Estrogen Patch ADT: My personal... - Advanced Prostate...

Advanced Prostate Cancer

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Estrogen Patch ADT

36 Replies

My personal experience was that during the 6 months I was on estrogen patches, my testosterone was undetectable for the most part, it did bounce up to the low 20s a couple of times but I was experimenting with the dose. When I got the dose tuned in my testosterone was undetectable.

Lupron reduces testosterone below 20 in about 50%-60% of men. If you are doing ADT then the goal is to reduce testosterone to zero. There are government studies that show that sub 20 is far superior to sub 50 (the supposed "castrate" level).

clinicaltrials.gov/ct2/show...

clinicaltrials.gov/ct2/show...

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36 Replies
Jac_J profile image
Jac_J

Great research

Im interested in side effects such as man boobies, muscle tone, fatigue etc because of E.

Are you still on Zytiga also?

Also, any insight into SARM's affecting testosterone, prostate size, benefits / side effects etc. I know thats another topic but as I am a little behind you (in terms of treatments etc) , I look to you as a source of valuable insights.

in reply to Jac_J

Thanks.The SARMs are supposedly less androgenic than testosterone.

If we assigned T = 100%

Then DHT = 500%

Most SARMs (e.g. ligandrol, ostarine) = 10%

RAD-140 SARM = 1.1%

SARMs decrease HDL. They dropped mine 60% in a month.

Deca is also of interest to me. It would be 32%. The reason that I am interested is that it has been studied for prostate therapies (it might work in a similar way as bicalutamide since it essentially blocks the ARs). And also there is a ton of real-world experience and research.

I'm taking Zytiga right now. I'll be stopping when I end the low T phase of my adaptive BAT.

When I did estrogen ADT, I didn't notice a lot of fatigue, but I had muscle loss (tone) and gyno (moobs). I had to wear my wife's sports bras :(

The moobs are probably the limiting factor for time. I stopped after 6 months so my moobs quickly went away (helped along by the high testosterone that I was doing). If you did it long enough the moobs become permanent. Maybe you could play around with SERMs to avoid the moobs. I tried tamoxifen for a bit but my MO was concerned about cardiac issues from tam so I quit.

Jac_J profile image
Jac_J in reply to

I have been taking mk2866 and mk677 for the last 3 weeks. No side effects. Possible benefits, but not enough time to evaluate conclusively.

I thought RAD-140 was more androgenic then mk-2866.

Does the information you posted above infer that it is safer for the prostate than mk-2866?

moreplatesmoredates.com/rad...

I may move to RAD-140 after mk2866 cycle is complete and I have a greater understanding of its effect on me.

Are you joking about the moobs?

This is a pic of 2 months after chemo end and 6 months ADT. Would like to get some size and definition back. So SARM's first, then maybe BAT next year if required and PSA declines enough for it not to be dangerous.

chemo body
in reply to Jac_J

On chemo/ADT you still have a body that 99.9% of men will never have!

Rad-140 is supposedly very anabolic and not very androgenic. en.wikipedia.org/wiki/Selec...

NIH did some studies.

I wish I was joking about the moobs. It was the truth. I'd look in the mirror at the prepubescent girl body with the boobies and cry. Fortunately, when I started injecting T I rebounded fast.

Jac_J profile image
Jac_J in reply to

Thanks for compliment.

Hopefully I will get fitter and a bit stronger soon. Im operating at about 75% imo. No body hair and reduction in eye lashes and eye brows

I have just been reading the link I sent you. Very interesting. Give it a read imo.

Any hair loss from RAD-140?

You commented in a previous post that the RAD-140 was very powerful (or similar). What do you mean by that? Please elaborate (briefly) on your experience.

Also do you plan to do Post Cycle Therapy (PCT)? This is (I think) primarily to restore normal endocrine function (increase T back to normal) and Testosterone/Estrogen ratio. Not necessary if you want to be castrate, do you think?

The interesting thing about SARM's is they suppress T production. Exactly what the Doctor ordered. The Oncologist that is. To what level it suppresses T is the question. So the potential benefit of SARM's (RAD-140 in particular) is that they give the benefits of T with T suppression and potential reduction in prostate size. To good to be true?

in reply to Jac_J

I didn't have any hair loss. I don't want to do a PCT for exactly the reason you mention. I want to be castrate. I inject T. Or not. So the endogenous T just gets in the way. It seems drastic but I've considered an orchiectomy. I control my T so what does an orchiectomy do for someone my age other than making things easier?

RAD-140 is a powerful anabolic. I gave some to a friend of mine and he's shocked at how fast he is gaining.

RAD seems potent but I've been messing with Deca. The gains are nothing short of amazing! 11.7 lbs lean in the last 31 days. And that goes along with fat loss of 2.06%. I assume a lot of that is normal fluctuation but if even half is real, that's simply insane. And it doesn't appear to be interfering with the low T phase of BAT. I've been low T for almost 3 weeks now and the gains are getting intense. I told my wife tonight that this is ADT on steroids. I didn't even realize what I said. :)

I'm not sure now how to proceed. It would be beneficial if I went on estrogen ADT with an AR/T drug (e.g. Zytiga, Xtandi, or even bicalutamide). I could get my T to zero and then play with Deca. I'd see any bump in PSA. Be great info and then I could start up BAT again.

I'll read the link thoroughly. I read through it when I was deciding on the SARMs but now I have the benefit of knowing a small bit about the subject.

Jac_J profile image
Jac_J in reply to

Fantastic results!

I may have to try RAD-140 after I give MK-2866 a 2 month trial.

