Am reconnecting with the trans community a bit and have discovered that the new thing GICs are doing to torment trans women, having moved on from RLE, is keeping them on starvation rations of HRT.
@Alda Vigdís 🇵🇸 🇱🇧 @Riley S. Faelan I crossed that bridge some time ago. Most of them are just mechanics, and a lot of them are not even very good at that.
@riley As far as I could pick up from my local pharmacists is that the default dose of dermal E is a single 0.75 mg. For all they know this is what everyone uses ranging for post-menopausal cis women or trans women.
Medical practitioners generally have no idea how all of this works and a lot of it has to do with a system of values rather than any medical reasoning.
@Alda Vigdís 🇵🇸 🇱🇧 @Riley S. Faelan @Sarah Brown I'm on 1.5mg of sandrena a day which a chart I just found under a rock says is equivalent to 3mg progynova. (Though ahem sometimes I just take two whole sachets because I feel like it.). 0.75mg seems... kinda homeopathic?
Actually, going to keep this chart because whenever I want to look up equivalent doses I can never find the data. chiark.greenend.org.uk/~ajlane…
@ajlanes That's a really useful chart, thank you! (bookmarks)
I seem to be gathering a lot of anecdata about patches not being as effective. Swtiching to transdermal from 2mg, at last test I was still under half target figures on a mixture of a 100 patch, one estrogel dose and one Lenzetto dose, after the patch alone was practically useless.
@alda That's not a good way to quantify "dermal" estrogen. Its bioavailability is very different in transdermal gel form and in transdermal patch form, for one, and common application frequencies differ, too.
Patches are virtually universally rated not in the amount of the effective ingredient that they contain (although it's documented, and can be important for War On Drugs purposes when the ingredient is a controlled substance), but the amount of the ingredient that they release. The ones I have had experience with release either 50 or 100 microgrammes per day, and last for four days (nominally half a week, but weeks have an odd number of days in them). A patch might contain, say, a whopping eight milligrammes of estradiol in it, but most of it will remain in the matrix by the time the diffusion efficiency will have dropped to a pint that one should replace the patch.
A typical transdermal gel dosage is about a milligramme of estradiol, in
... show more
@alda That's not a good way to quantify "dermal" estrogen. Its bioavailability is very different in transdermal gel form and in transdermal patch form, for one, and common application frequencies differ, too.
Patches are virtually universally rated not in the amount of the effective ingredient that they contain (although it's documented, and can be important for War On Drugs purposes when the ingredient is a controlled substance), but the amount of the ingredient that they release. The ones I have had experience with release either 50 or 100 microgrammes per day, and last for four days (nominally half a week, but weeks have an odd number of days in them). A patch might contain, say, a whopping eight milligrammes of estradiol in it, but most of it will remain in the matrix by the time the diffusion efficiency will have dropped to a pint that one should replace the patch.
A typical transdermal gel dosage is about a milligramme of estradiol, in this case, counted as the amount contained in the gel. It diffuses through the skin relatively fast, but not all of it reaches the blood.
(For order-of-magnitude context, a typical target level might be about 500 pmol/l. A mole of estradiol weighs about 270 grammes, and a woman might, on the bigger side, contain about five litres of blood, so all that target estradiol in her blood adds up to some 0.7 microgrammes; at a time, anyway.)
to be fair CX left me on 2mg Progynova a day. They agreed to up it when Barrett declared me "undercooked". My GP refused. Every so often, I've pushed but don't get anywhere. Once the new job is sorted, I'll look into working a private dose on top of prescribed
Riley S. Faelan
in reply to Sarah Brown • • •Sarah Brown
in reply to Riley S. Faelan • •@Riley S. Faelan Not high enough to induce puberty.
And then they’re telling them that no trans women develop beyond an A cup (this is a lie)
sabik
in reply to Sarah Brown • • •AIUI, not infrequently alongside an effective dose of anti-androgens
Alda Vigdís 🇵🇸 🇱🇧
in reply to Sarah Brown • • •It is also an extension of how doctors think that post-meopausal conditions are first and foremost psychosomatic.
As pro-science as I am, I've stopped considering many medical practitioners as being "people of science".
