Latest blood test results came back. This is my trough btw.
Waow…I’m gonna die. Teehee :3
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Girl, save some for the rest of us! 😭 (stay safe, though!)
No! Give me all the girl! 😭 /s
Girled too close to the sun lol, be careful!
LOL 😂
Yeah, this is bad and I’m taking care of it.
I’m more concerned about my prolactin tho…I think it’s brain tumor time 😔
dam thats some high estrogen lol. doesnt really high estrogen cause mood swings?
Yes, that’s one of the side effects
While I’m not the first to say it, I want to make sure you know that estrogen levels this high can cause major psychological issues (mood swings being a prime example) and greatly increase your risk for breast cancer and other complications*. My levels on monotherapy are 135pg/mL at trough with Estradiol Cypionate. This is far past supraphysiological, and could actually be hindering your development in your transition. More estrogen does not equal faster development. It can actually be a hindrance if it’s too high, let alone the plethora of health issues if you stay at that dose for a long time. Since you didn’t specify what ester you’re taking, I’m especially concerned, because this would be even more dangerous if you were taking Estradiol Valerate, due to the short half-life (meaning your peak could be over double this)
* EDIT: This was based on data gathered before current regulated bioidentical estradiol was in regular use, and is no longer correct. New data shows regulated bioidentical estradiol-only HRT does not significantly change the risk of breast cancer. The same study does, however, provide that there is an increased risk in those receiving combination estradiol and progesterone therapy, though it identified progestins as the problem, not estradiol.
Not to sound like an LLM, but you’re absolutely right. This is far beyond “high” E levels and it’s way too much. I know the risks, especially the breast cancer and the mental effects (negative). I’ll be changing my dose.
I actually am on valerate, which is why this is scary. I take 5mg every 3 days, so I’m gonna try changing to every 4 days. Valerate is a bitch, honestly and I should just DIY enanthate at this point. If my bf wasn’t such an asshole about it…I definitely know that more E != better development. These levels aren’t by choice, I had levels around 110pg/ml at every 4 days, so I decided to up it. It was working fine, at around 360pg/ml, which is still high, but it seems to have creeped up. I’ll change my dosage.
Thanks for the detailed response 🩷
I’m not 100% on this, can high levels really hinder progress? Cause my SHBG is still normal, which I thought was the biggest problem with ultrahigh levels.
So…is that why I’m so flat? 😭 /sReally, thank you 🩷. You seem to know quite a bit. I’m not completely in the dark, but I don’t have all the answers and I don’t claim (I hope!) to have them. Thanks!
5mg Valerate every 3 days is a lot. I know the half-life sucks, I actually get incredibly bad mood swings on it, which is why I DIY Cypionate despite having a Valerate prescription. My insurance doesn’t cover Cypionate, and I need letters from my HRT doc for surgery, so I just pretend I’m taking the Valerate I’m filling every month. This is so concerningly high, that honestly I’d cut it down to 3mg every 5 days (please note than I am not a doctor, but I based my recommendation on the tool I used to dose myself on DIY, and you can see both dosages compared here, just keep in mind that >800pg/mL at trough suggests your body retains significantly more estradiol than expected, so these are likely gross underestimates). You seem to be at the extreme for absorption, far higher than is typically expected at your current dose. Please do remember that it can take a couple months for hormone levels to stabilize, which may be why your last dose seemed lower than expected (though 300pg/mL is still exceptionally high for an EV trough). Give it at least 3 months from a dosage change until you get labs done to ensure they have stabilized.
And yes, when looking at cis girls, high estradiol can actually stunt their growth and development. SHBG is often an indicator for that, but there isn’t a significant amount of research on this topic, so it’s up in the air. I tend to exercise extreme caution, however, and have minimized my dosage of Estradiol Cypionate. There is at least some evidence that super high dose estradiol early on HRT treatment can cause stunted growth of breasts (halting in Tanner stage 4 and lower final breast size), but it’s not clear if that applies to high dose estradiol after awhile on HRT. The real answer is “we need more research to form a conclusive answer.” However, I will say that breast development continues after year 3, as was evidenced in a recent study (I believe in The Netherlands?), and the only reason that 3 year mark was provided is because that’s when previous testing stopped in practically every study beforehand. The researchers simply didn’t extend the data beyond 3 years. You can experience significant breast growth at any point during HRT. We sometimes see development into a cisgender woman’s 20s, so it can take many years, as breast development in trans women is very similar.
