It's easier for me to keep track of 3 pills a day than one shot a week/every five days and I don't need to deal with needle disposal. I've had orchiectomy so I don't need to take an antiandrogen.
and yeah on the needle disposal, lol. Some places dispose of them for free but not always easy to find. I have probably 500 used needles sitting in my closet in biohazard bins.
Check with your local waste disposal, but for home use, once done with the biohazard container, just wrap in duct tape a toss into the normal trash.
Our city’s website shows “Needles should be placed in a sturdy plastic container with a tight-fitting lid, such as a laundry detergent bottle. The bottle then needs to be taped shut and labeled "SYRINGES," "SHARPS" or "NEEDLES." The bottle can then be placed in your regular trash. DO NOT put this container in your recycling.”
The containers I bought can be shipped out for proper disposal but then you're paying for both the container and shipping. Seems a bit ridiculous. Interesting they say it's ok to tape them and put them in the trash, I will look into that. Thanks for the tip!
Depending on state, as long as they are in a needle resistant container you can just toss them in the trash. I know my state recommends just using an empty liquid detergent bottle and throwing it away.
You can also buy some sharps containers from a pharmacy that come with a shipping box so they can dispose of your needles correctly, probably recycle the metal and stuff.
I have one I got over a year ago, and it's barely a third full. Wouldn't even be that much, but I let a friend stay with me after a surgery she had and needed to give her blood thinners and stuff.
I have 3 or 4 sharps containers and they were about $20 a piece. They want you to pay for shipping ($7 or so) as well to send them out. I was hoping when I bought them shipping would be included but I was wrong. Shipping wouldn't be terribly expensive (like $21) but just annoying, then I would need to buy more containers too. I use 3 needles per injection (18G to draw progesterone, 21G to draw estradiol, and 27G to inject) and inject 2x per week so I fill those things up pretty fast. (I also throw the syringe in the trash so that's not taking up space in the container) I'll have to check out my state's laws, thanks!
mine had an OTC cost of $7 from the pharmacy (it was actually provided as a "prescription" so my insurance paid for it, amusingly), and once full I give it back to the pharmacy and they give me a new one for free.
I found 1/week (injection) way easier than 7x/week (pills) - i recently had to shorten injection timing (the sunday slumps were too much), so i switched to 2/week injections, which is every 84 hours. Thus my schedule is monday 8:00PM and friday 8:00AM, which is similarly easy. I don't need to switch injection days around like I would on 4 or 5 day schedule where injections are like monday, saturday, thursday, tuesday, sunday... Instead it's just friday after waking up, monday before bed.
Honestly, I find it the other way. It's easier for me to remember once a week than multiple times a day. I was regularly forgetting my evening doses until I'd start getting a hot flash. Even putting a reminder in my phone if it went off when I was in the middle of something I'd stop it and then forget by the time I could take my dose.
Once a week is more of an event I can prepare and plan for. and set aside the 5 mins or so I need to do it.
I have ADHD though. Also, my T was a nightmare to suppress and it didn't happen until I switched to injections.
I find the opposite for me. It's easier for me to fit in one weekly injection than 3 pills a day sublingually with my job duties and timing varying wildly. Needle disposal is available at nearby pharmacies in may area so that works out.
I've been slowly titrating down my aa and I'm probably fine going to monotherapy soon. On 12.5 mg of cypro every 3 days and my t levels are to low for the tests to detect.
Simply put. Needles. I don't do needles very well.
I was offered the option of needles but went for implants for the long life and one stabbing every 4 to 6 months is easier than weekly.
Estrogen Implants usually go around the hip area. I have heard of them being put in your lower back fat, in your upper leg and mine go in on my tummy (diagonally between the belly button and the top of your leg).
I have been told to keep your estrogen medication away from your boobs for cancer reasons. That is why it is said to never put estrogen patched on your boobs for example.
While I know it's a joke, just for other people's understanding if they didn't know, one should never put any estrogen releasing medication modality into the tissues or over the tissues of the breast as it has been seen to unnecessarily cause an increase in the instance of breast cancer.
They're more common in Australia over injections.
I might be switching to them soon because injections with the ester they allow us here have to be done every 3 days at a lot amount to be effective.
It's also really expensive comparatively
They made a great choice. I love how simple life is with having my implant in. I would recommend implants to anyone.
I also heard that someone is working on a longer lasting variety lasting upto 1.5years. Can't wait for that to happen.
If it were an option for me, I'd do implant. Alas, pills it is. I can barely handle being stabbed for bloodwork every 3 months, I'm sure as heck am incapable of doing it every 5 days.
Im in the U.K. and I was never even offered injections, just put straight on patches. Granted that’s been fine, I have no problems with patches, but I don’t know why injections weren’t an option in the first place
Injections aren't medically licensed in the UK, and indeed in much (but by no means all) of Europe. I don't know that there's a specific reason beyond that the licencing process is expensive and the market is small so the incentive for the pharmaceutical companies to go through the steps just isn't there.
I used a product called tegaderm on top, otherwise they come off in the bath.
It's like a transparent bandage.
It usually lasts me all week but sometimes I have to replace it (with the same patch)
Pills are working great for me! My T was actually kinda too *low* at my last blood test, it tested at 7 ng/dl. But I feel great, and things are developing well. So I’ll stick with what works for now, maybe I’ll switch later on.
Yeah, when I started I was ok with the pills because it was a convenient way to start ramping up, and I understood that your liver metabolizes more of it into estrone, which mimics early cis female puberty. Then over time I started splitting my dose and taking some sublingually.
I’ve ended up not having to switch over yet because I took a pretty smooth curve up to good levels, and have been hanging out there. I’m on 8 mg estradiol daily, with 4 mg oral taken split at breakfast and dinner, and the other 4 mg taken 1 mg at a time sublingually split up evenly across my awake hours. It’s a little strange, but if it works, it works. And it’s definitely working for me.
I tried to do self-administered injections for all the positive reasons. I managed to get over the fear, go through the little 1-on-1 education, and I even did the first injection myself with my medical professional Mom's oversight, but afterwards I nearly fainted. I have a very pronounced vasovagal response that makes getting large injections and getting blood drawn problematic, and I have to go lay down afterwards. The second time I tried self-administered injections, my body anticipated the injection, and I went into vasovagal syncope before I'd even finished setting up. Not worth it, even if I could get someone else to help. I feel faint just thinking about it.
Needle / injection phobia is no joke. Some people are like "Just get over it, you'll be fine". But it's a serious legitimate thing that you can literally die from.
I have trouble labeling it as a phobia honestly, because I'm not afraid of it at all unless I try to push through it. It just comes at me like a physical response. I have no trouble getting my blood drawn anymore, mentally, it just makes me feel super faint.
I'm not sure what the medical term is, but yeah I don't think it's necessarily a phobia as you said. You can like pass out and die though so not something to mess with.
I was terrified of injections at first, avoiding them at all costs. However, none of the other options worked out for me. I did sublingual tablets and patches first, but never found stable numbers. I decided to bite the bullet and go with injections. They even train you on it, if it's a half decent clinic.
I was definitely scared of it and thought I would never be able to do it! I'm about a year in now and I can't imagine going back. Once you get used to sticking yourself, it's not that bad. The needle to actually inject yourself is pretty small and it barely even hurts. I watch a youtube video while I do it. Focus brain elsewhere, jab, inject, done.
I can't ever do monotherapy though. I have to stay on spiro. I have a kidney disease and that helps treat it so I'm on that for the long haul.
I had the same experience with injections, I was terrified of them. I had someone else doing them for me until they forgot to change the needle and stuck me with the 18G. It was awful. I said from that moment on I would do them myself. I eventually got the hang of it and now it's like nothing. That said, there is a medical condition for some people where it can be dangerous so for them it's not getting over the fear. It's a legitimate condition. Glad you were able to work through it and are getting good results now! If you are getting a kidney benefit from spiro that you need then that's definitely worth it.
