I’m an enby and soon to start HRT.
I just had a strange conversation with a friend is saying that estrogen is messing up their dopamine levels.
They said on the pills, they felt ok, but the dose was too low. And then switching to weekly injections, they get a high for 4 days and then they have like a depressive crash on the last 3 days.
It’s started a little bit of a spiral for me as god knows I’ve struggled with brain chemicals all my life. From drepression to anxiety and back and forth, but I’ve been doing much better the past year.
And so I’m kind of freaking out that estrogen will make me spin out.
Has anyone else had issues like this with the injections. I know its very subjective what people feel.
Sounds like your friend is making assumptions about the correlation between their mental/emotional state and dopamine levels. It’s a superficially reasonable assumption, but given the interplay between hormones and brain chemistry it’s seems possible to me that dopamine levels simply have nothing to do with it and the issue is wholly to do with hormones.
I would be interested in reading any studies that support what your friend is saying. But minus evidence I have to think that your friend is l drawing incorrect conclusions about what would cause the phenomenon they’re experiencing.
You may well be right. People do like to do a bit of armchair neuroscience now and then. I suppose im not too bothered on whether it’s due to dopamine or something else. Just the mood swings are a concern for fear.
Hormones are active in the brain and if you are low it can cause mood problems. Most sources I’ve seen show a 4-5 day half-life for estrodial valerate. This can leave you pretty low before 7 days are up if you are on weekly injections. There are two ways that people typically work around this:
- Increasing the dosage high enough that you don’t dip too low. This unfortunately also means that your peak levels may get higher than your Dr is comfortable with.
- Splitting the dose in half and injecting two times a week instead of one. This will significantly smooth out the curve, but have the downside of requiring twice the injections.
This is an example simulation with a once weekly 5mg injection vs a twice weekly 2.5mg injection to illustrate the difference between the two:
I guess what I am saying is that there are options if the dosing schedule you start off with causes you problems that you can work through with your Dr. Also, the 5mg I used for the simulation was a semi random number and not a recommended dose.
Thanks for explaining it. That makes good sense!
+1 for injecting every 3.5 days for more mood stability.
I will also say that my mood instability was reduced when I was able to lower my dose after an orchiectomy - but that was because testosterone seemed to make me feel miserable (the problem was not low estrogen, but the way low estrogen caused my body to produce T).
Either way, estrogen isn’t going to “mess up your dopamine levels” - I think you are likely to feel better on injections than on pills, pills cause hour-by-hour fluctuations in your hormone levels while injected estradiol valerate has more gradual change in hormone levels compared to oral route, the half life being around 3.5 days.
Also, I struggled with depression and anxiety a lot pre-transition, and estrogen significantly improved my mental health - maybe you will have a similar experience?
When doing injections your level of hormones does not remain consistent over the period in between your shots. This can definitely lead to hormonal days on both ends of the week when your levels are very high or getting lower. I haven’t experienced this directly myself though, so I’ll let someone else chime in with some first hand experience with it.
If your friend is on Estradiol Valerat they should go for an injection ever 5 days as the depot effect for that ester isn’t that long. If they are on Estradiol Valerat seven days should be fine, but maybe the dosage is a bit low. Are they getting regular blood tests for E2 levels?
If I’m honest I’m not sure what shots they take or whether they are getting tested. But they do see an endo regularly, so I do believe the situation is being managed/monitored.
A week was a bit too long for me with 10mg e. valerate injections (monotherapy). It wasn’t unbearable, but I’d feel pretty shitty by day 6 or so. I’m on patches now, which gives me a much more stable level without too much hassle. Highly recommended if you can get them and don’t have a bad reaction to the adhesive.
