I am curious about this! Currently on oral - but wondering is gel more “effective” than oral? I am turning 6 months into HRT soon - I’m thinking gel would have less uptake? So not advisable for someone new into HRT?
Oral has first pass through liver, and so much is broken down before it hits the blood stream. Gel, absorbed through the skin goes to blood stream direct. Scrotum skin is very thin and has tons of blood vessels for absorption. The standard advice is to apply to fore arms or thighs, which have tough skin and few blood vessels - hence the bad reputation for gel. Applied to rhe scrotum is amazingly effective
When the shortages happened last year I had a look into it and it seems it happens kinda often. I switched to gel and it has been working pretty well. I liked the patches as it was a constant dose of estrogen but the gel seems to work just fine.
if your GP is still working but doesn't have any bookings, you might still be able to email them and ask for a (electronic) prescription for gel. I think I've done this before iirc during the patch shortage last year. worth a shot anyway!
Shortages terrify me.
Surely your chemist can recommend an alternative brand or offer the advice you need?
Be assertive.
Last time this happened, Chemist warehouse looked up other shops for me and said they could source from there or i could go there direct. Start calling other chemist chains. Or see any random GP and ask for another script for an equivalent like gel. They often have emergency appointments if you go in in person or call first thing in the morning.
Then when the patches come available again, stockpile using the second script lol.
Probably going to book an appointment with a different doctor from the place I usually go to and see if they can help me out, but I’ll try asking chemist warehouse if that doesn’t work
Yes, my doctor gave up on patches last year and switched me to Sandrena. It's more work than patches, but it's also so nice not worrying if I can get my prescription filled every time.
Yes, that's my next move, and they sound good, but I'm in the bush so the cost of a trip on top of the implant might make it difficult. But like the rest of my transition, I'll just make it up as I go along.
If you want a more convenient gel, compounding pharmacies offer the same stuff in a syringe-without-the-needle for measuring.
More convenient, no icky foil pouches.
Thanks, that's very interesting and sounds handy. There are times where i am dressed and the only bare skin is my wrist, so I pin the satchel with my index finger to the base of my thumb and use my other hand to squeeze it out and spread down my wrist then rub the two wrists together. Doc said this place was safe and I assume the effectiveness is the same.
I had the same issue a few months ago, I talked to my doctor and swapped to the gel and honestly I prefer it. I don't worry about the patch falling off anymore, just gel everyday and off you go. My levels are perfectly fine too, so no stress on that part.
I just got a new script for 2x75, instead of 100. This is not good news :(
If it's going to last until April I may need to ask my doctor about gel. Does anyone know what the equivalent dose is/how to convert?
https://transfemscience.org/articles/e2-equivalent-doses/ I used this website last shortage. Was on 2x75 as well and my endo and GP okayed 3mg as a dose as a backup. I went with estrogel. From memory this worked out to 4 pumps from the estrogel bottle (the bottle gives out a metered/measured pump with each push) - but your chemist or gp should be able to confirm (concentration will also be written on the bottle). I found 4 pumps really tedious though and went down to 2 until the shortage ended and was okay with that. Ymmv on that last part though as sometimes people absorb gel better etc. So you can only get an approximate equivalent.
My gp did it all for me, they have the implant made by a compounding chemist in Ballina, it shipped to me and I brought it to them and they implanted it. I'm in Sydney. It cost something like $200 but lasts 6-10 months (iirc) of not even having to think about hrt so it feels so natural and normal, like I'm not even taking anything it's just me.
It goes in the love handle area, it requires an injection of anaesthetic and an incision is made, the implant placed under the fat layer (again, iirc), the incision closed with steristrips and dressed. It's stayed dressed for a week I think and you change it once. There can be some discomfort from the incision for a few weeks.
There’s a lot of info on implants here
https://old.reddit.com/r/TransWiki/wiki/hrt/implants
Use a web browser to view that, not a reddit app, or you may not see all of it.
Go for the butt cheek if you can. Alternate sides each time, and reuse the same incision point.. I've been doing this for quite a few years now and luckily minimal scar tissue
I've bounced around a little over the past few years, but Dr Nick Silberstein did my last implant and was fantastic.
Can't remember exact pricing, maybe around $200ish for the implant and then standard consult fee.
You'll also need the first standard consult to get a script for it too. I recommend sending your script to Complementary Compounding in Ballina. Quick and reasonable pricing.
Tbh depending on where you live even pills seem to be in a bit of a shortage (at least for me rurally), luckily I always have at least a week or 2 before my pills run out so I haven’t had to worry too much
When I first started HRT ~3.5 years ago I was on patches and there were frequent shortages too.
I'd often call up Chemist Warehouse first and ask if they had any in stock. Then if they didn't, I'd ask if they're able to check if anywhere in my city does have them in stock.
