Estradiol monotherapy. Started HRT 3 months ago with 2mg Estradiol oral tablets. Have a doctor appointment in a few days and wanted to ask to double my oral prescription, split up 4mg into 4 doses sublingual every day. Not sure if my Estrogen levels are too high and my doctor will deny my request.

  • Pre-HRT Estrogen (TOTAL IA): 181 pg/mL
  • Pre-HRT Testosterone (Total IA): 246 ng/dL
  • Levels this week Estrogen Total IA: 438 pg/mL
  • Levels this week Testosterone Total IA 115 ng/dL

From what I understand I feel like I’m definitely not achieving Testosterone suppression. https://transfemscience.org/ recommends T levels around 10 ng/dL. But having E levels of 400 pg/mL is the right range for E.

Can I convince my doctor to double my dose if my E is already at >400 pg/mL?

Edit 01: I did not take my daily dose until after my blood was drawn. Blood draw was already 24+ hours since last oral dose.

  • dandelion
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    9 hours ago

    Even so, that snapshot is probably not accurate to your blood levels most of the time, since such high E should thoroughly suppress T production if it were consistently that high. There are probably still periods where your E drops enough for T production to be happening, the other main way to explain such high T is that maybe there was an error / inaccuracy in the labs. My endo shared that he is particular about which lab does the blood work and that it makes a big difference in the accuracy.

    Besides your blood labs, have you noticed physiological changes that might indicate T suppression or lack thereof?

    EDIT: I know a transfem IRL who after 3 mo. of oral estrogen had blood levels around 340 pg / mL and T around 95 ng / dL - so this isn’t the first time I’ve seen something similar (adequately high estrogen, but not fully suppressed testosterone).

    It’s hard because I started with injections, not oral, so my own experience was that T was immediately suppressed. My T was 305 pre-HRT and E was 30. After 2 months my T was 23 and E was 325. That was with a variable dose schedule, but averaging around 5 - 7 mg per week (usually split up into every 5 days or every 3 days during that time).

    • Florencia (she/her)OP
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      17 hours ago

      The only physiological change I’ve noticed is my areolas having pain when bumped. Have not noticed anything indicating T suppression.