Chart: Properties of HRT Estrogens

This is our most recent Estrogens Properties Table by Beverly Cosgrove and Juno Krahn — [Version 14, Nov 28, 2017]. The chart is intended to present estrogens as used as either suppressing testosterone (without using antiandrogens) or for the purpose of post-op maintenance. Some data is from “Cardiovascular Disease in transsexual persons…” Gooren LJ, Eur J Endo, 2014 Jun:170(6):809-19 and “Pharmacology of Estrogens and Progestogens — Influence of Different Methods of Administration” by Kuhl, from Climacteric, 2005;8 Suppl 1:3-63. The table may also represent unpublished research and non-medical opinions of the authors. Some risk data is extrapolated or inferred. This is for educational purposes only, not for medical use. DOSAGE INFORMATION is only representative of a typical dose. Doses can vary by a factor of 2-3, depending on the individual. Dose information here is to be regarded as unreliable unless verified by each patient with blood tests. Some terms: DVT: Deep Vein Thrombosis, a blood clot originating in the veins mostly due to fibrinolysis and can cause pulmonary embolism; “Clot”: platelet-based clotting which can lead to heart attack and other dangers; “Lipids”: undesirable blood lipoprotein effects; “CRP”: C-Reactive Protein, one of many inflammatory markers associated with cardiovascular problems; “SHBG”: Sex Hormone Binding Globulin, an indicator of the effort being made by the liver to detoxify sex hormones in the blood stream or the portal vein system.

estradiol-summary-chart14

13 thoughts on “Chart: Properties of HRT Estrogens

  1. While this is helpful, it would be more helpful if you defined some of the abbreviations. “E2 Recp Cov.” “EV” “EC” “E2” “uG” and others. If you are supplying this information to lay people, this is needed. I am a therapist working with trans folks and if I give this to them, they will have those kinds of questions.

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    1. Karuna, I embedded some of them… for instance at top left it gives Estradiol Valerate (EV) and Cypionate (EC). Then in the leading text I added some more abbreviations. I’ll keep adding until everything is clear.

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  2. […] [6] Because of the reduced risk of Deep Vein Thrombosis (DVT) and Coronary Heart Disease (CHD) discussed above, we believe there is no longer a general rationale for reducing the estrogen levels of post-GRS MTF patient in good health to postmenopausal female ones if the patient has never experienced an extended period (>10 years) of youthful levels, assuming that parenteral estradiol is used instead of oral methods. However, at the time of surgical removal of testicles, the need for Estradiol-based suppression of Testosterone ends, and suggested doses may be cut back. A chart showing some typical pre- and post-castration Estrogen doses is here. […]

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  3. Hi Beverly!! Can you explain the difference between “typical transition” and “typical maintenance”? Is one considered a starting point and the other standard regime once you have suppressed your T?

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  4. Just want to add that a pellet dosage stability can be easily achvieved, some doctors start on patches to get a base for a few months and then move to pellets. If the pellet dose is to low, they have another implanted. 90 days is not a horrible time frame.with doctor consult. The scar can be an issue but mostly clears. Patches are more like $100/month vs pellet of $130/ for 3months.

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    1. There’s a shortage of doctors who do pellets for those that want them. Unfortunately in the past, a few doctors giving pellets have overcharged or used ethically questionable patient management techniques. We do need more doctors who can do implants, especially for those who cannot do injections.

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  5. Has there been any new information on the rectal suppository method? It’s something I’ve thought about before but have never seen anyone else mention it actually being done until now. I’m planning to hopefully start injections soon, but it still seems interesting. I guess the bio-availability must be pretty high if the listed dose is half of sublingual/oral. Have you heard anything more about what kind of levels it gives and if/how much it spikes?

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    1. The rectal method for progesterone capsules is well established. We have very limited experience with using the method for estradiol tablets. As soon as we can get better data, we’ll publish it. It seems likely that some patients attempting estradiol by suppository are using Estradiol Valerate pills instead of Estradiol. That is why they may be getting poor results, because they aren’t aware of the difference. We know this is an important issue for UK patients who are being denied access to injection, sadly.

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  6. Beverly, i used rectal for a period of time, my levels slightly reduced compared to buccal despite increasing my dosage, but could be normal fluctuation from last dosage. i used elleste solo back then.

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