for that. I am on monotherapy 1mg estradiol tablet oral 2x a day. A few weeks ago, I started to crash mid to late afternoon. There is an interesting study on the efficacy of Estradiol Monotherapy and also whether antiandrogens like Spironolactone are effective in suppression. I am starting with estrogen monotherapy though so that might be part of things as I imagine my t levels will take time to drop. 5mg sublingual is equivalent to ~1. The 17-beta estradiol regimens used in this trial are once-daily sublingual 17-beta estradiol, twice-daily sublingual 17-beta estradiol, and the transdermal 17-beta estradiol patch. And yeah try to take 2mg every 8 hours. Instead of sleeping all day I've been researching other AA and estrogen options. Then, I decided I'd like to try What's the deal with Estradiol injections vs sublingual/oral, and concentrations? Am currently on 6mg/day sublingual Estradiol. 1089/trgh. Studies had to report regarding at least one of the following outcomes of interest: cardiovascular risk (acute coronary disease/myocardial infarction I've been doing monotherapy with Estrogel for two years and it's been great, but it's expensive and fairly inconvenient. I did the sublingual plus an anti androgen for 9 months, though, and it wasn't the worst. This is a gel that's applied to the skin, usually to arms or legs. Single doses of 17β-E2 were administered orally (1 mg) Estradiol >200 pg/mL (vs. When it comes to details: for estradiol oral route, sublingual is usually the best method. as far as you know it’s theoretical. 8-fold higher than the AUC (0-8 hours) for oral E2, measured using LC-MS/MS. Data were collected from 390 individuals of whom 296 had been treated with estradiol for at least 6 months and had adequate data available for analysis. When talking about supraphysiological levels of estradiol and monotherapy there is a distinction that needs to be drawn between levels in the 150-250 pg/ml range, and those up at 300+ pg/ml. I was wondering what the general dosing for EV injections look like when starting monotherapy. Additional comment actions. 1. Does anyone have a rough timeline of how long it takes for the estradiol to suppress testosterone to optimal levels? a shorter half life than both oral and sublingual routes which means it is imperative you take it multiple times per day for decent results For dinner people, it's even possible to reach the levels required for monotherapy just with sublingual pills. My levels were much different from yours on an identical dose to what you're currently taking. Some people can drop the AA on 4mg or 6mg sublingual. For estradiol, we Chronic gender-affirming hormone therapy (GAHT) with sublingual estradiol (SLE) has not been studied. 2). It works and it works well. That was on 8 mg EV per week. 5mg cyproterone acetate Results: Estrone concentrations were higher among participants taking sublingual 17β-estradiol tablets compared with transdermal or injectable preparations (p < 0. Purpose: Maintaining cross-sex hormone levels in the normal physiologic range for the desired gender is the cornerstone of transgender hormonal therapy, but there are limited data on how to achieve this. 5mg oral. The sublingual route is generally safer for blood and liver as compared to oral, 4mg of estradiol monotherapy . For the above interventions, we will consider all types of administration: oral, sublingual, transdermal, subdermal and intramuscular. All values were from blood samples taken fasting, before the morning dose. If the benefits of estradiol are associated with the peaks achieved, this could be a positive finding. I’ve been on 4mg per day sublingual monotherapy for 3 months. e. doi: 10. no research on that um. I've had an orchi so I don't need a T blocker. I did get a bit of breast growth, but it mostly just supressed my testosterone, so I would not expect to much 2mg estradiol monotherapy so I would not expect to much 2mg Abstract. That's exactly what happened, and I'm at the levels a cis woman would experience during her cycle. This isn't necessarily the case for everyone else, just background on my situation. sublingual administration. Transfeminine hormone replacement therapy (HRT) is sometimes referred to as male-to female (MtF) HRT or feminizing hormone therapy. We Oral estradiol tablets can be taken sublingually instead of orally and this allows for greater bioavailability and higher estradiol levels than with oral use. ” MtF 2 weeks on estradiol monotherapy . I actually thought that was a little bit fast so I went down to 2mg 2x a As it bypasses the liver, the levels of estrogen are such to suppress testosterone production on their own, meaning you can do mono-therapy and avoid the expense and negative side effects of anti androgens Dromey_P • I take sublingual estradiol and no anti-androgen. , estradiol alone without an antiandrogen). I don't know if I'll be using sublingual forever, probably just until the tablets I have run out and then I'll invest in patches or gel, or possibly even injections, but for now its what I have, and I was wondering what would be considered small--average--large doses for 2mg tablets of estradiol if I but most people take them sublingual. I actually went into my first appointment specifically requesting estradiol monotherapy and had an argument prepared to back my request but ran into an open minded NP who had no problem with prescribing I personally started nearly two months ago on 2mg of estradiol sublingual. This is the first open-label randomized trial comparing different GAHT regimens for that monotherapy is the best approach for me. I currently take 6 mg sublingual pills every day and that's sufficient for me to have E around 300 and T around 0. Transgender women aged 18 to 45 years who are being evaluated for the initiation of GAHT with 17-β estradiol and did not have a history of Figure 1: Levels of estradiol (E2), progesterone (P4), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) with 2 mg oral micronized estradiol valerate tablets (Progynova) administered sublingually (SL) 3 or 4 It's not impossible to do monotherapy with pills but it depends on how well your body absorbs and how slow your liver metabolizes estradiol. Extension of the simulator to other hormonal preparations like injectable testosterone, There are two sublingual options: sublingual drops and troches. For context, I am 30 years old. Methods: Single doses of Sublingual Estradiol. 7pg/ml for estradiol and 302 ng/dL for testosterone. Would not change a thing. Sublingual drops are a liquid placed under your tongue, and troches are lozenges or tablets that are placed under the tongue or between the cheek and gum. All participants received spironolactone as an antiandrogen. I started on 2mg sublingual 3x daily and after 6 weeks my E2 was 279 and T was 19. Sublingual estradiol: 0. Another option of taking E2 is transdermal estrogel. 14 In contrast, the area under the curve (AUC) for 24 hours with sublingual E2 (in cisgender postmenopausal women) has been found to be 2. I've been considering switching to oral estrogen but I'm concerned that it won't work as well, it won't be as easy to control my E levels, and it might have side effects. Ive come across monotherapy being talked about a lot and I'm very interested in it. 0022. After three months on estrogen monotherapy (6 weeks of 4mg sublingual and 6 weeks of 6mg buccal), my levels are: Testosterone - 36 (Suppression) Estrogen - 97 The best part is that these levels were taken a full 10 hours after my last dose, so they are below trough levels. The most commonly used routes of administration are transdermal (gel or patches) and oral (tablets). When you start injections your levels become good, you dont need sublingual, it's a waste of money and time Reply reply mj24r24 • cis girls don't have testicles. Additionally, sublingual E2 was found to have an increased E2-to-estrone ratio at all time Purpose: Chronic gender-affirming hormone therapy (GAHT) with sublingual estradiol (SLE) has not been studied. I'm on monotherapy and my estrogen levels are quite high with my testosterone levels quite low (both are within normal for a cis woman). Methods: We analyzed data on all transgender females seen in our clinic since 2008 Estrogen blockers are more a detransition from MtF thing and an intersex treatment as they work out there much better Reply reply Sublingual 3mg E monotherapy. For this reason, sublingual estradiol is frequently used in transfeminine people. Can't really predict if it's enough for monotherapy, you'll need tests to confirm it but it's pretty likely overall (8mg very likely but also unnecessarily high most of the time). That's why the delivery method is critical here: except for the lucky few with natually low T levels, patches or injections are pretty much required for estradiol monotherapy to work I recently started estrogen monotherapy (2mg sublingual estradiol once per day) and over the last 3 weeks, the effects have so far been pretty negative: Almost entirely diminished sex drive Fatigue / easily tired out Feeling apathetic/disinterested/bored more than usual Estrogen Monotherapy . Sublingual use of estradiol tablets has several The definition of transdermal estrogen application included gel, patch, or spray. 