Sarah Brown
in reply to Alda Vigdís 🇵🇸 🇱🇧 • •Alda Vigdís 🇵🇸 🇱🇧
in reply to Riley S. Faelan • • •@riley As far as I could pick up from my local pharmacists is that the default dose of dermal E is a single 0.75 mg. For all they know this is what everyone uses ranging for post-menopausal cis women or trans women.
Medical practitioners generally have no idea how all of this works and a lot of it has to do with a system of values rather than any medical reasoning.
Sarah Brown likes this.
Alexandra Lanes
in reply to Alda Vigdís 🇵🇸 🇱🇧 • •@Alda Vigdís 🇵🇸 🇱🇧 @Riley S. Faelan @Sarah Brown I'm on 1.5mg of sandrena a day which a chart I just found under a rock says is equivalent to 3mg progynova. (Though ahem sometimes I just take two whole sachets because I feel like it.). 0.75mg seems... kinda homeopathic?
Actually, going to keep this chart because whenever I want to look up equivalent doses I can never find the data. chiark.greenend.org.uk/~ajlane…
Sarah Brown
in reply to Alexandra Lanes • •Alexandra Lanes
in reply to Sarah Brown • •Sion [main]
in reply to Alexandra Lanes • • •@ajlanes That's a really useful chart, thank you! (bookmarks)
I seem to be gathering a lot of anecdata about patches not being as effective. Swtiching to transdermal from 2mg, at last test I was still under half target figures on a mixture of a 100 patch, one estrogel dose and one Lenzetto dose, after the patch alone was practically useless.
@goatsarah @riley @alda
Alexandra Lanes likes this.
Alexandra Lanes
in reply to Sion [main] • •Alexandra Lanes
in reply to Alexandra Lanes • •Riley S. Faelan
in reply to Alda Vigdís 🇵🇸 🇱🇧 • • •@alda That's not a good way to quantify "dermal" estrogen. Its bioavailability is very different in transdermal gel form and in transdermal patch form, for one, and common application frequencies differ, too.
Patches are virtually universally rated not in the amount of the effective ingredient that they contain (although it's documented, and can be important for War On Drugs purposes when the ingredient is a controlled substance), but the amount of the ingredient that they release. The ones I have had experience with release either 50 or 100 microgrammes per day, and last for four days (nominally half a week, but weeks have an odd number of days in them). A patch might contain, say, a whopping eight milligrammes of estradiol in it, but most of it will remain in the matrix by the time the diffusion efficiency will have dropped to a pint that one should replace the patch.
A typical transdermal gel dosage is about a milligramme of estradiol, in
... show more@alda That's not a good way to quantify "dermal" estrogen. Its bioavailability is very different in transdermal gel form and in transdermal patch form, for one, and common application frequencies differ, too.
Patches are virtually universally rated not in the amount of the effective ingredient that they contain (although it's documented, and can be important for War On Drugs purposes when the ingredient is a controlled substance), but the amount of the ingredient that they release. The ones I have had experience with release either 50 or 100 microgrammes per day, and last for four days (nominally half a week, but weeks have an odd number of days in them). A patch might contain, say, a whopping eight milligrammes of estradiol in it, but most of it will remain in the matrix by the time the diffusion efficiency will have dropped to a pint that one should replace the patch.
A typical transdermal gel dosage is about a milligramme of estradiol, in this case, counted as the amount contained in the gel. It diffuses through the skin relatively fast, but not all of it reaches the blood.
(For order-of-magnitude context, a typical target level might be about 500 pmol/l. A mole of estradiol weighs about 270 grammes, and a woman might, on the bigger side, contain about five litres of blood, so all that target estradiol in her blood adds up to some 0.7 microgrammes; at a time, anyway.)
@goatsarah
Alda Vigdís 🇵🇸 🇱🇧
in reply to Riley S. Faelan • • •Riley S. Faelan
in reply to Riley S. Faelan • • •@alda Sorry.
It turned out grumpier than I meant to.
I've not been having a good day.
@goatsarah
Nikkileah
in reply to Sarah Brown • • •Once the new job is sorted, I'll look into working a private dose on top of prescribed
Sarah Brown
in reply to Nikkileah • •