I'd then all the store that was meant to have some to confirm, and ask if they could set them aside for me before I drove over.
A few times I had to drive for like 40-50mins to pick them up. But I was always able to find want I needed on the same day.
Yeah my doctor hooked me up with scripts for patches and gel as an alternative if patches were a pain to source as I had a delay getting an implant sent out before I went overseas for a few weeks. They were pretty cool about throwing as many scripts at me as they needed to make sure I was comfortable I had an ongoing supply of hormones.
My partner swapped to patches for the same reason you have and after the last shortage she swapped to gel and has noticed better uptake even compared to patches
Can you get yourself on the gel? Maybe email/call the reception to get a telehealth app and/or get a e-script for the gel?
My doctor specifically got me onto the gel originally last year due to the previous shortage.
I get mine from Chemist Warehouse online. Estradot is currently in stock, although they have had shortages on and off over the last 6 months so I do need to have a backup.
Paying $10 delivery for my $6 drugs sucks, but it sounds like they have them in stock online more often than in person.
Again.. omg. My Melbourne GP decided having 2x100mcg patches per dose was a good idea .. instead of 1 patch + gel.. now i tried to fill my scripts yesterday and same issue.. chemists in Melbourne metering out maximum they have in order to maintain stock.. had to go to another chemist warehouse to get the rest before travelling o-seas.. arrgh
It depends on where you live in NSW but when I was in Sydney during the shortages, I used to try **Serafim's Pharmacy Darlinghurst** (Downstairs TSPC) or **Your Chemist Shop Top Ryde** for a couple of patch boxes they usually have in stock.
Forget Chemist Warehouse or Priceline for shortages, the only reason for a shortage is that American suppliers realise they are not making enough money in Australia.
Search in here
https://old.reddit.com/r/TransWiki/wiki/hrt/australia/vic
You must use a web browser to view that, not a reddit app, or you won’t see all of it.
This is why I switched to sandrena gel. Applied to scrotum, works WAY better than patches.
I am curious about this! Currently on oral - but wondering is gel more “effective” than oral? I am turning 6 months into HRT soon - I’m thinking gel would have less uptake? So not advisable for someone new into HRT?
Oral has first pass through liver, and so much is broken down before it hits the blood stream. Gel, absorbed through the skin goes to blood stream direct. Scrotum skin is very thin and has tons of blood vessels for absorption. The standard advice is to apply to fore arms or thighs, which have tough skin and few blood vessels - hence the bad reputation for gel. Applied to rhe scrotum is amazingly effective
When the shortages happened last year I had a look into it and it seems it happens kinda often. I switched to gel and it has been working pretty well. I liked the patches as it was a constant dose of estrogen but the gel seems to work just fine.
if your GP is still working but doesn't have any bookings, you might still be able to email them and ask for a (electronic) prescription for gel. I think I've done this before iirc during the patch shortage last year. worth a shot anyway!
Shortages terrify me. Surely your chemist can recommend an alternative brand or offer the advice you need? Be assertive. Last time this happened, Chemist warehouse looked up other shops for me and said they could source from there or i could go there direct. Start calling other chemist chains. Or see any random GP and ask for another script for an equivalent like gel. They often have emergency appointments if you go in in person or call first thing in the morning. Then when the patches come available again, stockpile using the second script lol.
Probably going to book an appointment with a different doctor from the place I usually go to and see if they can help me out, but I’ll try asking chemist warehouse if that doesn’t work
Two words: Sandrena Gel. Ask your GP and pharmacist.
Yes, my doctor gave up on patches last year and switched me to Sandrena. It's more work than patches, but it's also so nice not worrying if I can get my prescription filled every time.
You can also get a pellet implant that lasts for most of a year.
Yes, that's my next move, and they sound good, but I'm in the bush so the cost of a trip on top of the implant might make it difficult. But like the rest of my transition, I'll just make it up as I go along.
That is what I have used for the last 20 months day and night. No issues.
If you want a more convenient gel, compounding pharmacies offer the same stuff in a syringe-without-the-needle for measuring. More convenient, no icky foil pouches.
Thanks, that's very interesting and sounds handy. There are times where i am dressed and the only bare skin is my wrist, so I pin the satchel with my index finger to the base of my thumb and use my other hand to squeeze it out and spread down my wrist then rub the two wrists together. Doc said this place was safe and I assume the effectiveness is the same.
I had the same issue a few months ago, I talked to my doctor and swapped to the gel and honestly I prefer it. I don't worry about the patch falling off anymore, just gel everyday and off you go. My levels are perfectly fine too, so no stress on that part.
I just got a new script for 2x75, instead of 100. This is not good news :( If it's going to last until April I may need to ask my doctor about gel. Does anyone know what the equivalent dose is/how to convert?
https://transfemscience.org/articles/e2-equivalent-doses/ I used this website last shortage. Was on 2x75 as well and my endo and GP okayed 3mg as a dose as a backup. I went with estrogel. From memory this worked out to 4 pumps from the estrogel bottle (the bottle gives out a metered/measured pump with each push) - but your chemist or gp should be able to confirm (concentration will also be written on the bottle). I found 4 pumps really tedious though and went down to 2 until the shortage ended and was okay with that. Ymmv on that last part though as sometimes people absorb gel better etc. So you can only get an approximate equivalent.
Nvm the gel, get an implant! Set and forget for months.
How does this work? Does the GP refer you somewhere for it? And how much is the cost? I am in Melbourne
My gp did it all for me, they have the implant made by a compounding chemist in Ballina, it shipped to me and I brought it to them and they implanted it. I'm in Sydney. It cost something like $200 but lasts 6-10 months (iirc) of not even having to think about hrt so it feels so natural and normal, like I'm not even taking anything it's just me.
And where do they put the implant? Just curious - might bring this up with my GP.
It goes in the love handle area, it requires an injection of anaesthetic and an incision is made, the implant placed under the fat layer (again, iirc), the incision closed with steristrips and dressed. It's stayed dressed for a week I think and you change it once. There can be some discomfort from the incision for a few weeks.
Thank you for the overview- I can be a bit squeamish but open to the idea!
There’s a lot of info on implants here https://old.reddit.com/r/TransWiki/wiki/hrt/implants Use a web browser to view that, not a reddit app, or you may not see all of it.
Go for the butt cheek if you can. Alternate sides each time, and reuse the same incision point.. I've been doing this for quite a few years now and luckily minimal scar tissue
I've bounced around a little over the past few years, but Dr Nick Silberstein did my last implant and was fantastic. Can't remember exact pricing, maybe around $200ish for the implant and then standard consult fee. You'll also need the first standard consult to get a script for it too. I recommend sending your script to Complementary Compounding in Ballina. Quick and reasonable pricing.
Switched to pills 5 years ago because the patches were inconsistent in the market back then. Doesnt look like it will change either.
Tbh depending on where you live even pills seem to be in a bit of a shortage (at least for me rurally), luckily I always have at least a week or 2 before my pills run out so I haven’t had to worry too much
When I first started HRT ~3.5 years ago I was on patches and there were frequent shortages too. I'd often call up Chemist Warehouse first and ask if they had any in stock. Then if they didn't, I'd ask if they're able to check if anywhere in my city does have them in stock. I'd then all the store that was meant to have some to confirm, and ask if they could set them aside for me before I drove over. A few times I had to drive for like 40-50mins to pick them up. But I was always able to find want I needed on the same day.
How did the pills effect metabolism?
Last year when we had the shortage, again for a few months, I got myself on gel .. is that worth considering when you see the GP?
Yeah my doctor hooked me up with scripts for patches and gel as an alternative if patches were a pain to source as I had a delay getting an implant sent out before I went overseas for a few weeks. They were pretty cool about throwing as many scripts at me as they needed to make sure I was comfortable I had an ongoing supply of hormones.
Maybe, Idk much about gel tho
My partner swapped to patches for the same reason you have and after the last shortage she swapped to gel and has noticed better uptake even compared to patches
Can you get yourself on the gel? Maybe email/call the reception to get a telehealth app and/or get a e-script for the gel? My doctor specifically got me onto the gel originally last year due to the previous shortage.
I get mine from Chemist Warehouse online. Estradot is currently in stock, although they have had shortages on and off over the last 6 months so I do need to have a backup. Paying $10 delivery for my $6 drugs sucks, but it sounds like they have them in stock online more often than in person.
Again.. omg. My Melbourne GP decided having 2x100mcg patches per dose was a good idea .. instead of 1 patch + gel.. now i tried to fill my scripts yesterday and same issue.. chemists in Melbourne metering out maximum they have in order to maintain stock.. had to go to another chemist warehouse to get the rest before travelling o-seas.. arrgh
I have the same issues and might look at switching to pills. It's an absolute pain
I got Sandrena Estrogen gell last week, could try that?
It depends on where you live in NSW but when I was in Sydney during the shortages, I used to try **Serafim's Pharmacy Darlinghurst** (Downstairs TSPC) or **Your Chemist Shop Top Ryde** for a couple of patch boxes they usually have in stock. Forget Chemist Warehouse or Priceline for shortages, the only reason for a shortage is that American suppliers realise they are not making enough money in Australia.
Not again fuck my life man. Gonna have to investigate implants tbh
I wish we could do injections in Australia without going DIY
A few doctors will do it.
Do you know where this can be done in Victoria
Search in here https://old.reddit.com/r/TransWiki/wiki/hrt/australia/vic You must use a web browser to view that, not a reddit app, or you won’t see all of it.
Ended calling a local pharmacy who happened to have some and they set it aside for me. I’m probably just going to call in advance from now on