Doctor thinks my E is too high
Title I’ve been on HRT for 6 months, with 5mg weekly injections for the last 3 of those months. 3 months ago, my E was 22 pg/ml, now it is 333 pg/ml. Doctor says that is too high and is going to to reduce me to a “maintenance dose”. Just wanted to check with other people if this is consistent with their experiences. Thanks!
What ester are you injecting, I assume because you’re in the US it’s valerate? I bet your estrogen is pretty low at trough, given valerate’s half life is 3.5 days … When are you getting blood drawn for the labs? The recommendation I have always heard is to always draw blood at trough.
As an aside, my cis-sexual female spouse has levels that exceed 300 pg/mL each month (those being “natural” physiological levels, no HRT or birth control).
I would be concerned if you were taking oral route of administration from the possible tax on your liver, but since you’re using injections, I think they are going to have a harder time proving there is any real risk from having blood estrogen levels like that, it’s totally within normal physiological ranges of cis women.
I’ve had levels in the 500s pg / mL and my endo wasn’t concerned because he know it was a temporary monotherapy approach until I had surgery.
A doctor that is alarmed by seeing 300 pg / mL is probably not a good doctor, and they should be checking how you feel primarily to determine dose, not just the numbers that are read back. The hormone levels a person needs for their health varies, including cis people.
If you are experiencing symptoms from too much estrogen, you might consider lowering your dose - but is that happening?
I would talk to the local trans community and see what doctors people recommend - you want someone who will give you autonomy in your care and who is educated enough to know where the actual risks are.
seems like you know a lot about this.
I’m personally sitting somewhere in the 400-500pg/ml range as its where my energy is the highest. I’m doing monotherapy indefinitely.
would you suggest i try to prioritize surgery so i can reduce my levels?
Really im just curious what time frame a “temporary monotherapy” counts as.
yes, I highly recommend an orchiectomy from a skillful surgeon, ideally someone that also performs vaginoplasties (so they are more likely to know how to preserve options for a future vaginoplasty if that becomes a possibility and desire later).
The temporary timeline was at most a year, since in the U.S. insurance requires a minimum of 1 year on supervised HRT before allowing any trans gender-affirming surgeries.
Anecdotally, I never found monotherapy as stable for my mood as having more normal estrogen levels post-op, but most of the stability just came from my body no longer occasionally producing testosterone levels I didn’t tolerate well. (High estrogen definitely made me more emotional, but in some ways I enjoyed how it felt - once my life calms down enough, I plan to incorporate occasionally more frequent or higher doses to simulate a monthly cycle.)
Simulating a monthly cycle sounds kinda fun. I hope I can do that in the future too!
Still just a baby trans girl tho. I’m amazed at how big of a difference a little estrogen has done for me.
I’ll look into orchie, I don’t think i want a vagina but idk maybe its worth keeping the option.
Thanks!
Kayday
dandelion