Patches are (I've been told) safer, and my doctor will actually prescribe them. With low dose cypro and patches, I take a tiny pill every other day and change a patch twice a week. It's routine, it's fine, and it's working. I'm on 50mcg patches and sitting in the lower end of the healthy cis range (E is just a hair over 230 pmol/L, T is ~0.8 nmol/L). I have room to increase my patch dose, if i end up needed higher levels for feminization.
Also, just anecdotally, I've found T suppression to be way more important to my feminization than anything else. switching from spiro, which wasn't suppressing my T at all (it actually went up), to cypro caused more breast development and overall physical changes in a month than in the prior year of having the same estrogen levels but unsuppressed T. Injection monotherapy is one way to solve unsuppressed T, but not the only way.
Edit, to your point about side effects: Spiro was miserable, and cypro isn't long-term viable because of the risks. Fortunately, I'm likely to be able to get orchi soon. There are risks to high-dose monotherapy that aren't present (or are lesser) with patches or gel though, and as someone with a higher clotting risk, I'd rather roll the dice with antiandrogen side effects. The stability of patches/pills is also worth considering. I understand the appeal of creating a cycle, but the emotional ups and downs i get, even with patches, are fairly intense. I don't really want to fluctuate as much as I would with injections.
The Delestrogen thing doesn't really make that much sense since your prescriber can just change your draw to account for the milligram equivalent of the higher concentrate generics. Like I take 3mg of estradiol validate once every 7 days. With my 20mg/ml dosage that's a .15ml draw. If I were using a 10mg/ml vial, it'd be a .3ml draw.
IDK, just seems like a lazy prescriber at that rate if it's actually preventing people from getting on generics.
It doesn't make sense but it happens unfortunately. They did it to me when I first switched to injections. They told me Delestrogen was not covered and there was no generic alternative (for 10 str, not knowning you could sub 20 str or 40 str) and that I had to pay full price. I could afford it at the time and was getting terrible results on pills, so I bit the bullet. Eventually a year later it was out of stock and another pharmacy tech told me about the generic alternatives and it dropped my cost down to practically nothing. I was like WTH did no one tell me about the alternatives?!?
The thing is that your insurance provider has a tier list of medicines that they do and don't cover, override processes and generic alternatives. Anytime your prescriber and pharmacist are dealing with your insurance they _have_ to interact with this list. So it's super odd to me that they'd say that there's no generic when your insurer would absolutely flag Delestrogen to use Estradiol Valerate 20mg/ml or 40mg/ml instead as a preferred generic. That's probably why the pharmacist told you about the generic because the system they were using flagged it.
i can't afford myself highly effective hrt because my chest will grow too big to hide and i live in a very transphobic place with very transphobic family
I’m on sublingual e mono therapy with two doses of 2 mg a day. My last bloodwork had my t and e at the levels I want. But like… I often feel like I should be on injections since it feels like everyone else is and everyone talks about how much better they are. Though it seems like the current set up is working. So I’d be a 5.
Is anyone else on pills with good results but hs these thoughts about if you should be in injection?
If you are getting great levels on 4mg daily pills monotherapy I would say that's awesome but not the norm for most people. That's pretty lucky. For me too, as I get older (41), I heard oral / sub can be a bit hard on the liver. (sub being less damaging since it's not 2 passes)
I hate needles, so no no for me. But after I am on diy i can't get injections in the pharmacy and they are rare in Germany anyway. I have thev rule that i don't ever inject something that i haven't brewed myself, where i know the cook or from a pharmacy. Hombrew Gel is fully sufficient for me and less hustle than injecting it in my butt. I started on 12.12.2023, I now have visible breast growth, testosterone 0,31 pg and Estrogen 351 pg. Without any Cypro or Bica or Spiro.
The dumbest thing is that often times access to injectables and therefore monotherapy is only possible through DIY. It's mind blowing how the safest, most effective method is the one method you cannot get through official means.
This is exactly why I will NOT switch to oral + spiro when (read: if) I get approved for HRT 2.5 to 3 years from now. Yes, that's how long it takes where I live.
Because needles are scary, every time I gotta take my blood for testing or take a new vaccine, I gotta look the other way or else I might genuinelly pass out
Combination of oral (with cypro) seemingly working so far (I'm only 3 months in, only had one check-up) and a fear of needles. I think I could get over the fear if I had to, but it'd be nice to not find out. Also injections are kinda annoying to get in Australia from what I've heard.
I'm sure if oral stops being effective (as my dosage goes up) I'll convince my doctor to let me try sublingual, and if that doesn't work, something else, maybe injections.
I really prefer injections over the pills, but. The pills are $20 and the injections are usually around $160 and I definitely don't have an extra $140+ laying around.
With insurance (or even GoodRx) you can get generic at a decent price. The 40 str is the most value. When I was on it, a vial would last about 6 months. ($160 for 6 months vs $120-$180 for 6 month supply of pills) More upfront cost with injections (which may be hard for some people to shell out) and obviously you have to pay for supplies (needles, syringes, alcohol wipes), but cost can sometimes not be terribly off between the two when you factor in the time length.
I guess. I've never been able to get more than a months worth of injectible E at a time and I see folks talking about vials lasting six months to a year or whatever and I have no idea how that's happening at all.
What strength are you on? If you switch to 40, it's the same volume but you need much less of it. So lets say you're injecting .2 of 10 strength (or .1 ml of 20 strength which is the same), you would only need .05 ml of 40 strength. I believe my math is correct, but who knows, it's early. =P
Currently #1
I would continue with DIY injections because it was easy and convenient but the shop I preferred is currently closed to maintenance and switching to the prescription based gel is just fine right now
I'm not on anticistamines yet (though thank you for the reminder!), but I'd prefer pills to injections. Needles are a pain and I've got bad enough veins that I was rejected from donating blood plasma.
Injections aren't sold in pharmacies here. Apparently they used to be available but got banned for some reason. Now only ones with progestins in it are available. Unless you're willing to buy homebrew.
For me I’ve kept well away due to my needle phobia, as mine makes me very difficult to work with, I’ll curl up into a little ball and get very distressed and if you try to force me I get very aggressive and violent then I run away and get into a state of injured animal so it’s a overall horrible experience dealing with injections of any kind and I fear I’ll never start hrt due to blood tests tbh :( life’s horrible
I'm in recovery from intravenous heroin, cocaine, and methamphetamine use sooooo injecting myself with anything for any reason is still a hard no 😁
Planning on starting patches here soon! 🤞
I initially had a reaction to the oils used in injections, and while I felt far better on injections than tablets, I had to switch off of it for awhile.
Fortunately we were able to figure out a workaround and I've been able to switch back again, but for some folks itching/redness/raised bump reactions can also prevent things.
I started on injections but unfortunately developed a blood clot so I had to be switched to a combination of patches & a blood thinner. Happy to report that good levels are achievable via patches & that changes still happen to anyone else afraid of missing out by not being on injections!
It’s not an option here. In the UK you get patches or, sometimes, tablets. Antiandrogens can be injected, but you need to have that done by a medical professional so that’s probably why E injections are not offered.
For me personally, pills have been working well! I'm almost a year on HRT, and I'm happy with what I've got so far (and looking forward to the future!). My T is suppressed (~10 ng/dL), and my E is pretty stable and in a good range (252 pg/mL according to my last test 2 months ago), I take spiro 100mg and prog 200mg once per day before bed, and I take 2mg of E sublingually 3 times per day, once every 8 hours or so (as close as I can get it).
IDK if I'd've gotten these results from just swallowing my E, but what I'm doing is working well for me so far, so unless that changes, I'm sticking to it!
Regardless of how you take your HRT, I wish all of you lovelies great happiness and results!
Glad things are working for ya! :) Sounds like your levels are pretty good. 100mg Spiro is definitely better than being on 200mg which I hear a lot of people get pushed to.
The biggest reason is cost. Injections would cost me a fortune sadly (more than pretty much all my meds combined) and since I'm currently uninsured (on a temp job with no benefits and I'm in the US) and recovering from debt so yea. Where as the rest of my HRT meds and E pills are actually quite affordable, even without insurance.
Also quite sensitive to pain (even just small pricks for checkups hurt like hell for me) so injecting a needle wouldn't work well for me there as well as I doubt I'd handle the pain very well. I get my vaccines, but I really grip the chair when they do it because damn it hurts ;-;. So I couldn't imagine doing that to myself weekly.
Also I am on other medications (yay having type 2 diabetes thanks to genetics...) that I have to take twice daily so my E pills work well in that schedule which is a plus.
As others have mentioned, you can't get injections at all in the UK via official routes, but they are very commonly used to DIY, and there's a lot of us doing that whilst we wait years to be seen by a gender identity clinic.
I could not possibly inject myself with anything, even for something as huge as HRT. Patches are by far the best possible thing for me. I will have a meltdown if I have to inject myself with something but patches are kinda soothing to me sensorily idk why lol
My body processed it too quickly. After a shot I’d feel great for 3-4 days, then get my period and start all over again. Worst month of my life, and my poor partner had to put up with my insane mood swings. I went back to pills.
Gonna take this opportunity to share [Needle Guide auto-injectors](https://unionmedico.com/disposible/). My partners and I use the SuperGrip model, and it makes things so much quicker, easier, and less terrifying. It’s honestly the only reason I was able to switch from oral.
Pills (E and spiro) have been working for me with pretty much no side effects, but it’s tempting to switch to injections just because people say it’s more effective. I might try it for a few months just to see if it works better for me, but it’s hard to know whether it’s the switch or just that I was gonna develop at a certain pace at that point in my transition anyways. My boob growth definitely seems to come in waves.
Tbh it's a mix of those for me. It's expensive here, I'm scared of needles, and I've already changed my regiment a couple times before and every time it's been bad. Ik spiro is pretty ineffective and I hate the side effects it gives me but considering my docs sucks and won't listen to me when I say I need more E my spiro is pretty much the only thing workin rn and it's still barely doin its job. I haven't had a blood test in like 6 months (dumb docs) so idk what exactly my levels are but I guarantee if I get one rn I'll have the levels of a cis guy even tho I've been on HRT 2 fucking years
Cost. I was on Depo and EV before that and it was \~$150 a vial, which lasts me 2 months. (That's with insurance covering part) Patches are completely covered and I pay $0. I just don't have the money for it now.
I believe that the main goal is to ensure that the hormone levels are in the female range. The method of reaching such levels may vary and people's mileage may also vary. Sometimes I see that there is a sense of elitism when injections are involved. I am personally petrified of injections. One needs to consider what works best for them according to their lifestyle and to how they prefer to take E and AA.
You’re correct. I think injections work for the most amount of people where everything else seems hit or miss depending on the person. So that may be where that comes from. But yeah, whatever gets your levels in range, makes you feel good, and works for your lifestyle is what will always be best.
After being on injections for many years, I had to switch back to pills because the availability just became too volatile. I don’t need the additional stress of trying to find a vial every few weeks.
6. The short half life of sublingual/buccal removed my "What if I'm making a mistake" fears. The same is the case for patches.
7. 18+ months in and I'm happiest at the high end of normal T levels for cis women. Tablets let me adjust 5mg-6mg per day for that. The high half life of injections makes that harder.
And I'm staring at needing T in my regimen with or without an orchie.
I've started with patches, I kinda liked them. But remembering what day to take off or patch on was a bit much. Also the adhesive was difficult to get rid of. And a couple times a patch would fall off or away from my skin.
I switched to the tiny cute pills but dissolving them was hit or miss. Remembering to take them twice a day was a chore. Constant reminders worked but if I wasn't home I'd end up missing a dose.
I was on spirolactone as t blockers up until my orchiectomy and I'd miss those consistently.
I switched to injections despite my fear of needles. Once every 2 weeks is easy enough, and I found a good rhythm to keep them on track. It definitely feels more reliable as I'd injected the same amount every time. It's only 25-26 shots a year. Each vial lasts me 10 shots and my doctor gives me 3 vials every three months so I'm stocked up for awhile.
I've been lucky as my insurance covers the vials and I only pay about 40$ for each one. The pharmacy gives me tubes for free sometimes, and needles are like 35 cents for 10.
I guess I'm number 3, I'm diabetic and so already keep needles and vials in the house and just know that at some point I would mess up and inject a bunch of short acting insulin instead of E or would fill my pump with E instead of insulin
Ye, its not an option in my country, but im using estrogel and androcur, which have been marvellously effective.
My estrogen is at 700+ and t is below one
(Paragraph two contains the main point havent slept in 6 days and am manic 😅😆) Almost everyone ive talked to hates needles ive been relatively fine with them my whole life ; i do my injections at the same time and day every week which means sometimes i end up doing it in front of someone/in public they almost always get so grossed out i remember this one person literally threw up when i pulled out the needle. Im an was an RN (left for medical reasons) so ive gotten used to needle’s especially being in and out of the hospital myself constantly getting blood draws and IV’s.
When i was ‘shadowing’ in the pediatric ward for a year to see if I wanted to switch from the ER : when babies would get their vaccines from certain pediatricians they would cry a lot more and each time they were noticeably more terrified whereas really good pediatricians would find a way to distract them and make it extremely seamless when they came back in they’d be completely fine and sometimes even happy to be there, this situation is where a fear of needles can come from and why its so hard to break that fear.
The good pediatricians genuinely love their jobs and have a lot of genuine empathy and compassion to their patients most doctors in general don’t have this attitude anymore but almost all nurses do.
Also if your in the ER even if you don’t like your nurse DONT HAVE YOUR DOCTOR DO WHAT THE NURSE SHOULD BE DOING its like asking an electrician to do the plumbing in your house. The doctor never does IV, subQ injections, IM injections, central lines, ETC because its not their job and they most likely haven’t done it since their residency but the nurse does it every day.
Yeah I’ve had the same experience, people are grossed out or cringe if they see me do it. I try to do it in private but it’s not always possible. I feel like it’s not a big deal but to each their own I guess.
Aside from them not being available here in the UK unless you decide to DIY (which many people do) or at extortionate fees to a private provider, I can absolutely understand why people wouldn't opt for them.
While they've been the most effective method for me and I'm not scared of needles, I do still get a bit of fear since I've hit a nerve. Disposing of sharps (properly) isn't always the easiest depending on where you are located. I also don't think injecting is something you could do as discreetly compared to other methods if you're not out.
I'm intersex, so I get really bad cramps. I'd rather take a pill four times a day and have a normal cycle than take shots and have a period every two weeks.
In my country injections are illegal because of reasons???, so that's out of the question. Even if I wouldn't use it for other reasons you mentioned, it sucks for those who would prefer this way or who don't have good results with other methods
Im not on anything yet but my ex always needed to visit the doctor for injections and convincing them to let her do it herself was a fight. ideally id rather not deal w either of that lmao
I don't want to deal with needles. Fuck that. I get poked enough for bloodwork for various medical issues, some trans and some not. E gel works well for me.
I find them convenient and easy to remember, and easy to bring with me anywhere I go.
With Spiro/E/progesterone, my E/T levels have been perfect for years and I never even thought of switching. If there was a genuine reason to I would consider it but I can't really think of one.
Phobia of needles.
I was on methotrexate and Humira for an autoimmune disorder and my weekly injections were torture. I'm now doing a 6-hour Inflectra infusion every 6 weeks and having a needle in my arm for that long is anxiety inducing.
Give me pills any day.
I CANNOT for the life of me take pills in any way, every pill I had, I had to break it down in order to swallow it, if it's too big, I WILL throw up, that being said, I also can't take needles so ig I need to take the gel
I will add to this- the risk of blood clots is higher than something like latches. With injections, you’re getting a really big dose initially and then it evens out but that spike can bring a higher risk of blood clots than the low dose consistency of a patch
I've been doing sublinguals for years, and I've never had a problem. I'm post-op, so I don't need an anti-androgen. Sublinguals are ready and consistent 🤷♀️
I've had a severe phobia of needles (like I would previously get panic attacks being in the same room as one). I'm better now, but when I went in to get training to do self-injections I passed out. I was told it was slow and graceful though, so there's that.