First of all, thanks so much for the detailed response (again) 🩷
I know 5mg every 3 days sounds insane, but I am actually going off of real blood tests, always. My body does weird stuff with valerate, so my dose has been adjusted a couple of times already.
I can’t speak for the breast growth stunting, but this is some good info. I think they’re growing, but tbh? I think I would end up flat anyway, no matter what I did. I’m kinda over it, so I’ll just focus on not brutally overdosing myself with estrogen and I think I’ll be good.
There’s just so little research…into women’s health in general, but with trans women, it’s even worse and it sucks, cause it’s actually a fairly interesting subject.
Really, thanks for your replies. It might seem like I’m just a bumbling idiot who doesn’t know what they’re doing (I totally am), but I promise I’m not that incompetent. Thank you so much for your concern and also for the great information ❤️
Of course! Always looking to help!
I’m going to deviate from the empirical now, because I realize that some of my opinions may or may not be helpful in your context. First,and funnily enough this one is empirical, plenty of trans women have perfectly normal transitions on just oral estradiol, which we know results in far lower serum estradiol levels, so I’d be cautious of trusting the 300-500pg/mL that was thrown out there by someone else as being “the most effective.” As we agreed earlier, more E =/= better development. With this in mind, I’m going to walk you through how I landed on my dose.
I have severe bipolar disorder and borderline personality disorder, and I’ve found that extremely high dose estradiol made my symptoms significantly worse. Given that a common symptom of estradiol is mood swings, that didn’t come at a surprise for me. I’d met and talked with many trans women who did oral, and they were overall very happy with their transition development. So what I decided to do, for the sake of my own sanity, was lower my estradiol dose as much as I could while maintaining testosterone suppression. If you read around, you may find sources citing ~300pg/mL as the ideal for monotherapy. Well, at trough, I sit at 135pg/mL and don’t need an anti-androgen. And now that I covered it from the some ~300pg/mL I had before, I’m doing much better mentally. That’s been my personal experience, and I don’t mean to imply it will work well for you, just putting it out there.
Now if you wanna get into empirical evidence, this meta analysis is an excellent source to draw from. It goes over recommended ranges, including WPATH’s recommended range of 100-200pg/mL (which honestly I think is too narrow, but at 200pg/mL, average testosterone suppression is about 90%, which is high enough to be below 50ng/dL of testosterone). I’ve linked specifically to the section on injectable estradiol, but you can scroll up for lots more info. It covers what all our best research points to.
Additionally, I don’t buy into the “progesterone too early stunts growth” stuff, as the only study on that was done on rabbits, and they used extreme, supraphysiological levels. I believe that confirmation bias has fed the rest of the rumor. Out of an abundance of caution though, I did start my progesterone 16 months into HRT. I don’t expect that to matter, though.
I’d focus on getting your estradiol levels down fast, however. That high of a dosage can (and evidenced by my bipolar/borderline ass *will) cause significant psychological effects. Everything is your choice, of course, it just worries me seeing a reading that high.
Best of luck however you move forward <3
You’re so nice, omfg 😭
Tysm! 🩷You mention BPD/bipolar…well, I’m starting to think I might be similar. Not as bad, but…well, not great. And my E levels definitely have at least some effect on that.
I think 300-500pg/ml is high as well, but I just wanna say something…
This is not to criticize or make fun of anyone, but I’ve had a certain experience. I’m part of a Discord server of trans people, mostly women. They’re a bit…conservative with the recommended E levels. To each their own, but they say stuff like “200pg/ml is already too high” and “100pg/ml is enough for monotherapy” and they’re really adamant about it, lashing out at people who speak against that quite harshly. They also keep insisting prog does absolutely nothing. To be honest, I’m not a fan of that place, but to each their own. And this is a complete side-tangent, so probably ignore this.I’m glad I’m not the only one who doesn’t buy “prog too early”. I know the study was done on rabbits with extremely high levels and also, if I’m not mistaken, they used progestins instead of actual progesterone? Not completely certain tho.
