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Serum estradiol levels and implants/pellets/injections

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barter1960
barter1960

Hi I've been postmenopausal due to premature ovarian failure related to having a partial hysterectomy for nearly 20 years. My symptoms were managed for 7 years using estradiol pills. I was then switched to a patch which worked well for me for nearly 12 years...although I had to use a patch and a half of the highest dose patch. I'm from the US, but my patch was the Vivelle Dot  which is the same are the Estradot 100 in the UK. I can't say that I have ever felt completely normal after having my surgery and immediately experiencing ovarian failure when I was 35. I am now 54 and have been trying to find the right implant dose that works best for me. Here in the states, most implant/pellet docs insert very low estrogen doses and huge testosterone doses. That regiman really messed me up and it has taken my testosterone a year to decrease to a level where I feel well. I had to change doctors in order for that to happen. My new provider started me off by giving me 100 mg. E implant and 100 mg. T implant. I don't think he clearly understood that my testosterone was over the top. He lowered my testosterone implant to 50 mg. and left me estrogen implaint dose at 100 mg. during my last visit, gave me a 5 mg. depo estrogen shot to boost my level and keep me comfortable until the estrogen implant kicked in. As soon as the injection wore off, all of my symptoms returned. I have always had severely debilitating symptoms from low estrogen. My implant doctor does not dose based on lab work but by symptoms only. I recently visited my GP for my annual exam and he ran some routine blood work as well as a hormone level check. My estradiol level was 985.3 and my testosterone was 122 which is great. However, he flipped out over my high estradiol level. I had given myself and injection a couplf o days before and wonder how much it affected my estradiol reading. Now, my implant doctor who originally said that labs were "only numbers" wants to lower my estrogen implant dose and take the estradiol shots away. I feel the best I have felt in 20 years and am not having any side effects at all. Have any of you ever needed your estradiol/estrogen/oestrogen (all the same) levels as high as I seem to need mine in order to feel well?

0 likes, 4 replies

4 Replies

  • stell_a
    stell_a barter1960

    Posted

    Hi Barter,

    you are not the first one reporting to feeling better with bioidentical estrogen injections. Try to research more online. Apparently, estrogen injections are more effective because they maintain a ration E2/E1 more beneficial than any other form of administration. So what you are saying doesn't come as a surprise...

    • barter1960
      barter1960 stell_a

      Posted

      Hi Stell_a, really? I can't find much information about the injections online. Could you lead me to some links? Also, the estradiol injections I am using are the depo-estradiol cypionate injections 5 mg./ml. I've ran across information regarding the depo-estradiol valerate injections but can't find what the difference in cypionate and valerate is! I've wonder if they are equivalent. And, yes, I'd LOVE to forget the pellets and use the injections ONLY. I feel great using the injections.
    • stell_a
      stell_a barter1960

      Posted

      Hi Barter, unfortunately the cypionate is not a bioidentical estrogen.

      From Wikipedia

      Estradiol cypionate, or estradiol cipionate, is a synthetic ester, specifically the 3-cyclopentylpropanoyl ester, of the natural estrogen, estradiol.[1][2] It was first introduced in 1952 by Upjohn in the United States,[3] and has been in widespread use since. Estradiol cypionate is absorbed more slowly than estradiol itself, and for that reason, it can be administered less often.[4] Compared to other commonly used estradiol esters, via the intramuscular route, estradiol cypionate was found to have the longest duration of action with a duration of ~11 days, while estradiol benzoate and estradiol valerate were found to last for 4–5 days and 7–8 days, respectively

      We are also trying to get hold of bioidentical E2 injections but they are not available easily apparently.

      As for the links, I asked my friend and I will get back to you when I have them.

    • barter1960
      barter1960 stell_a

      Posted

      You know, I've had several people tell me that but that's not completely true. It's much like the Vivelle Dot patch in that it is derived from plants and is supposedly identical to what our bodies make. Also, like the Vivelle Dot, it is FDA approved. Here's a list of bioidenticals that are FDA approved in the U.S. I got this from the North American Menopause Society's website. 

      Table. FDA-approved Bioidentical 

      Hormone Therapy Products

      Composition Product Name

      Oral 17β-estradiol Estrace

      Various generics

      Oral estradiol acetate Femtrace

      17β-estradiol matrix patch Alora

       Climara

       Esclim

       Fempatch

       Menostar

       Vivelle

       Vivelle-Dot

       Various generics

      17β-estradiol reservoir patch Estraderm

      17β-estradiol transdermal gel EstroGel

      Elestrin

      Divigel

      17β-estradiol topical emulsion Estrasorb

      17β-estradiol transdermal spray Evamist

      17β-estradiol vaginal cream Estrace vaginal cream

      17β-estradiol vaginal ring Estring

      Estradiol acetate vaginal ring Femring

      Estradiol hemihydrates vaginal tablet Vagifem

      Vagifem LD

      Estradiol valerate injection Delestrogen

      Estradiol cypionate injection Depot-estradiol

      Oral micronized progesterone Prometrium

      Vaginal progesterone cream Crinone*

      Vaginal progesterone ovules Endometrin*

      *FDA approved for infertility, not menopausal hormone therapy.

      Complete information available on the NAMS website at http://www.menopause.org/docs/professional/tfpbio_0812.pdf?sfvrsn=2

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