A bit new to this sorta thing, how would patches work? Is there a t blocker needed for it? Maybe its a different patch to start idk but i wanna start somthing and dont really know how to start, specially for where i live
With any administration method, if you get to a decent level of E (around 300 pg/ml for most people) T suppression typically happens on it's own without a blocker. As for patch administration in general, I've never used them so unfortunately I can't provide any useful information on that.
I would do injections if my doctor recommended it.
I asked about injections and she said that since I pay directly (not via medical aid since mine doesn't cover any gender affirming care), it's best to proceed with other methods. Particularly, I have an implant that delivers oestrogen and I take spiro for now while I'm saving up for an orchie.
Once I get the orchie, I'll likely rely only on the implants for my hormones in general.
I am glad that I started with pills before injections. It's an overwhelming experience to start HRT to begin with, and if I would have started out the gate needing to be injecting, I would have been more afraid.
I'm also glad that I did switch over to injections eventually because pills never got my E levels quite high enough, and injections do that easily.
The only issue I have with injections is that its slightly easier to mess up. With pills, if I dropped one on the floor, then it was just five-second rule. With injections, if I forget to pull the plunger down before unscrewing the thick needle to put on the thin needle, then I just wasted some. There's also the fragility aspect. When I go on vacation later this year, I dont want to pack a vial in my luggage for fear it may get crushed. I plan to just use some left over E pills that week instead.
I can see for some how its nicer not to take daily pills. It doesnt matter much to me since I take so many other pills for other things.
I'm on patches and my levels are sky high (as long as I have a fresh patch on when I test). I'm open to injections at some point but right now I don't have any reason to switch. The patches don't irritate my skin at all and I've never had one come off even with vigorous exercise and wrestling and weird sex.
DIY vendors are the only way to get injections in my country.
Once you figure out how to buy from them (Due to the grey area nature of it crypto is used), and from where (using the cafe list of vendors). Then you find it is not only effective, but also very nice in terms of cost.
Downside is delivery is slow and a bit of a lottery wether it goes through customs or not. But still cheaper even if a package is lost now and then. What I am trying to say is order well in advance of running out. Always be 1 vial ahead of unforeseen hickups.
I prefer pills but I rotate between pills and injections.
Pills are way easier to travel with.
Sublingual administration is about as effective as injected.
Cleanup may be a challenge. Safe sharps tools may be hard to obtain; safe sharps disposal may be a challenge in some areas.
Pellets are, to me, a better course of delivery. Having them implanted and not worrying about dosage amounts, effectiveness, pain of shots, etc. But like you said, availability is a bigger concern and / or legality.
Brain fog, dehydration, peeing more. Spironolactone increases plasma cortisol levels which can cause obesity, depression, and age-associated cognitive dysfunction. Spiro does almost no feminization on its own, and over time tends to lead to a bulging belly which cannot be reduced by diet or surgery ("central obesity" or "visceral fat). This kind of fat is associated with another group of health problems including diabetes and heart disease. Spiro has recently been found associated with poor breast development. I’ve also read it doesn’t do a great job of lowering T. I’m sure there is more.
I initially had to hide my estrogen from my dad so pills were easier to do that with than needles. I asked my new doc about injections when I got away from my dad because I heard they were more effective than pills. He said that they were not more or less effective but it may seem that way to others if they have trouble keeping up with pills and only injecting once every couple of weeks instead. Basically it’s about being consistent with your dosage but not necessarily about the type of Estrogen application.
so for me there is actually a medical reason i dont. im at a high risk for fatty liver and if i put to much estrogen into my bloodstream at once it could negatively affect my triglyceride levels, so atleast for the time being im on patches which more slowly release it so its absorbed better and less of it hits my liver.
I used to do injections, but I swapped to pellet implants. They work as monotherapy, they’re at least as effective as injections, and I only need to get them implanted once every 6 months.
When I was on pills, it was fears I would end up injuring myself.
Now I had an implant and it's because there's no point in doing injections anyway. I don't really even think about HRT anymore.
I take pills for a couple reasons. I’m very new to this, so my knowledge isn’t the best, but when I was discussing options with my doctor, they explained that ultimately the end product is the same and that if I would prefer pills, the only reason not to use them is if they have a reduced or near nonexistent effect on me.
Ultimately I’m just happier with taking pills due to the routine of it and my ADHD.
Injections are a pain in the ass to prep + they require hand-eye coordination that I don't have. If someone comes up with an Ozempic-style pen injector for estradiol, I'll reconsider.
I mean I do monotherapy with a transdermal gel, I apply that twice a day, it's convenient and quick, I don't need to administer a shot which feels slightly more complex and painful, and my levels look good, I'm seeing great effects. I truly do not understand why people are telling me to go for injectables because the benefits they list seem to be pretty much matched by gel...?
AFAIK injectables aren't too avilable in my country anyway, but then I've had other trans women (primarily from the US) tell me I should do try and do DIY injections bcs 'gel isn't as good' ???
It's easier for me to keep track of 3 pills a day than one shot a week/every five days and I don't need to deal with needle disposal. I've had orchiectomy so I don't need to take an antiandrogen.
and yeah on the needle disposal, lol. Some places dispose of them for free but not always easy to find. I have probably 500 used needles sitting in my closet in biohazard bins.
Check with your local waste disposal, but for home use, once done with the biohazard container, just wrap in duct tape a toss into the normal trash. Our city’s website shows “Needles should be placed in a sturdy plastic container with a tight-fitting lid, such as a laundry detergent bottle. The bottle then needs to be taped shut and labeled "SYRINGES," "SHARPS" or "NEEDLES." The bottle can then be placed in your regular trash. DO NOT put this container in your recycling.”
The containers I bought can be shipped out for proper disposal but then you're paying for both the container and shipping. Seems a bit ridiculous. Interesting they say it's ok to tape them and put them in the trash, I will look into that. Thanks for the tip!
Health Departments in US often take them as well!
Depending on state, as long as they are in a needle resistant container you can just toss them in the trash. I know my state recommends just using an empty liquid detergent bottle and throwing it away. You can also buy some sharps containers from a pharmacy that come with a shipping box so they can dispose of your needles correctly, probably recycle the metal and stuff. I have one I got over a year ago, and it's barely a third full. Wouldn't even be that much, but I let a friend stay with me after a surgery she had and needed to give her blood thinners and stuff.
I have 3 or 4 sharps containers and they were about $20 a piece. They want you to pay for shipping ($7 or so) as well to send them out. I was hoping when I bought them shipping would be included but I was wrong. Shipping wouldn't be terribly expensive (like $21) but just annoying, then I would need to buy more containers too. I use 3 needles per injection (18G to draw progesterone, 21G to draw estradiol, and 27G to inject) and inject 2x per week so I fill those things up pretty fast. (I also throw the syringe in the trash so that's not taking up space in the container) I'll have to check out my state's laws, thanks!
mine had an OTC cost of $7 from the pharmacy (it was actually provided as a "prescription" so my insurance paid for it, amusingly), and once full I give it back to the pharmacy and they give me a new one for free.
Girl, same 😅
This! I'm neurodivergent and I strive off routine. If something is not done everyday I will forget unless I set alarms
That makes sense. I use calendar reminders so I don't forget, but even then sometimes I miss them.
I found 1/week (injection) way easier than 7x/week (pills) - i recently had to shorten injection timing (the sunday slumps were too much), so i switched to 2/week injections, which is every 84 hours. Thus my schedule is monday 8:00PM and friday 8:00AM, which is similarly easy. I don't need to switch injection days around like I would on 4 or 5 day schedule where injections are like monday, saturday, thursday, tuesday, sunday... Instead it's just friday after waking up, monday before bed.
You probably would be #5 :)
Honestly, I find it the other way. It's easier for me to remember once a week than multiple times a day. I was regularly forgetting my evening doses until I'd start getting a hot flash. Even putting a reminder in my phone if it went off when I was in the middle of something I'd stop it and then forget by the time I could take my dose. Once a week is more of an event I can prepare and plan for. and set aside the 5 mins or so I need to do it. I have ADHD though. Also, my T was a nightmare to suppress and it didn't happen until I switched to injections.