I’m getting my levels down ASAP. It might just be why I’ve been feeling the way I have lately. I actually had no idea my levels were that high…jeez. This really is way too much…
Thanks for your concern! Thanks so much for the pointers, this is great info. Transfem Science is honestly great.
I’ll do the best I can and good luck to you too! 💜
IIRC you want to be looking for 300-500 for best results, keep your trough over 300 without elevating your SHBG, at Tanner 4 you can add progesterone.
Thanks, but…
I know just about where my levels should be and I know this is NOT it, lol.I’ve mentioned this many times, and this is just my opinion, you don’t have to agree with me, but I don’t believe in waiting until a certain Tanner stage before adding prog. I’ve been on it since month 3 of HRT and I’m doing fine. I joke about being flat all the time, but I’m actually quite happy.
You do you tho! This is just my opinion, you’re absolutely entitled to your own!Can be great for mental but the consensus I’ve read is it stunts breast growth, choose your own adventure darling ✌️
Totally respect that. I’ve already chosen mine :3
greatly increase your risk for breast cancer and other complications
This is FUD.
It’s not. That’s been empirically tested. Breast cancer (among other hormome-influenced cancers) risk is increased with supraphysiological serum estradiol. Don’t believe me? Here’s an article from The Breast Cancer Foundation.
Sorry, but I’m not going to give any source that doesn’t even attempt to distinguish between premarin and modern forms of HRT much credence. If it doesn’t even mention it, it’s not a serious source.
We’re now seeing a resurgence in post-menopausal cis women on HRT. The fears about breast cancer are largely outdated and based on decades-old studies using premarin, an estrogen that hasn’t been used in decades. The FDA recently changed how it labels estrogen to better reflect modern medical science.
Obviously if you happen to get an estrogen-sensitive breast cancer, higher E levels will increase the risk. But can you show me any studies using modern bio-identical HRT that show a higher rate of developing cancer with higher blood E levels? Can you link to a single study? Not a website, but an actual study?
estrogen level seems rlly high (like, 7x my levels), if I recall right having that much can hinder your progress and cause other issues
Not sure about hindering progress, but this is bad. I’m gonna try changing the interval from 3 to 4 days.
what kind do you use?
Valerate, since it’s the only ester I can get officially 😔
I really should DIY, but my bf is very vocal about not supporting that decisionI’d push to 5 days/cycle then for sure
thankfully there is no shortage of estrogen in that medication lmao. idk why there would be any issue with doing diy, its the same stuff the doctors doing but you monitor your blood levels instead. but its a moot point since you aren’t being underdosed at least
i just use (well, usually use, thats another story :/) patches and Spiro cus that’s easiest for my goober ass brain
I really wanna try 4 days first, to see how that goes. Valerate is finicky and jumping by 2 days at a time might be too much. I’ll definitely lower my dosage tho.
Patches are good! The ones in my country suck ass tho, lol. And I’m a big fan of injections, so that’s what I use.
Thank you Nikki 🩷
You’re amazing!Go for it, you know your body better than me :) I love the Dotti patches, everyone seems to have trouble with their brand lol. I hate needles so I could never do injections 🥺
Any time good luck miss !!
That’s… A lot.
Wow, probably time to adjust your dose…
Definitely. I’m doing valerate, 5mg every 3 days. Time to switch to every 4 days…
I know fuck-all about this. Is it normal in HRT to self-monitor your hormone levels and adjust your dose on your own? Or is this a symptom of less than optimal health care systems? I’d be far too intimidated to decide that without a doctor.
I’ve been on gender affirming care for a year with very, very minimal care from a local women’s health clinic. iirc I started DIY injections and scheduled my first doctor’s appointment in the same week, and was put on a 6 month waiting list for the latter. Then I got a blood test during the initial assessment but the doctor didn’t analyze it for another 4 months.
