This raises the question – is it better to take all of your dose at once, or spread it out over the day?
The goal of feminizing hormone therapy is the development of female secondary sex characteristics, and suppression/minimization of male secondary sex characteristics. The area under the curve from 0 to 1 hour is therefore 225.5 pg/ml*hr. In women who are currently taking oral estrogens, treatment with estradiol transdermal system should be initiated 1 week after withdrawal of oral hormon… One of the issues up on the radar screen in natural hormone replacement therapy is whether taking estrogen in the oral (pill form) or transdermal (skin cream or patches) works best. To find the area under the more complicated curve from 1 to 24 hours, I used a little calculus and integrated, and ended up with a value of 1,296 pg/ml*hr. The results were plotted, and startling. However, sublingual estradiol tends to more closely mimic real life, at a ratio of 1:3. However, I must emphasize that many changes happened over that two-year time period, and thus it’s certain that there is experimental bias involved in this process. 4. So I generated another graph, assuming conservatively that anything over 1,000 pg/ml was wasted.In this case, the mean value of estradiol through the day is 304 pg/ml for the “all at once” case, and 320 pg/ml for the “spread out” case. However, a direct comparison between the two does not appear to exist in the scientific literature which is available. “Oral Mucosal Drug Delivery.” Hmm, I wonder how a dr. can assess base levels when the range is so wide based on the measurement time.
Each of them provides the option to choose my lab time prior to my appointment, so right from the start I decided to track how long before the labs I would take a 2 mg estradiol tablet sublingually.
The two flatter lines representing the “swallowing” case are very unimpressive overall.Looking at the area under the curve, we can try to compare the total dose of estradiol which is received by the woman taking the pill.
The dose medicines in this class will be different for different patients.
Estrone is described as a “weak” estrogen, as it has only about 4% of the potency of estradiol. I was actually quite impressed with the close visual agreement between the predicted curve (red) and my real-world results (red). The other question that I have is if cisfemale ranges are all over the place depending on cycle time, how can a target value really be determined? Assuming the 1-mg dose is taken, then in the case of oral administration the product of time and estradiol level is approximately 480 pg/ml*hr.
See the following graph for a good comparison.First, note that the three lines which portray a huge spike in estradiol are all from taking estradiol sublingually. Summing the two values gives a result of 1,521.5 pg/ml*hr.For those keeping score, the total estradiol absorbed by your body when taking the same pill sublingually as opposed to orally is about 3.2 times the dose received when taking oral estradiol.Now let me call your attention to the shape of the sublingual estradiol curve. Women may get low, but it’s the high that gets very high. Six women took a variety of doses of estradiol via both methods, and their blood serum estradiol levels were measured at 0, 1, 2, 3, 4, 6, 8, 12, and 24 hours after they took their dose. 2003 Estrogen patches may not carry the blood clots risk of estrogen pills. In other words, all that estradiol over that limit is wasted.
Whereas the bioavailability of sublingual estradiol is about 25% – five times as much.
(It's already very clear that progesterone cream works better than progesterone pills.) Estradiol, Climara, and Vivelle-Dot are all available as 50 mcg patches. I assume there are corresponding nuclear repressors/corepessors that limit the activity, would saturation create some sort of excess repression versus cycling?Those are both excellent questions, and I admit there is a dearth of data on this subject. Estradiol patches similar to those used in this study, in the 50 mcg dosage, are used either once or twice weekly. Sure you can take some sort of average or mean, but, we do we know the optimum level to get the estrogen receptors to activate at their maximum intervals? You also would want to maintain your base level estradiol.
Estrogen patches may not have the same risk for blood clots that oral estrogen pills do. From 0 to 1 hours, I estimated the estradiol level linearly, as 451*HOURS.
Calculating the area under the sublingual curve is more difficult. It’s debatable whether this is statistically significant.On the other hand, there is a practical consideration at play.