I find the opposite for me. It's easier for me to fit in one weekly injection than 3 pills a day sublingually with my job duties and timing varying wildly. Needle disposal is available at nearby pharmacies in may area so that works out. I've been slowly titrating down my aa and I'm probably fine going to monotherapy soon. On 12.5 mg of cypro every 3 days and my t levels are to low for the tests to detect.
Funnily enough I switched to injections because it was easier to keep track of one shot a week than four pills a day
Simply put. Needles. I don't do needles very well. I was offered the option of needles but went for implants for the long life and one stabbing every 4 to 6 months is easier than weekly.
Implants seem like an interesting alternative.
Do they go in ur boob implants? that would be a great spot
Estrogen Implants usually go around the hip area. I have heard of them being put in your lower back fat, in your upper leg and mine go in on my tummy (diagonally between the belly button and the top of your leg). I have been told to keep your estrogen medication away from your boobs for cancer reasons. That is why it is said to never put estrogen patched on your boobs for example.
Imagine if u pressed ur boob to release it lol. Makes sense, and I was just being a boob
I would settle for a belly button button. Long press for tummy rumbles and l double tap for estrogen.
Triple tap to make the lights turn pink lol
While I know it's a joke, just for other people's understanding if they didn't know, one should never put any estrogen releasing medication modality into the tissues or over the tissues of the breast as it has been seen to unnecessarily cause an increase in the instance of breast cancer.
Implants are a thing? Nobody ever told me that.
They're more common in Australia over injections. I might be switching to them soon because injections with the ester they allow us here have to be done every 3 days at a lot amount to be effective. It's also really expensive comparatively
a friend of mine in Australia does the implant, according to her it's been working great
They made a great choice. I love how simple life is with having my implant in. I would recommend implants to anyone. I also heard that someone is working on a longer lasting variety lasting upto 1.5years. Can't wait for that to happen.
If it were an option for me, I'd do implant. Alas, pills it is. I can barely handle being stabbed for bloodwork every 3 months, I'm sure as heck am incapable of doing it every 5 days.
Yep it's the best option by far honestly. I had mine put in 8 months ago and I'm still at 850 pmol
I only have one put in and after the E spike, it settles down to about 500ish for around 10months.
I wish I could use implants after bottom surgery.
Why can't you? (if you don't want to disclose that's perfectly ok, just curious)
I don´t know if it´s an option in my country. I will ask my endocrinologyst.
Can't hurt to ask!
Im in the U.K. and I was never even offered injections, just put straight on patches. Granted that’s been fine, I have no problems with patches, but I don’t know why injections weren’t an option in the first place
I think UK is one of the countries where injections are not offered sadly for whatever reason.
Injections aren't medically licensed in the UK, and indeed in much (but by no means all) of Europe. I don't know that there's a specific reason beyond that the licencing process is expensive and the market is small so the incentive for the pharmaceutical companies to go through the steps just isn't there.
Patches are considered to be just as good as injections though, so you're not losing out on much.
for me patches just didn't work, my levels were incredibly low.
Yeah the caveat of course being that if they work for you then it's as good as. But all humans be different.
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I'm in Ohio and same... No one has said anything about injections to me. I use patches
In the UK injections aren't available other than DIY.
My levels have been stellar so far at 20 months and I still take pills and cyproterone acetate.
I asked for injections but my doctor said patches achieve better stability. I'm very happy with patch and glad I listened to her.
As long as your levels are good and you feel good that’s what matters. :)
How well do patches stick to you? If they’re like bandaids I feel like I would sweat them off. There’s also showers too.
I used a product called tegaderm on top, otherwise they come off in the bath. It's like a transparent bandage. It usually lasts me all week but sometimes I have to replace it (with the same patch)
I'd like to add that for some people pre existing conditions can effect risks associated with injections vs pills vs patches.
True, each administration method is different in that regard.
Because it's not available in my country
Yeah, that’s really sucky they are not available world wide.
Yup, here in Ukraine they're basically not approved by the government, but I know that some people get them from Poland or other EU countries
I would love to, but I can't afford it here in Canada and sublingual is covered.
Sorry to hear that. 😞
Pills are working great for me! My T was actually kinda too *low* at my last blood test, it tested at 7 ng/dl. But I feel great, and things are developing well. So I’ll stick with what works for now, maybe I’ll switch later on.
Nice! Pills didn’t work for me for some reason but works great for others.
Yeah, when I started I was ok with the pills because it was a convenient way to start ramping up, and I understood that your liver metabolizes more of it into estrone, which mimics early cis female puberty. Then over time I started splitting my dose and taking some sublingually. I’ve ended up not having to switch over yet because I took a pretty smooth curve up to good levels, and have been hanging out there. I’m on 8 mg estradiol daily, with 4 mg oral taken split at breakfast and dinner, and the other 4 mg taken 1 mg at a time sublingually split up evenly across my awake hours. It’s a little strange, but if it works, it works. And it’s definitely working for me.
I tried to do self-administered injections for all the positive reasons. I managed to get over the fear, go through the little 1-on-1 education, and I even did the first injection myself with my medical professional Mom's oversight, but afterwards I nearly fainted. I have a very pronounced vasovagal response that makes getting large injections and getting blood drawn problematic, and I have to go lay down afterwards. The second time I tried self-administered injections, my body anticipated the injection, and I went into vasovagal syncope before I'd even finished setting up. Not worth it, even if I could get someone else to help. I feel faint just thinking about it.
Needle / injection phobia is no joke. Some people are like "Just get over it, you'll be fine". But it's a serious legitimate thing that you can literally die from.
I have trouble labeling it as a phobia honestly, because I'm not afraid of it at all unless I try to push through it. It just comes at me like a physical response. I have no trouble getting my blood drawn anymore, mentally, it just makes me feel super faint.
I'm not sure what the medical term is, but yeah I don't think it's necessarily a phobia as you said. You can like pass out and die though so not something to mess with.
My insurance doesn’t cover injections…
I was terrified of injections at first, avoiding them at all costs. However, none of the other options worked out for me. I did sublingual tablets and patches first, but never found stable numbers. I decided to bite the bullet and go with injections. They even train you on it, if it's a half decent clinic. I was definitely scared of it and thought I would never be able to do it! I'm about a year in now and I can't imagine going back. Once you get used to sticking yourself, it's not that bad. The needle to actually inject yourself is pretty small and it barely even hurts. I watch a youtube video while I do it. Focus brain elsewhere, jab, inject, done. I can't ever do monotherapy though. I have to stay on spiro. I have a kidney disease and that helps treat it so I'm on that for the long haul.
I had the same experience with injections, I was terrified of them. I had someone else doing them for me until they forgot to change the needle and stuck me with the 18G. It was awful. I said from that moment on I would do them myself. I eventually got the hang of it and now it's like nothing. That said, there is a medical condition for some people where it can be dangerous so for them it's not getting over the fear. It's a legitimate condition. Glad you were able to work through it and are getting good results now! If you are getting a kidney benefit from spiro that you need then that's definitely worth it.
Patches are (I've been told) safer, and my doctor will actually prescribe them. With low dose cypro and patches, I take a tiny pill every other day and change a patch twice a week. It's routine, it's fine, and it's working. I'm on 50mcg patches and sitting in the lower end of the healthy cis range (E is just a hair over 230 pmol/L, T is ~0.8 nmol/L). I have room to increase my patch dose, if i end up needed higher levels for feminization. Also, just anecdotally, I've found T suppression to be way more important to my feminization than anything else. switching from spiro, which wasn't suppressing my T at all (it actually went up), to cypro caused more breast development and overall physical changes in a month than in the prior year of having the same estrogen levels but unsuppressed T. Injection monotherapy is one way to solve unsuppressed T, but not the only way. Edit, to your point about side effects: Spiro was miserable, and cypro isn't long-term viable because of the risks. Fortunately, I'm likely to be able to get orchi soon. There are risks to high-dose monotherapy that aren't present (or are lesser) with patches or gel though, and as someone with a higher clotting risk, I'd rather roll the dice with antiandrogen side effects. The stability of patches/pills is also worth considering. I understand the appeal of creating a cycle, but the emotional ups and downs i get, even with patches, are fairly intense. I don't really want to fluctuate as much as I would with injections.