In my state (in the US), it seems like you either do it all alone or accept a glacial response time. For anecdotal evidence, I had B cup boobs before I got my first prescription, and it’s still an incorrect one.
My healthcare system is fine, really. It’s just that my body responded in a not-so-standard way to valerate injections, so I’m still adjusting my dose to see what’s right. I’m working with a doctor, but by now, I know more than he does about this, to be completely honest 😂 /s
for the most part doctors don’t know shit about trans healthcare (or are actively hostile), unless you get very lucky with your endocrinologist you really need to educate yourself so that you can tell when and how to take matters into your own hands (and be able to identify if your doctor is trying to fuck you over, intentionally or not)
for this reason a lot of trans people just cut out the doctor entirely and go full DIY, buying graymarket hormones online (which also have some advantages over the legitimately available products in most countries) and tracking their hormone levels themselves
EDIT: see this other comment i made like an hour ago for an example
I spiked mine this high for six months and spurred the girls to grow again. I don’t think there is a benefit to keeping your levels this high permanently though.
Of course not! This wasn’t my plan, I honestly had no idea. I’m lowering my dose, this is way too much estradiol. Boobs hurt tho 😭
Well, I hope the boob hurt leads to boob grow.🤗 How long was it this high?
Here’s hoping!
No idea honestly, but I’ve been on 5mg/3days for a while now and my last blood test (almost 3 months ago now) showed around a 360pg/ml trough.
So…quite a while, I think.If you do get some growth out of it, send me a DM or reply to this post. I’m curious if anyone else has the success I did. After 4 years, having plateaued, I gained 2 cups.
If you do get some growth out of it, send me a DM
This seems like a really clever way of asking for boob pictures, lol /s
That’s actually really interesting. 2 cup sizes? Really??? Wow…
I mean, that could have just been some late growth, but that would be an insane coincidence. Also, after 4 years, I’m not so sure…
Either way, congrats on the 2 cups!I think I’m growing. But I think I have been growing this whole time, I’m only 8 months in. I try to maintain a timeline, so you can kinda see the progress. Still, weird…
Lol, yes, I need them… For Transcience!
I now see now you’re early in the process though. I don’t think it would be helpful data this early anyway.
I went from a C that had been stable for a year to DDs. I’m pretty certain it was the E spike. They were stable and seemed to be satisfied with all they had wrought upon the world.
But you never know, boobs can do whatever they want at any time. And, I know very few cis women who stopped growing completely and forever by 20.
I think you’re doing great for 8 months. A lot of groundwork has to be laid underneath before the fat can move in. Don’t forget to eat and eat! Boobs come from sugar and fat and everything delicious!
What’s still weird? Having boobs?
I don’t think it would be helpful data this early anyway
Awwww, I was taking my shirt off 🥺 /s
I went from a C that had been stable for a year to DDs
Girl, WHAT
That’s insane, in the best way possible. Holy fuck…
Genuinely really happy for you 🩷
Your back must hurt…Don’t forget to eat and eat! Boobs come from sugar and fat and everything delicious!
Don’t tempt me, sugar and fat is basically my entire diet 😭 /s
Really should eat more tho…What’s still weird? Having boobs?
No, having boobs is the best, lol
What I meant is, I thought I’d feel…idk, worse when having such astronomically high E levels. I thought it would be more obvious with more symptoms, you know?
Girl, be careful.
Those e levels are bad and will straight up hinder the effects of HRT. Also, if you can get levels that high, you don’t need an anti-androgen
[CITATION NEEDED.]
Don’t confuse T and E. Excess T gets converted to E. There is no reverse mechanism.
the reasoning i’ve heard has nothing to do with conversion to T, but that excessively high E levels will cause your body to attempt to get rid of the excess sex hormones by ramping up SHBG production, and if this reaction is strong enough you end up with less free estradiol than if you were taking a smaller dose. that said, this is just something i’ve overheard from other transfems, i don’t know if this is backed up by research, nor what E levels would be necessary to achieve that.
I agree that higher E levels will lead to higher SHBG levels, but I’m very skeptical that this would on net result in lower free estradiol levels on net.
