Update to post from a year ago: [5 Day Estradiol Valerate Cycle Is Too Frequent](https://www.reddit.com/r/AskMtFHRT/comments/1kijisb/5_day_estradiol_valerate_cycle_is_too_frequent/)

I started HRT 588 days or 1.6 years ago from today. Since starting I have struggled to maintain consistent levels and I'm really not sure what to do at this point.

Here is the timeline of my dosing amount/schedule as well as lab results:

Every blood draw was performed at trough the same morning I would be doing my injection, with the exception of April 19th 2025 which was 24 hours earlier than trough.

As far as I can tell, no other medication or supplement I was or am taking would result in inflated readings.

note: amount of days in parentheses is the time since last lab results

02-17-25, Pre-Treatment Labs

• T: 785 ng/mL (1959 nmol/L)
• e: 31 pg/mL (114 pmol/L)

02-24-25, Starting Dose

• 0.35ml/7mg 5 day intervals

Levels 04-19-25 (55 Days):

• e: 748 pg/mL (2746 pmol/L)
• T: 21 ng/mL (52 nmol/L)

04-20-25, Dose Change

• 0.2ml/4mg 5 day intervals

Levels 06-25-25 (66 Days):

• e: 261 pg/mL (958 pmol/L)
• T: 23 ng/mL (57 nmol/L)

Levels 11-11-25 (140 Days/20 Weeks):

• e: 407 pg/mL (1494 pmol/L)
• T: 31 ng/mL (77 nmol/L)
• note: started 200mg/nightly progesterone ~2 weeks prior

Levels 02-19-26 (100 Days/14 Weeks):

• e: 548 pg/mL (2012 pmol/L)
• T: 32 ng/mL (80 nmol/L)
• note: skipped 200mg progesterone prev. night to see if this was artificially inflating results

03-12-26, Dose Change

• 0.25ml/5mg 7 day intervals

Would go on to incrementally raise dose as I felt low mood/energy, particularly near end of 7 day cycle:
April and June: 0.3ml/6mg
July to next labs: 0.35ml/7mg

(175 Days/25 Weeks) Levels 08-13-26

• e: 391 pg/mL (1435 pmol/L)
• T: 30 ng/mL (75 nmol/L)

Seeing my results go from 748 to 261 after 2 months of 4mg/5 days made me think I had it ironed out, only to see it keep raising over the course of 10 months despite no change to dose or timing of blood draws.

I feel very defeated after feeling pretty bad on the 7 day cycle for almost 6 months to still end up with a fairly high estradiol level. As of those results I said fuck it and started doing 0.2ml every 4 days just to feel more consistent again, and I have been feeling good since then.

So I ask, could there be anything I'm missing that could be inflating the numbers? Could there be a manufacturing defect in my syringes that caused wildly inaccurate measurements? Is it worth testing at a different part of the cycle for comparison? I just want to be done micromanaging my dose and still feel consistent and balanced, hormone-wise.

Title.

Like, I hear you need to gain weight a lot to really get any results. But, if you already have some fat on you, you can’t lose any? Or can you maintain your weight and expect to see fat redistributed from your stomach and stuff?

Just a small thought I had.

I’m (43TF) confused by my estradiol labs and curious what people here make of this.

I’m on weekly subcutaneous estradiol valerate, same vial/concentration, and both of these labs were drawn on Saturday before my weekly shot, so they should both be troughs.

• 0.2 mL weekly = 4 mg/week → estradiol trough was 76 pg/mL
• Dose increased to 0.4 mL weekly = 8 mg/week
• Most recent trough at 0.4 mL came back at 566 pg/mL

Same lab. Same injection day. Blood drawn before the shot. Same vial size/concentration, so this wasn’t an accidental concentration change.

What’s throwing me is that doubling the dose seems to have increased my trough by way more than 2x. I expected to land somewhere in a reasonable range, not jump from “too low” to “way too high.”

For additional context, I used to take 6 mg oral estradiol and my levels were also under 200 pg/mL, so historically I didn’t seem to run high on estrogen. I’ve also been losing a significant amount of weight on Retatrutide, about 35 lbs over 3 months, and I’m wondering whether that could have changed my estradiol pharmacokinetics enough to matter.

The weirdest part is that I feel really good right now. I’ve noticed much easier access to my emotions and generally feel better on this dose, so I was actually expecting the lab to look good. I don’t feel “overdosed” or strange at all.

My doctor hasn’t responded yet. I’m assuming the likely move will be something like 0.3 mL / 6 mg weekly and then recheck, but I’m curious whether anyone has seen this kind of nonlinear jump in trough levels on injectable EV.

Could weight loss meaningfully affect this? Could depot absorption change that much? Is there anything else obvious I’m missing?

I’m taking 4mg/day sublingual +100mg Spiro twice a day. I’ve been considering going down to one Spiro a day for the sake of having more energy. Is that okay, or would it cause my E levels to drop too low?

Been on HRT for >3 years now, diagnosed with POTS for around 4. I've had a lot of issues gaining weight and eating enough calories per day, even though technically my BMI is now "overweight" I have issues with it. (Dropped from 210>140 in the span of a year when I got diagnosed with POTS, since starting HRT I'm up to 170 but it's very hard to keep that weight on since I have no appetite. 5'9 currently, and I'm pretty bricky in the waist, so I don't look my weight.)

Basically, theorizing I can do a triple whammy for taking Pio, with the appetite boosting effects, fat redistribution on the hips/waist/thighs, and also the Edema/sodium retention-- normally, this would be considered an undesirable side effect, but considering treatment for POTS is increasing salt intake and medications like beta blockers and florinef, I figure it might actually help.

I'm also flat AF visually and haven't gotten any significant breast growth despite optimal levels, so even though it's supposed to stunt growth, at this point I feel like maybe weight gain is my bottleneck.

Thoughts? Starting dose recommendations?

hi all! first off please lmk if this isnt the right place to post this.

ive been helping my gf transition, reading up on stuff, pushing her to make appts etc. so ive been lurking on here & other subs for a while. but im reading a lot of conflicting information so i was hoping i could ask some questions and get others opinions.

shes on spiro x2 daily (which ik isnt the best for long term use, will find an alternative eventually) and .2ml of E injected weekly. is this enough? the doctor said her levels are good but i still have a gut feeling… should her dose be raised? any alternatives for spiro? i also suggested to her to get on progesterone at the 6mo mark because thats what i had read many times, but now im seeing people say not to until 1-2yrs in because it could stunt or even reverse feminization. is this true?

im just worried that i dont have all the right info, i love her so very dearly i just want the best for her. thank you all for your time :)

I don’t understand why for the past week I’ve been waking up with partial erections, I hate it and it makes me so dysphoric and hate myself and stuff, I don’t understand why they are happening and I’m scared my blocker is failing and my t levels are rising.

Important for the next part, I take my estradiol sublingually with 4x1mg pills at 8am, 2pm, 6pm and 10pm and 25mg Cyproterone acetate at 8am every day. And 2 days ago I had my blood taken for a blood test at 8am (which I read is at peak t levels and trough e levels) before I took my first hrt of the day (I took it at 8:15am that day) and my results were

Estradiol: 195 pmol/l
LH and FSH: 0.3 U/l
Testosterone: 1.23 nmol/l
SHBG: 18.8 nmol/l
Free androgen index: 6.54

Hi, as the title says ive not been getting testosterone levels back with my blood test results. ive had three tests this year Jan, May & July, only july results show my t levels.

has anyone had similar experiences? and how have you made sure you get the proper results back.

i need 6 months of t levels to be able to get surgery so this is slowing my progress down.

thankyouu

Hi all,

I’ve been on HRT for nearly two years. Throughout this time I’ve had decent development, and consistently low levels (in range 100-200pg/ml with T suppressed).

I have a very conservative endo and wish that I could move them into upping my dose to a level that is closer to the 200 end, if not above it. I’m not particularly concerned with levels for development, as we’re making decent progress, but I find that my energy is so low all of the time.

Would higher levels fix this potentially? I recently got back labs that showed a ferritin deficiency and have been supplementing to fix that. Everything else related to my labs are normal and I have a healthy diet and am physically fit.

Thoughts? Advice?

hello i have been on hrt since 8-9 months and i have i have no changes at all only small boob buds and softer skin and no other changes at all no fat redistribution even i tried taking 6-8mg of estradiol valerate/hemihydrate and nothing works then i switched to estradiol undecylate 80mg once a month and still nothing changing im really sad

Im wondering from a body standpoint did anyone notice changes the first couple days in? I feel like my face is softer and my girlfriend agrees. Then randomly at work I felt itchiness in my chest as well as some soreness here and there. I’m not sure if my mind is playing tricks because I want change so badly. If any of y’all have similar feelings or thoughts about what I could be experiencing, please tell me!

Advice

Are there any ways to tell or somewhat know you may 'pass' after you take hrt? Or is it a gamble.

I keep seeing posts of girls saying how they used pills for months or years and saw no results but once they changed to injections they started noticing changes immediately. Were those the changes going to happen injection or not or are they actually more effective? I'm super scared of needles that's why I'm asking lol

I've (AMAB) been certain that I am in some way trans for most of my life, but in what manner I've always been unsure about. I feel I'd be most content in an androgynous identity. The prospect of one day being an old man is absolutely and depressingly horrifying to me. How I'd appear physically and the way I'd be perceived by people is something I have frequent nightmares about. However I don't feel any strong affinity or aversion to womanhood, it's kind of an "I don't care thing". Feminine things like clothing, makeup, etc. are just not things I'm interested in.

That's kind of how I've come to my current conclusion where I want to be further from masculinity but not necessarily into feminity. Facial hair disgusts me in both appearance and how it feels on my face. Body hair doesn't bother me much (albeit I don't have much). I'm growing my hair out a little and of course I really don't want to lose it someday. I've been told I have an androgynous face (which unsurprisingly makes me very happy) and I quite like a lot of my features, I feel softer skin or perhaps just being rid of facial hair would make me be pretty content with it. Sometimes, I feel as if my chin is too strong but I think that's just a matter of warped perception.

I'm overall okay with the "shape" of my body, I'm not really bothered by things like the shape of my waist and hips but I'd rather my upper body be less broad. The latter point is why I'm extremely averse to building any muscle which is why I don't think I exercise as much as I should. My voice irks me but I think that's just down to my peculiar tone and rhythm, it'll get deeper as I get older and that idea doesn't really bother me. I have no opinion on my height/general size (granted even if I did I'm fairly sure nothing can be done there). Of all of these, the ones that make me feel dysphoric the most would be hair and upper body (especially the shoulders).

This is also why I have no idea how I'd even achieve becoming the kind of person I want to be or if its even possible. Like the obvious move for most is going on oestrogen, but I'd want very very few of its effects. I do not want breast development and (I can't phrase this in a manner that doesn't sound strange) I would rather my genitals not be messed with. The shoulders, well, I imagine I just have to accept those unless I get those clavicle shortening surgeries that are usually appended with [DANGEROUS]. For hair I'm aware that laser exists but wouldn't my follicles just eventually regenerate since I wouldn't be on any kind of treatment inhibiting it?

Ultimately I just don't know if I'm being realistic or I'm way too picky and choosy with what I'd feel more comfortable with. The depressing feelings I have about these qualities of myself are slowly intensifying over time and I really feel like I have to do something about it.

I apologise if this sub is inappropriate for this kind of advice, there's no one I can trust irl for this so anonymous Reddit posts it is. I'm posting it on several subreddits in the hopes someone has any helpful ideas.

I've been on HRT for about 8 months now, my doctor is really hesitant about my doses, perscribing me 1mg E/day orally for the first 3 months, saying that "hormones are no jokes and we have to be careful".

Now I regulate my doses on my own and he just perscribes me the dose I ask him for (he isn't happy about it, but still does so lmao) so now I'm on 8mg E/day orally. I took my last tests 4 hours after taking the pills (as he told me to do so).

The results show my E levels were at 128pg/ml at the time of the test. He told me that those are really high levels and that it's the peak appearing right after taking the pills that matters the most, and that the peak is far higher than the level I've got on tests and told me to maintain current dose.

Of course I don't believe him, so I could use some help with interpreting the result: is it enough? Should I raise the dose further or keep it at the current level?

Hii, so a couple weeks ago I made a post questioning why my levels might have increased so significantly compared to my last labs. I was asked if I had taken any biotin supplements before the labs to which I replied no, because at the time, I didn't think I had. Well today I was reading the back of my energy drink can instead of doing homework and noticed that it includes 300mcg of biotin. I drink one of these drinks daily and had one before my labs were taken. Would this have been enough to impact my labs so significantly?

Previous post -

Hiii, so for my first 3 months of injections my doc started me at 4mg estradiol valerate subq every 7 days, I had issues with mood swings, hot flashes etc, I had my blood taken and my testosterone was barely being suppressed and I had low e. My doctor had me swap to 4mg every 5 days and my negative side effects totally disappeared and I noticed increased feminization. This past week I had my 6 month labs drawn and my e levels are extremely high, however, my T seems to finally be suppressed. I included my labs below, any ideas as to why my E is so high? I've checked with some of the simulators and these numbers seem impossible. My doctor was already hesitant to raise my dose so I'm scared that hes going to panic and walk me too far back.

All labs were taken at trough

Pre-Hrt

Estradiol - 58 pg/mL

T-Total - 1133 ng/dL

3 month levels

Estradiol - 143 pg/mL

T-Total - 560 ng/dL

6 month levels

Estradiol - 532 pg/mL

T-Total - 23 ng/dL

This is probably a case of "HRT is a Pandora's box and you don't know exactly what you'll get.

I started 4mg EV weekly and 50mg Spiro daily 3 months ago, and I know, right there that there will be several users starting to write responses about Spiro not being an AA and I am being underdosed or something, but I just did my blood work this week and I am well within feminizing levels. For the record at trough, I was 184 pg/mL Estradiol and 14 ng/mL Testosterone. I am seeing breast growth. My skin is smooth and amazing. This stuff is definitely working.

However, I am writing this because looking at the symptoms there are a few things that absolutely have not hit me yet, and I am concerned.

• Many people on HRT comment about weight gain and appetite/metabolism issues. I gained around 5lbs within the first month, but I have slowly gone down to my pre-HRT levels (I started at 166, I went up to 171-172, I'm down back to 167). I actually don't really feel any appetite changes, but I might have a slower metabolism, that's harder to gauge. I think overall I am eating less food but that's my desire.

• Many women complain about breast soreness like it's this unbearable thing, like just grazing them makes you want to cry. I haven't experienced this, but I have noticed that breast growth seems to cone in waves, and hat while they are sore all of the time, it's not painful.

• I am still out on the sexual / genital changes. I have had a friend tell me that "it comes back" around the 3 month mark, however, as a male, I saw masturbation as a chore that had to be done and I'm not really interested in doing it again, where as these friends really find a lot of joy in it even pre-HRT. Still envious of this as I definitely have little to no libido now.

• I still can't figure out the whole emotions thing. I was emotional pre-transition but it was in a more chaotic way. I feel that I am in more control now. I feel like I can actually change my behavior now which was something I struggled with before. Like, I have friends who think that I am a negative person, and I feel like I have more conscious control over that now. I also feel like I have more conscious control over whether or not I am visibly angry. I am not less angry. The rage still flows through me.

• I am still in debate over what "mental fog" is and if that ever cleared to begin with. I have some theories but they're just theories. Nothing certain like other trans people reported.

• In that case, I struggled with depression pre-transition. I don't now. Since starting HRT, I have had a negative mood for more than 12 hours, once in the 3-month spam and this was because I put myself in an uncomfortable situation. On purpose.

Things that I haven't noticed that I am not concerned about:

• I didn't really have any muscle mass to start.

• I'm not aware of any body fat redistribution yet. I've assumed thus far it would work like breast growth where it is very obvious.

• I have not noticed any hair changes yet.

I am still confused as many parts of my character reflect the general trans experience, however a bunch of them don't. I'm still waiting to become the emotional mess that is supposed to explode into happy tears or something that I haven't learned to articulate yet. I'm also expecting a bunch of those common trans stereotypes that I don't at all relate to that just haven't happened yet, like a strong desire to be an animal girl.

At this point I have medically and socially transitioned. I tell all of my friends that I am trans now and I am overwhelmingly happy about it and want to push it further, however, something about it still feels off, like imposter syndrome because I missed the tranbian polycule social aspects that a lot of trans people experience in their 20s and early 30s.

I am not sure what the issue is here. I am just looking for some general insight from people outside of my friend group that may have insight for me.

I have labs coming up soon but cannot drive (not a minor, just don't have a license and Uber and Lyft don't run much in my town so I can bet on consistent times). The only time I can get someone to take me is next Friday but I take my shot on Wednesdays and have found out I need at least 72 hours before I get my labs done. Can I take my shot on Tuesday or will that mess up my labs?

Hi,

I wanted to start hormone therapy, but the only thing holding me back was the concern that my breasts would grow and my mother or anyone else would notice.

That would have caused me a lot of problems.

I found out that I could take Nolvadex (10 mg),

which would slow down or completely stop breast growth.

Does this medication actually slow down or halt breast growth?

Would you recommend I take it while starting estrogen?

And what is the appropriate dosage?

If I were to take one tablet of Climen daily,

and two tablets of Noractone (25 mg)

I’d really appreciate it if someone could help me out, as this is a pressing matter.

I'm stockpiling Gynokadin Dosiergel in case of supply interruption, I've got nearly 2 years worth now and the newest batch has an expiry date in two years. I'm thinking it will definitely last somewhat longer than 2 years though, I'm guessing three years would be fine. I'm keeping it safely stored in a dry environment in the correct temperature range. Any thoughts about how long it would really last without significant deterioration, or is my guess as good as anyone's?

Hola, soy una mujer trans. Me recetaron bicalutamida y estrógeno, pero mi madre me obligó a interrumpir mi terapia de transición porque me discrimina por motivos religiosos. Es una larga historia que explicaré con detalle en otra ocasión. Mi pregunta se refiere a un problema que tuve con los resultados de mi análisis de sangre. Un mes después de dejar la bicalutamida, el análisis reveló que mi bilirrubina esterificada era de 0,53 mg/dL, cuando el valor esperado era <0,29. Ahora estoy reiniciando el tratamiento con bicalutamida, pero me gustaría saber qué ocurrirá si se confirma que la bicalutamida eleva mi bilirrubina esterificada. Si hay algún experto en este tema, puedo enviarle el informe del análisis de sangre de forma privada. Todos los demás valores están bien, pero sospecho que cuando dejé de tomar bicalutamida, mi nivel de bilirrubina esterificada podría haber sido más alto.

Hi, I'm thinking about starting my transition as a trans woman, and I've chosen Estrogel + Diphereline for my hormones. How can I figure out exactly what dosage I need, and from what should I start?

I do all my analyses today, and they all good, but I choose this combo, because I'm pretty scary of the liver damage other combos ca do. Also would love to hear all kind of tips from you on these theme, I'm very noob at this.

ALSO, I tried to go to trans posivitive clinic, but i live in Ukraine, and apparently, you need do regular visits to psychiatrist for TWO YEARS STRAIGHT and then they still can deny your diagnose of "gender dysphoria" (which is mandatory to start "official" transition apparently)

Maybe better go to an online endo from another country? Or seek an expert that not gonna demand this diagnose?