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It's been a bit over a year since I last shared my transition progress on here so I thought I want to update you all.
Here is my last post: https://phtn.app/post/lemmy.dbzer0.com/7781431
Forgot to add:
Yes, there are many factors and reasons for that.
Certainly dose and route of administration do determine things like E2 blood levels and does impact T, but if you are taking oral, for example, your blood E2 levels are fluctuating throughout the day much more than with, for example, injections. Your blood labs are a single snapshot, not representative of your blood levels all the rest of the time. I always try to get my blood labs done at trough, just before my next injection, when my levels are likely to be the lowest.
Even what ester you use matters, e.g. injecting estradiol valerate (which has a shorter half-life) causes your blood levels to fluctuate (higher and then lower) than an ester like estradiol enanthate, which is slower and more gradual.
All of this can influence the feminizing effects, and of course genetics, diet, hydration, exercise, age, and so many other things can play a role as well.
Most of the estrogen taken orally is absorbed by the liver, so it's an inefficient method of raising blood estrogen levels, and anecdotally I notice a slower / reduced feminizing effect from trans women I know taking oral routes rather than injections.
Whether you've had surgery also plays a role, again anecdotes, but I've read reports that feminizing effects were slower before gonad removal and increased after surgery.
Anyway - when I see progress pics I want to know what dose, route of administration, and other relevant notes to contextualize the progress.
I know trans women IRL who have been on oral estrogen for over a year and seen very little effect despite "good" blood labs (she didn't have the numbers so I don't know what she thought "good" was, and she was just repeating what her doctors told her).
I know another trans woman IRL who has been on oral estrogen for months and still has male levels of testosterone and very mild feminization.
I also have a trans woman friend and colleague who has been on oral estrogen for nearly a year and she likes her results, but I've been on estrogen about the same amount of time with injections and I would subjectively say she hasn't feminized as much in the same amount of time.
Still, ultimately it's about what your goals and desires are, my friend has no motivation to change her setup and is happy with her changes. That's ultimately what's important.
Thank you so much for the write-up!
I am on injections myself. Wish I could get EE but currently stuck with EV, since that is the only available form here.
I'm on EV as well because it's the main ester that doctors can prescribe here. I was able to get a Rx for estradiol cypionate, but the concentration was so low that I had to fill my syringe and inject three times to get a single dose and that just wasn't worth it. Maybe post-orchi when I'm no longer on high-dose monotherapy I could revisit that.
EEn is more common for DIY, and if you're in the U.S. for the next 4 years, it's probably worth figuring out how to source that (probably better sooner vs later, having a stockpile is a good idea).
For reference I take my estradiol through patches and take cypro as anti androgen.
Nice, I don't know doses well for patches but I've heard it's not a bad method. The main problems I hear are that they can come off and be expensive to replace, they can cause rashes and irritated skin, and sometimes there can be poor absorption / lower-than-ideal blood levels from patches (better than oral, though!).
I never considered patches because my skin is very sensitive and I am often rough on my body and I think I would lose patches due to daily activities (exercising, soaking in hot baths, brushing up against things when doing manual labor, etc.).
Cypro sounds better than spiro, but reading about it I don't like the idea of taking a synthetic progestogen, since it causes increased risk of blood clots and breast cancer:
https://transfemscience.org/articles/transfem-intro/#cyproterone-acetate
I wouldn't be too worried about it, but I'm just glad I can avoid that risk entirely with estrogen monotherapy (and in the long term with surgery).
For me patches work really good. I apply them to my butt and put a tegaderm patch over it to make it more resistant to water and movement, I don't ever have to worry about it coming off. Cost is also not really a problem since most of the cost is covered by insurance anyway. My last blood levels were 123 pg/ml for E and 39 ng/dl for T (these are my levels with my starting dose (75μg/24hours estradiol (with 2 patches per week) and 10mg cypro), since then I could decrease my cypro intake by a little bit). Regarding the anti androgen I don't really have a choice since that is whats used here in Germany and also my endo only prescribes dermal application estradiol, so spray, gel or patches and she doesn't do monotherapy as far as I know. But since I'm planning on doing bottom surgery in the near future anyway I don't worry about that too much.
Edit: And injections are unfortunately almost impossible to get here.