@iouring Thanks for clarifying 🩷 It takes 2 or more to communicate effectively, so there's definitely an element of misunderstanding on our own part there too. For that, we also offer our own apologies 🫶

We think we didn't explain our level stuff well either. We'll try to clarify, but sorry in advance if we don't do that right.

We were trying to get across that higher peaks are okay, but not that they should be aimed for over the long term.

We don't like to use absolute ranges, as it varies a lot from person to person, but we typically suggest variable ranges of ~200 to ~400 pg/mL (or ~750 to ~1500 pmol/L) for estradiol, where gonadal suppression is required.

We'd known some people who've needed a far lower E2 level to achieve full gonadal suppression (sometimes lower than 400 pmol/L!), so it really is a matter of people finding out over time.

We'd honestly love to be able to ethically gather data from consenting trans+ people on feminising GAHT, with free blood tests to take their hormone ranges at multiple points between doses.

We suspect that there may be a link between trans+ people on feminising GAHT with less stable estradiol level ranges and periods, but it's not like someone's gonna study that.

100% though on preferring a more-stable estradiol level for anyone who wants it, cis or trans+. We much prefer having a more stable level.

Our weekly dose only looks high in simulators. In reality, our actual tested results have been consistently lower and replicable.

For each 1 mg of estradiol enanthate we inject weekly, our estradiol level goes up by about:

• 166 pmol/L on the morning of day 6
• 125 pmol/L on the morning of day 7

As such, if we injected 6 mg EEn weekly, our estradiol level would fall to below 750 pmol/L by the evening on day 7.

As such, we inject a little bit more (7 to 7.5 mg) to give ourselves a bit of wiggle room for it to stay a bit higher by the evening.

#trans #TransDIY #TransGAHT #mythbusting #TransFemHRT #TransFemGAHT #queer #LGBTQ+ #LGBTQIA+ #transgender #FeminisingHRT #FeminisingGAHT

@iouring Hi Lucielle. We appreciate that you're almost certainly coming from a place of good faith with your thoughts there. However, we do want to gently and kindly (without any meaninghighlight how your points are coming across to us 🥺

• That we lack knowledge on the topic of GAHT, particularly different esters.
• That homebrew / DIY GAHT is unsafe.
• That perfectly-fine estradiol level ranges are unreasonable or high.

We don't know if you intended your thoughts to come across this way. It might be a language or culture barrier. Nonetheless, we want to try to clarify some misconceptions you seem to have.

Esters within the homebrew community

Cypionate

This has fallen out of fashion especially where it has largely been replaced by enanthate, which is better-suited for weekly injections. The raws are often slightly cheaper than enanthate, but if you're buying pre-made, it will often cost more. Its only real viable use is if you are able to get prescription estradiol cypionate.

Valerate

This is considered the least-common ester within the homebrew community, due to:

• Its short elimination half-life making it only well-suited for injections twice-weekly or every 5 days.
• It causing higher peaks and lower troughs.

It's mostly only used by people able to get estradiol valerate on prescription, but it is sadly commonly prescribed weekly at non-ideal doses by underqualified medical staff.

Undecylate

This is commonly compounded at both 50 mg/mL and 100 mg/mL now, making it well-suited to higher-volume, less-frequent injections.

It is less-commonly used due to a mixture of factors, including:

• The longer elimination half-life necessitating a larger loading dose.
• The higher cost of the raws.
• It requiring a different carrier formulation for higher concentrations.
  • 50 mg/mL can typically be done in MCT or grapeseed oil with 2% benzyl alcohol, but 100 mg/mL may require up to 40% benzyl benzoate to keep the ester suspended.

Estradiol levels and ranges

Neither 1,000 or 2,000 pmol/L are particularly unreasonably high. It is sadly only considered so for trans+ fems by transmisogynistic medical institutions and systems.

Consider the guidance given by WPATH SOC8. This suggests an arbitrary, pseudoscientific estradiol range of 100 to 200 pg/mL (367 to 734 pmol/L) for feminising GAHT. This is predicated on the myths that:

• Merely having a higher estradiol level increases your VTE risk, which is not true.
• Having a higher estradiol level increases breast cancer risk, which again is not true.

This has sadly led to medical institutions trying to use median figures for their estradiol ranges, or using arbitrarily-rounded lower ranges. The NHS, for example, uses a whole host of sub-optimal estradiol ranges for feminising GAHT, irrespective of the negative consequences on the wellbeing of patients.

Common guidance also ignores the well-recognised "monotherapy" model, whereby a higher estradiol trough is maintained in order to apply negative feedback to the HPG axis. This negative feedback causes a series of reactions that results in total gonadal (testicular) suppression without the need for other meds (e.g., GnRH agonists; GnRH antagonists; anti-androgens).

It's worth noting that testosterone monotherapy, which is the most-common method of masculinising GAHT, uses the same principle of applying negative feedback to the HPG axis to cause gonadal (ovarian) suppression.

In terms of estradiol ranges, it is much more-helpful to look at common estradiol ranges of cis women during menstruation than to go by median ranges. Figures vary wildly, but studies have shown peaks of around 650 pg/mL to 750 pg/mL, which corresponds to ~2,386 to ~2,754 pmol/L.

Even the misogynistic NHS gives level ranges like these:

• Mid-luteal: 180 - 1,068 pmol/L
• Peri-ovulatory: 349 - 1,590 pmol/L

Blood tests

We totally agree that blood tests (as regularly as affordable or even available) should be carried out to measure your estradiol trough to ensure that it's sufficiently high, and to ensure that your testosterone level is fully suppressed.

Resources you might find useful

• DIY HRT Wiki 2.0
• HRT4All
  • You may need to answer a quiz to access it, after which it'll take you to their homepage.
  • If you have troubles accessing in one browser, clear the site data and/or try a different browser.
• Wiki Trans (en français)

#trans #TransDIY #TransGAHT #mythbusting #TransFemHRT #TransFemGAHT #queer #LGBTQ+ #LGBTQIA+ #transgender #FeminisingHRT #FeminisingGAHT

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