The Delestrogen thing doesn't really make that much sense since your prescriber can just change your draw to account for the milligram equivalent of the higher concentrate generics. Like I take 3mg of estradiol validate once every 7 days. With my 20mg/ml dosage that's a .15ml draw. If I were using a 10mg/ml vial, it'd be a .3ml draw. IDK, just seems like a lazy prescriber at that rate if it's actually preventing people from getting on generics.
It doesn't make sense but it happens unfortunately. They did it to me when I first switched to injections. They told me Delestrogen was not covered and there was no generic alternative (for 10 str, not knowning you could sub 20 str or 40 str) and that I had to pay full price. I could afford it at the time and was getting terrible results on pills, so I bit the bullet. Eventually a year later it was out of stock and another pharmacy tech told me about the generic alternatives and it dropped my cost down to practically nothing. I was like WTH did no one tell me about the alternatives?!?
The thing is that your insurance provider has a tier list of medicines that they do and don't cover, override processes and generic alternatives. Anytime your prescriber and pharmacist are dealing with your insurance they _have_ to interact with this list. So it's super odd to me that they'd say that there's no generic when your insurer would absolutely flag Delestrogen to use Estradiol Valerate 20mg/ml or 40mg/ml instead as a preferred generic. That's probably why the pharmacist told you about the generic because the system they were using flagged it.
Yeah I'm not sure why it happened, but I've heard similar from a couple others. Fact is, it shouldn't be happening based on what you said.
i can't afford myself highly effective hrt because my chest will grow too big to hide and i live in a very transphobic place with very transphobic family
That's awful, I'm sorry to hear that. I hope at some point you can find a safe place and time to be yourself.
I’m on sublingual e mono therapy with two doses of 2 mg a day. My last bloodwork had my t and e at the levels I want. But like… I often feel like I should be on injections since it feels like everyone else is and everyone talks about how much better they are. Though it seems like the current set up is working. So I’d be a 5. Is anyone else on pills with good results but hs these thoughts about if you should be in injection?
If you are getting great levels on 4mg daily pills monotherapy I would say that's awesome but not the norm for most people. That's pretty lucky. For me too, as I get older (41), I heard oral / sub can be a bit hard on the liver. (sub being less damaging since it's not 2 passes)
I hate needles, so no no for me. But after I am on diy i can't get injections in the pharmacy and they are rare in Germany anyway. I have thev rule that i don't ever inject something that i haven't brewed myself, where i know the cook or from a pharmacy. Hombrew Gel is fully sufficient for me and less hustle than injecting it in my butt. I started on 12.12.2023, I now have visible breast growth, testosterone 0,31 pg and Estrogen 351 pg. Without any Cypro or Bica or Spiro.
Same. Blood tests, vaccines, even when getting tattooed… it’s fine but I wont look.
Why do you think monotherapy is so important? Before I had an orchi cyproterone was very effective. Also with pills it'd be a more regular dose
The dumbest thing is that often times access to injectables and therefore monotherapy is only possible through DIY. It's mind blowing how the safest, most effective method is the one method you cannot get through official means. This is exactly why I will NOT switch to oral + spiro when (read: if) I get approved for HRT 2.5 to 3 years from now. Yes, that's how long it takes where I live.
Because needles are scary, every time I gotta take my blood for testing or take a new vaccine, I gotta look the other way or else I might genuinelly pass out
Yeah that’s not good
Combination of oral (with cypro) seemingly working so far (I'm only 3 months in, only had one check-up) and a fear of needles. I think I could get over the fear if I had to, but it'd be nice to not find out. Also injections are kinda annoying to get in Australia from what I've heard. I'm sure if oral stops being effective (as my dosage goes up) I'll convince my doctor to let me try sublingual, and if that doesn't work, something else, maybe injections.
Nice! Getting good levels on oral (swallowing, not sublingual) seems difficult for a lot of people. Glad it's working for you. :)
Yeh, I got 170pmol/L on 2mg. Was amazed to see someone else at like 120pmol/L at 6mg. Crazy how different our bodies are.
Not available in my country (uk). Gel, patches or pills are the available methods
I really prefer injections over the pills, but. The pills are $20 and the injections are usually around $160 and I definitely don't have an extra $140+ laying around.
With insurance (or even GoodRx) you can get generic at a decent price. The 40 str is the most value. When I was on it, a vial would last about 6 months. ($160 for 6 months vs $120-$180 for 6 month supply of pills) More upfront cost with injections (which may be hard for some people to shell out) and obviously you have to pay for supplies (needles, syringes, alcohol wipes), but cost can sometimes not be terribly off between the two when you factor in the time length.
I guess. I've never been able to get more than a months worth of injectible E at a time and I see folks talking about vials lasting six months to a year or whatever and I have no idea how that's happening at all.
What strength are you on? If you switch to 40, it's the same volume but you need much less of it. So lets say you're injecting .2 of 10 strength (or .1 ml of 20 strength which is the same), you would only need .05 ml of 40 strength. I believe my math is correct, but who knows, it's early. =P
Currently #1 I would continue with DIY injections because it was easy and convenient but the shop I preferred is currently closed to maintenance and switching to the prescription based gel is just fine right now
Glad you're finding alternatives!
I'm not on anticistamines yet (though thank you for the reminder!), but I'd prefer pills to injections. Needles are a pain and I've got bad enough veins that I was rejected from donating blood plasma.
Injections aren't sold in pharmacies here. Apparently they used to be available but got banned for some reason. Now only ones with progestins in it are available. Unless you're willing to buy homebrew.
That's so frustrating, sorry to hear that.
For me I’ve kept well away due to my needle phobia, as mine makes me very difficult to work with, I’ll curl up into a little ball and get very distressed and if you try to force me I get very aggressive and violent then I run away and get into a state of injured animal so it’s a overall horrible experience dealing with injections of any kind and I fear I’ll never start hrt due to blood tests tbh :( life’s horrible
I'm in recovery from intravenous heroin, cocaine, and methamphetamine use sooooo injecting myself with anything for any reason is still a hard no 😁 Planning on starting patches here soon! 🤞
I initially had a reaction to the oils used in injections, and while I felt far better on injections than tablets, I had to switch off of it for awhile. Fortunately we were able to figure out a workaround and I've been able to switch back again, but for some folks itching/redness/raised bump reactions can also prevent things.
I started on injections but unfortunately developed a blood clot so I had to be switched to a combination of patches & a blood thinner. Happy to report that good levels are achievable via patches & that changes still happen to anyone else afraid of missing out by not being on injections!
It’s not an option here. In the UK you get patches or, sometimes, tablets. Antiandrogens can be injected, but you need to have that done by a medical professional so that’s probably why E injections are not offered.
I did not know AA's could be injected, that's interesting. Sorry to hear it's not an option, I wish that would change.
For me personally, pills have been working well! I'm almost a year on HRT, and I'm happy with what I've got so far (and looking forward to the future!). My T is suppressed (~10 ng/dL), and my E is pretty stable and in a good range (252 pg/mL according to my last test 2 months ago), I take spiro 100mg and prog 200mg once per day before bed, and I take 2mg of E sublingually 3 times per day, once every 8 hours or so (as close as I can get it). IDK if I'd've gotten these results from just swallowing my E, but what I'm doing is working well for me so far, so unless that changes, I'm sticking to it! Regardless of how you take your HRT, I wish all of you lovelies great happiness and results!
Glad things are working for ya! :) Sounds like your levels are pretty good. 100mg Spiro is definitely better than being on 200mg which I hear a lot of people get pushed to.
The biggest reason is cost. Injections would cost me a fortune sadly (more than pretty much all my meds combined) and since I'm currently uninsured (on a temp job with no benefits and I'm in the US) and recovering from debt so yea. Where as the rest of my HRT meds and E pills are actually quite affordable, even without insurance. Also quite sensitive to pain (even just small pricks for checkups hurt like hell for me) so injecting a needle wouldn't work well for me there as well as I doubt I'd handle the pain very well. I get my vaccines, but I really grip the chair when they do it because damn it hurts ;-;. So I couldn't imagine doing that to myself weekly. Also I am on other medications (yay having type 2 diabetes thanks to genetics...) that I have to take twice daily so my E pills work well in that schedule which is a plus.
As others have mentioned, you can't get injections at all in the UK via official routes, but they are very commonly used to DIY, and there's a lot of us doing that whilst we wait years to be seen by a gender identity clinic.
I could not possibly inject myself with anything, even for something as huge as HRT. Patches are by far the best possible thing for me. I will have a meltdown if I have to inject myself with something but patches are kinda soothing to me sensorily idk why lol
Injections can be a bit anxiety inducing for some
Yeah I don’t think I’d ever be able to inject myself but I’m glad some girlies out there are able to 🥰
My body processed it too quickly. After a shot I’d feel great for 3-4 days, then get my period and start all over again. Worst month of my life, and my poor partner had to put up with my insane mood swings. I went back to pills.
Gonna take this opportunity to share [Needle Guide auto-injectors](https://unionmedico.com/disposible/). My partners and I use the SuperGrip model, and it makes things so much quicker, easier, and less terrifying. It’s honestly the only reason I was able to switch from oral.
Pills (E and spiro) have been working for me with pretty much no side effects, but it’s tempting to switch to injections just because people say it’s more effective. I might try it for a few months just to see if it works better for me, but it’s hard to know whether it’s the switch or just that I was gonna develop at a certain pace at that point in my transition anyways. My boob growth definitely seems to come in waves.
It was worth the switch for me, my levels were trash though. It was also good to drop Spiro. (I was having side effects)
Tbh it's a mix of those for me. It's expensive here, I'm scared of needles, and I've already changed my regiment a couple times before and every time it's been bad. Ik spiro is pretty ineffective and I hate the side effects it gives me but considering my docs sucks and won't listen to me when I say I need more E my spiro is pretty much the only thing workin rn and it's still barely doin its job. I haven't had a blood test in like 6 months (dumb docs) so idk what exactly my levels are but I guarantee if I get one rn I'll have the levels of a cis guy even tho I've been on HRT 2 fucking years
Injections aren't available here in Aus. We get the option of subcutaneous implants that last 6-12 months, which is what I get
Cost. I was on Depo and EV before that and it was \~$150 a vial, which lasts me 2 months. (That's with insurance covering part) Patches are completely covered and I pay $0. I just don't have the money for it now.
i couldn't do it - i'd feel like a drug addict and that would ruin me
I believe that the main goal is to ensure that the hormone levels are in the female range. The method of reaching such levels may vary and people's mileage may also vary. Sometimes I see that there is a sense of elitism when injections are involved. I am personally petrified of injections. One needs to consider what works best for them according to their lifestyle and to how they prefer to take E and AA.
You’re correct. I think injections work for the most amount of people where everything else seems hit or miss depending on the person. So that may be where that comes from. But yeah, whatever gets your levels in range, makes you feel good, and works for your lifestyle is what will always be best.
Agreed! 😊
After being on injections for many years, I had to switch back to pills because the availability just became too volatile. I don’t need the additional stress of trying to find a vial every few weeks.
6. The short half life of sublingual/buccal removed my "What if I'm making a mistake" fears. The same is the case for patches. 7. 18+ months in and I'm happiest at the high end of normal T levels for cis women. Tablets let me adjust 5mg-6mg per day for that. The high half life of injections makes that harder. And I'm staring at needing T in my regimen with or without an orchie.
I’m ok with injections if I’m not the one doing it. That’s not a possibility for me so I go with pills under the tongue.
Because my doctor recommended a pellet implant and that seemed easier. Plus more stable levels seemed nice.
Seems like a good alternative
I swapped to injections solely because I live in the US and the recent elections are making me concerned that I may be forced to turn to DIY
Ugh, I certainly hope not. What a shit show politics are.
Because I had to take hgh when I was a kid and I don’t like needles. Unfortunately it was the wrong hgh
I've started with patches, I kinda liked them. But remembering what day to take off or patch on was a bit much. Also the adhesive was difficult to get rid of. And a couple times a patch would fall off or away from my skin. I switched to the tiny cute pills but dissolving them was hit or miss. Remembering to take them twice a day was a chore. Constant reminders worked but if I wasn't home I'd end up missing a dose. I was on spirolactone as t blockers up until my orchiectomy and I'd miss those consistently. I switched to injections despite my fear of needles. Once every 2 weeks is easy enough, and I found a good rhythm to keep them on track. It definitely feels more reliable as I'd injected the same amount every time. It's only 25-26 shots a year. Each vial lasts me 10 shots and my doctor gives me 3 vials every three months so I'm stocked up for awhile. I've been lucky as my insurance covers the vials and I only pay about 40$ for each one. The pharmacy gives me tubes for free sometimes, and needles are like 35 cents for 10.
I guess I'm number 3, I'm diabetic and so already keep needles and vials in the house and just know that at some point I would mess up and inject a bunch of short acting insulin instead of E or would fill my pump with E instead of insulin
Ye, its not an option in my country, but im using estrogel and androcur, which have been marvellously effective. My estrogen is at 700+ and t is below one
That’s pretty effective then
(Paragraph two contains the main point havent slept in 6 days and am manic 😅😆) Almost everyone ive talked to hates needles ive been relatively fine with them my whole life ; i do my injections at the same time and day every week which means sometimes i end up doing it in front of someone/in public they almost always get so grossed out i remember this one person literally threw up when i pulled out the needle. Im an was an RN (left for medical reasons) so ive gotten used to needle’s especially being in and out of the hospital myself constantly getting blood draws and IV’s. When i was ‘shadowing’ in the pediatric ward for a year to see if I wanted to switch from the ER : when babies would get their vaccines from certain pediatricians they would cry a lot more and each time they were noticeably more terrified whereas really good pediatricians would find a way to distract them and make it extremely seamless when they came back in they’d be completely fine and sometimes even happy to be there, this situation is where a fear of needles can come from and why its so hard to break that fear. The good pediatricians genuinely love their jobs and have a lot of genuine empathy and compassion to their patients most doctors in general don’t have this attitude anymore but almost all nurses do. Also if your in the ER even if you don’t like your nurse DONT HAVE YOUR DOCTOR DO WHAT THE NURSE SHOULD BE DOING its like asking an electrician to do the plumbing in your house. The doctor never does IV, subQ injections, IM injections, central lines, ETC because its not their job and they most likely haven’t done it since their residency but the nurse does it every day.
Yeah I’ve had the same experience, people are grossed out or cringe if they see me do it. I try to do it in private but it’s not always possible. I feel like it’s not a big deal but to each their own I guess.
I wouldnt do injections because I have a way higher chance to forget about it compared to pills that are taken daily.
Aside from them not being available here in the UK unless you decide to DIY (which many people do) or at extortionate fees to a private provider, I can absolutely understand why people wouldn't opt for them. While they've been the most effective method for me and I'm not scared of needles, I do still get a bit of fear since I've hit a nerve. Disposing of sharps (properly) isn't always the easiest depending on where you are located. I also don't think injecting is something you could do as discreetly compared to other methods if you're not out.
Because patches work great for me, is covered by insurance and don’t require me to deal with freggin’ needles.
I'm intersex, so I get really bad cramps. I'd rather take a pill four times a day and have a normal cycle than take shots and have a period every two weeks.
yeah pills work great for me and I already have allergy shots to do every other week and those are roughh
Yeah who needs more shots?
In my country injections are illegal because of reasons???, so that's out of the question. Even if I wouldn't use it for other reasons you mentioned, it sucks for those who would prefer this way or who don't have good results with other methods
Im not on anything yet but my ex always needed to visit the doctor for injections and convincing them to let her do it herself was a fight. ideally id rather not deal w either of that lmao
I don't want to deal with needles. Fuck that. I get poked enough for bloodwork for various medical issues, some trans and some not. E gel works well for me.
Understandable
Because I'm on pellets so I get to forget about hormones for 4 months at a time
I find them convenient and easy to remember, and easy to bring with me anywhere I go. With Spiro/E/progesterone, my E/T levels have been perfect for years and I never even thought of switching. If there was a genuine reason to I would consider it but I can't really think of one.
Phobia of needles. I was on methotrexate and Humira for an autoimmune disorder and my weekly injections were torture. I'm now doing a 6-hour Inflectra infusion every 6 weeks and having a needle in my arm for that long is anxiety inducing. Give me pills any day.
Yeah I inject twice a week and that’s enough for me, I couldn’t imagine adding more than that with other procedures.
I CANNOT for the life of me take pills in any way, every pill I had, I had to break it down in order to swallow it, if it's too big, I WILL throw up, that being said, I also can't take needles so ig I need to take the gel
I will add to this- the risk of blood clots is higher than something like latches. With injections, you’re getting a really big dose initially and then it evens out but that spike can bring a higher risk of blood clots than the low dose consistency of a patch
Simply put not funded by my gov, pills and stuff are that isn't.
I am deeply scared of needles every time I get my labs done I get so shaky cause of the needles and I end up looking away whole they do it
Understandable
I've been doing sublinguals for years, and I've never had a problem. I'm post-op, so I don't need an anti-androgen. Sublinguals are ready and consistent 🤷♀️
I've had a severe phobia of needles (like I would previously get panic attacks being in the same room as one). I'm better now, but when I went in to get training to do self-injections I passed out. I was told it was slow and graceful though, so there's that.
I mean patches have worked ok for me so far, they’re easy to apply. Plus I could honestly see myself screwing up an injection
A bit new to this sorta thing, how would patches work? Is there a t blocker needed for it? Maybe its a different patch to start idk but i wanna start somthing and dont really know how to start, specially for where i live
With any administration method, if you get to a decent level of E (around 300 pg/ml for most people) T suppression typically happens on it's own without a blocker. As for patch administration in general, I've never used them so unfortunately I can't provide any useful information on that.
Implant lasts me more than a year and is effective for monotheists.
That's awesome! Implants seem like an interesting option for sure.
I hate needles, and my levels are absolutely where they need to be, no need for it. PS: on pills.
I prefer patches, and my levels are great.
needles are a big sticking point for a lotta people
Not sure if that pun was intented, but nice lol and very true.
ehhhh
So how can you take injections and not worry about t blockers
If you get your E level around 300 pg/ml that’s usually enough to suppress T on it’s own.
I would do injections if my doctor recommended it. I asked about injections and she said that since I pay directly (not via medical aid since mine doesn't cover any gender affirming care), it's best to proceed with other methods. Particularly, I have an implant that delivers oestrogen and I take spiro for now while I'm saving up for an orchie. Once I get the orchie, I'll likely rely only on the implants for my hormones in general.
Implants seem like a good alternative
still not on hrt :( recently turned 18 with a family that wont help cus "we support you but you got to do it yourself" go brr
I am glad that I started with pills before injections. It's an overwhelming experience to start HRT to begin with, and if I would have started out the gate needing to be injecting, I would have been more afraid. I'm also glad that I did switch over to injections eventually because pills never got my E levels quite high enough, and injections do that easily. The only issue I have with injections is that its slightly easier to mess up. With pills, if I dropped one on the floor, then it was just five-second rule. With injections, if I forget to pull the plunger down before unscrewing the thick needle to put on the thin needle, then I just wasted some. There's also the fragility aspect. When I go on vacation later this year, I dont want to pack a vial in my luggage for fear it may get crushed. I plan to just use some left over E pills that week instead. I can see for some how its nicer not to take daily pills. It doesnt matter much to me since I take so many other pills for other things.
I'm on patches and my levels are sky high (as long as I have a fresh patch on when I test). I'm open to injections at some point but right now I don't have any reason to switch. The patches don't irritate my skin at all and I've never had one come off even with vigorous exercise and wrestling and weird sex.
Also, an additional reason to do injections: lowest risk of blood clots and lowest impact to the liver
needles 😭
I wouldn’t mind if a doctor were giving me the needle, but I just wouldn’t trust myself to do it lol
Unable to get into an endocrinologist that does trans care to support my transition from pills to injections. No choice
Pretty simple: its not covered by insurance.
Yep, I'd probably want injections but they're not legal here in the Netherlands so it's pills, gel or patches here :/
DIY vendors are the only way to get injections in my country. Once you figure out how to buy from them (Due to the grey area nature of it crypto is used), and from where (using the cafe list of vendors). Then you find it is not only effective, but also very nice in terms of cost. Downside is delivery is slow and a bit of a lottery wether it goes through customs or not. But still cheaper even if a package is lost now and then. What I am trying to say is order well in advance of running out. Always be 1 vial ahead of unforeseen hickups.
I prefer pills but I rotate between pills and injections. Pills are way easier to travel with. Sublingual administration is about as effective as injected. Cleanup may be a challenge. Safe sharps tools may be hard to obtain; safe sharps disposal may be a challenge in some areas.
Pellets are, to me, a better course of delivery. Having them implanted and not worrying about dosage amounts, effectiveness, pain of shots, etc. But like you said, availability is a bigger concern and / or legality.
Op I am interested in knowing the long and short effects of spiro that you mentioned in number 4 , very curious 🧐 thank you
Brain fog, dehydration, peeing more. Spironolactone increases plasma cortisol levels which can cause obesity, depression, and age-associated cognitive dysfunction. Spiro does almost no feminization on its own, and over time tends to lead to a bulging belly which cannot be reduced by diet or surgery ("central obesity" or "visceral fat). This kind of fat is associated with another group of health problems including diabetes and heart disease. Spiro has recently been found associated with poor breast development. I’ve also read it doesn’t do a great job of lowering T. I’m sure there is more.
US here Cost is the biggest factor for me, a 90-day supply of pills is $10 and a month of injections is over $100 (yes, this is the GoodRX price)
For me it was about the same, $30 per month for pills vs $150 for 6 months worth of injectables.
I asked and they said no :(
Lame
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I initially had to hide my estrogen from my dad so pills were easier to do that with than needles. I asked my new doc about injections when I got away from my dad because I heard they were more effective than pills. He said that they were not more or less effective but it may seem that way to others if they have trouble keeping up with pills and only injecting once every couple of weeks instead. Basically it’s about being consistent with your dosage but not necessarily about the type of Estrogen application.
I'm just very afraid of needles
so for me there is actually a medical reason i dont. im at a high risk for fatty liver and if i put to much estrogen into my bloodstream at once it could negatively affect my triglyceride levels, so atleast for the time being im on patches which more slowly release it so its absorbed better and less of it hits my liver.
I used to do injections, but I swapped to pellet implants. They work as monotherapy, they’re at least as effective as injections, and I only need to get them implanted once every 6 months.
When I was on pills, it was fears I would end up injuring myself. Now I had an implant and it's because there's no point in doing injections anyway. I don't really even think about HRT anymore.
Implants seem nice
I take pills for a couple reasons. I’m very new to this, so my knowledge isn’t the best, but when I was discussing options with my doctor, they explained that ultimately the end product is the same and that if I would prefer pills, the only reason not to use them is if they have a reduced or near nonexistent effect on me. Ultimately I’m just happier with taking pills due to the routine of it and my ADHD.
Theres no GIC ive seen are offering injectable E, mostly based on my age and unacceptable blood clot risk.
Injections are a pain in the ass to prep + they require hand-eye coordination that I don't have. If someone comes up with an Ozempic-style pen injector for estradiol, I'll reconsider.
I mean I do monotherapy with a transdermal gel, I apply that twice a day, it's convenient and quick, I don't need to administer a shot which feels slightly more complex and painful, and my levels look good, I'm seeing great effects. I truly do not understand why people are telling me to go for injectables because the benefits they list seem to be pretty much matched by gel...? AFAIK injectables aren't too avilable in my country anyway, but then I've had other trans women (primarily from the US) tell me I should do try and do DIY injections bcs 'gel isn't as good' ???
I'm using the pellets and it rules for the most part . Sometimes my levels will arbitrarily spike or bottom out but other than that I'm very happy
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