I saw my Urologist yesterday and he freely admits that people like you or me (younger and fit) are not represented well in any research and therefore the results of treatments may differ from expected. Experimentation is the key in finding what works for you. As you are proving.

in reply to Jac_J

My MO just shakes her head and smiles when I tell her about something I'm doing. She's said "you're doing great, keep doing what you're doing because it's working", "we don't need to meet other than to chat because there is nothing to meet about".

She tried to stop me from doing estrogen ADT but that worked and she couldn't argue with my lab tests (I purposely did not say anything even remotely like "I told you so". That would have been stupid and added no value. I respect her immensely and never want her to pull her punches.

We need to be smart and figure out what works for us. Our goals are different than most people's. Not many of us care about bodybuilder-type goals. That is a huge gap for some of us and I know of a couple of guys who are ready to give up the standard ADT and just live their life out.

j-o-h-n profile image
j-o-h-n in reply to Jac_J

Hey!!! That's me....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 12/09/2021 1:49 PM EST

noahware profile image
noahware

My experience with tE2 was not so good. I kept upping the number of recommended patches (1.5x, 2x, 2.5x) over a few months, with T hanging in the mid-100s. T finally dropped only to about 60 at its lowest, as PSA and ALP climbed.

After this 12-week attempt, four weeks on degarelix and T was down to 4. Hot flashes galore, but nice drops of PSA and ALP.

I still think part of the problem was the generic brand (Dotti) that I used. If you look at the dozens of online reviews by women using this brand, who were switched from another brand, they are almost universally highly negative.

It is also possible that like some small percentage of men in the PATCH trial (as with some men on Lupron) this method simply does not work for me to drop T to sufficiently low levels. Reasons?

in reply to noahware

Perhaps as you pointed out, Dotti. Also, what is the 2.5x? 2.5 mg/day in a weekly patch?

I had to use 0.3 to 0.4 mg/day of Climara to drop my T to zero.

noahware profile image
noahware in reply to

The "1.5x, 2x, 2.5x" refers to number of patches changed twice weekly: starting with four (per PATCH), then six, then eight, then ten.

In the PATCH trial, castration rates at 3 months were 93% among patients assigned LHRHa and 93% among those allocated tE2.

I appear to be among the unlucky 7%.

But note: Dotti is a 2x weekly patch, where PATCH protocols use a 1x weekly patch... but changed 2x weekly! Climara is such a patch, prescribed as 1x per week, correct?

[BTW, many of the women giving bad reviews to Dotti had formerly been on Climara!]

in reply to noahware

What was the dose of estrogen in each Dotti patch? I used 3-4 of the strongest dose Climara patches each week. Climara is a weekly patch.

Odd that they changed the patch out twice a week. According to the manufacturer the Climara weekly patch delivers a fairly constant dose of estrogen for 7 days. On the 8th day it drops off quite a bit.

My total dose was 0.3-0.4 mg/day.

Climara vs time
noahware profile image
noahware in reply to

Same dose as your Climara, I believe. These are 0.1 mg/day, changed 2x weekly, four patches per cycle. So first month, the theoretical dosing of my total of 32 patches should have been 0.4 mg/day. T was at 180, so we upped the dose 1.5x.

Second month of my total of 48 patches should have been dosing me at 0.6 mg/day. And after THAT month, T was .... still only about 180! (E2 at 190 pg/mL.) Clearly I was getting E2 into my system, but was there something about the delivery system that was failing me, or was it just that my body was failing to respond to the delivery of E2?

Because my first scrip had been screwed up I had some extra patches, so the third month I took it upon myself to do 8 patches 2x a week (doubling the original dose) and even went to ten.., and at the end of this, T only fell to 60. E2 was tested at a final high of 487 pg/mL, so there was no doubt the patches WERE delivering E2.

Theories?

in reply to noahware

I don't know but I'm going to hazard a guess that your cancer was perhaps making testosterone. That occurs in all of us to some degree. Maybe Zytiga would have helped? Blocks CYP17 enzyme.

noahware profile image
noahware in reply to

Or else adrenal production is high? I had pretty high baseline T.

On Zytiga now... it is doing the trick for sure!

in reply to noahware

Possibly. If so, Zytiga blocks that production also.

sciencedirect.com/topics/me...

in reply to noahware

I stumbled across this tonight:ncbi.nlm.nih.gov/pmc/articl...

"2. Androgen receptor amplification

AR gene amplification was found in 30% to 50% of CRPC patients, resulting in the overexpression of AR [26,27]. Even under androgen deprivation therapy, low levels of androgen still exist. AR overexpression enables prostate cancer to progress to castration levels of androgen. Prostate cancer cells with AR amplification can survive under androgen deprivation therapy, progressing to CRPC. AR amplification was more common in patients resistant to enzalutamide than to abiraterone [20]."

100% of us eventually progress to CRPC. If you have amplification, probably need to figure out a way to deal with it if you're doing ADT. I'm thinking perhaps ADT and Zytiga. (ADT could be estrogen ADT)

in reply to noahware

Adrenals make significant amounts: medscape.com/answers/273153...

noahware profile image
noahware in reply to

Thanks... that link prompted a search, and this popped up, which you might find interesting (it seems to imply men with higher adrenal androgens get a better PSA rsponse with abi, after becoming CR):ar.iiarjournals.org/content...

in reply to noahware

Great find. Thanks. It does make sense to me that higher androgens pre-treatment might be associated with better success. Probably no way to separate those generated by adrenals vs. testes. