I recently had an injection that seemed to go wrong (CW: blood, I inject EV subq and I hit something like a capillary, there was a lot of blood and it bruised badly afterwards). Within a couple days I felt unusually dysphoric as a result of what I assume was a failure for the oil to depot and slowly release over time.

I get these “dysphoric thoughts” that maybe the estrogen is causing the problems, that I don’t have objective proof that I’m trans, etc. Lots of doubt, paranoia, and increasing amounts of anxiety and irrational fear (about transition, but also in general, e.g. thinking spiders are in my bed), and I start to experience depression and anhedonia (things aren’t as pleasurable, everything feels pretty flat emotionally, I just feel “bad”).

Of course when I inject again and it goes well, I feel much better and I forget about these problems.

I was just wondering if anyone has advice on how to deal with dysphoria when there are gaps in the HRT. Obviously in the long term, surgery will fix the hormone issue and I suspect that will fix this problem. Until then, though, I am stuck in a rather fragile place where I feel normal (even good, even amazing) when my estrogen levels are high and suppressing my testosterone. Any small slip in that and I barely function as a person.

Before HRT I would just do whatever I could to increase mental well-being:

  • physical exertion (aerobic exercise, weightlifting, etc.)
  • going outside and getting sunshine
  • keeping up with hydration
  • keeping good sleep hygiene (sleeping enough, going to sleep at the same times, etc.)
  • meditation every day

But now it feels harder for me to “bootstrap” when there are gaps in HRT and my hormones aren’t right, it’s like I’m no longer used to how hard it was before.

Anyway - any tips or thoughts, would like to hear other’s experiences.

  • dandelion@lemmy.blahaj.zoneOPEnglish
    0·
    6 months ago

    Ah, that’s definitely a good idea. My endo initially told me to inject 5 mg estradiol valerate every 10 days (I chose to inject subcutaneously). I couldn’t last longer than 8 days, the dysphoria got so bad (I started to wonder how I possibly survived without HRT for so long, it really seems insane to me how I used to live).

    I changed to every 5 days with 5 mg, but I kept lowering my dose (I was afraid of my endo forcing me onto a lower dose if my blood work showed too high E levels). I tried lower doses more frequently. All in all, lower doses were a mistake, I kept having a few days of horrible-ness in the trough. Eventually I went back to 5 mg every 5 days, and found around day 4 I started to feel weird, so to avoid issues I started injecting 5 mg every 4 days.

    I know the half life is supposedly every 3.5 days, and I’m essentially relying on the estrogen to act as the anti-androgen (bicalutamide didn’t seem to have any effect on my mood, positive or negative, so I stopped using it), so I’m intending such a high dose, I’m just not sure what those upper limits are or when I might be taking too much.

    On the one hand, more frequent but a lower dose (even 4.6 mg) seems to have less of that anti-androgen effect that 5 mg has, and it feels less euphoric (mentally, I mean - estrogen sometimes feels like a recreational drug). On the other hand, less frequent doses means unevenness and potential troughs where things get dicey. I think as long as my injections don’t fail (like when I injected into a vein or capillary), it seems like this dose / frequency works well enough for me. Still, it’s a bit concerning that my basic functioning is so fragile, I wish I had better coping strategies.

    For example, I wonder if anyone uses gel in conjunction with injections, or if anyone injects a partial dose when it seems like something didn’t go right. I get the impression this just isn’t as frequent of a problem, I’ve never heard that hitting a capillary caused such dysphoria as a result.

    Another factor: I started HRT three months ago, so it could be that my body more easily slides back to testosterone right now and I just need to get over this initial transition to a new hormone regime.

    Thanks for reading my post and for the suggestions! 🥰

    • AlmostDefective@lemmy.world
      0·
      6 months ago

      I changed to every 5 days with 5 mg, but I kept lowering my dose (I was afraid of my endo forcing me onto a lower dose if my blood work showed too high E levels).

      Something to think about in terms of your estradiol results is how long it’s been since your last injection. I’ve had several providers tell me they don’t care how long it’s been since my last injection, they just want to see. I push back that and only let them draw when it’s a true trough sample (e.g. I inject every 7 days, so I have blood drawn on that 7th day before I inject). This will give you (and your endo) a truer value to base your dosages/frequency on.

      (bicalutamide didn’t seem to have any effect on my mood, positive or negative, so I stopped using it)

      I had a similar experience to bicalutamide, but I kept taking it up until my orchiectomy. I tried spironolactone, but I didn’t like the results. If you’re not in the US, ask your doctor about cyproterone acetate. That stuff made me feel levelheaded; sadly because I was self medicating I had to stop when I began seeing a professional.

      Another factor: I started HRT three months ago, so it could be that my body more easily slides back to testosterone right now and I just need to get over this initial transition to a new hormone regime.

      This definitely sounds true. Based on my experiences, the first several months had ups and downs (hormone-wise). When those lows hit you, talk to a therapist, hangout with a friend, do a mini-fashion show in your room, go for a hike. The lows will pass; things definitely get easier. 💜