6-fold higher than that with oral dosing, demonstrating increased drug exposure and higher peak serum concentrations. Individuals treated Estrogen monotherapy, libido changes? Started HRT a week ago today and had an awful reaction to spiro (it interacted poorly with another medicine I have to take) and both bica+finasteride aren't good options for me, either. Sublingual estradiol has better bioavailability, for your e levels 0. This alternative approach, often referred to as high-dose estradiol monotherapy, has the advantage of avoiding the side effects, risks, and costs of antiandrogens and progestogens. 12 The If you are doing monotherapy, you will probably need quite a high estradiol level to suppress testosterone, which is why people doing monotherapy commonly use injections rather than oral estradiol. My T levels are dropping from 836ng/dL 8 months ago to 293 ng/dL Hormonal changes under sublingual estradiol only, or the combined oral treatment in treatment-naive trans women. If you have naturally low t or are especially susceptible to estrogen, it might be enough to very slowly I recently read about the possibility of going off blockers with the help of hrt monotherapy. The level of estradiol in my system almost completely suppresses the T, without the need for anti androgens. taking estradiol sublingual. I was on sublingual monotherapy for about a year, usually around 150 E, and my T was suppressed fine. Attempting estradiol monotherapy using non-injectable or transdermal forms of estradiol such as pills carry an elevated risk of blood clotting, and we recommend you do not try this. Sublingual Estradiol Offers No Apparent Advantage Over Combined Oral Estradiol and Cyproterone Acetate for Gender-Affirming Hormone Therapy of Treatment-Naive Trans Women: Results of a Prospective Pilot Study Transgend Health. The sublingual was not very effective as you can imagine. Sublingual administration of estradiol may be a useful alternative to oral administration for some transfeminine people and can be used for feminising hormone therapy instead. In any event, start sublingual and see how things go. I 17(MtF) have been on 1mg sublingual estradiol every 12 hours (monotherapy) for two weeks and I feel like my body is reacting to it way more than it should? So far I have noticed skin texture change, mood swings (I can cry now!!), "brain fog" cleared, breast buds, nipple size/color change, thinner hair Oestrogen for feminising hormone treatment comes in different preparations. I've had a good HRT experience in the past but eventually stopped my regimen due to circumstances (and chickening out). I would strongly encourage exploring both if necessary to see if monotherapy alone can suppress your T. In that time, my T has dropped from 432 ng/dL to 104. I don't know about transdermal. That means I'm probably within range on both testosterone and estrogen A notable finding by Doll et al 5 was that the peak estradiol level measured in the blood was significantly greater when the estradiol tablets were administered sublingually rather than orally. You could also consider trying injections. Injections aren't required for monotherapy. Reading through a detailed but somewhat rushed DIY transition guide from Lena, there is a mention that “20mg of oral estradiol per day (5 mg twice a day) suppresses testosterone as well as 8mg of estradiol enanthate per week. If I get the same total Estrogen every time but the ratio changes up that means on a 1:6 I get 139:833 or in a 1:8 108:864. 5mg estradiol taken sublingually/buccally three times a day (total of 1. Love 💙💜🤍 Reply reply [deleted] • I'm personally doing injections, heard they're the best for monotherapy so that's what I decided to do Sublingual (under your tongue) and buccal (in your cheek) both improve your bodies absorption of estrogen. This I just received a vial from otokonoko of estradiol valerate 40mg/ml. which allows for um. Methods: Twenty-two trans women enrolled into either the CO arm or the SLE-only arm (0. cause the vast majority of estradiol in United States is micronized. Before doing that you should be aware that E fluctuates rapidly with sublingual. Reply Evie-05x like everyone said, 4mg can be enough Getting the estradiol levels to either 150 pg/ml or 200 pg/ml (depending on source) usually pushes the T to The study Hormonal Treatment of Transgender Women with Oral Estradiol found that 4-6 mg was the sweet spot for 70+% of the participants, taken orally. I'm at 6mg per day. I had to quit spiro due to side effects. It's totally fine, totally doable and for a lot of people - completely successful. tquxmfyvhkyacrmnbguuutjcptcmigldixvgosqckufnyqkxsrvrdgvulmayivjmlicqzimcahrsyald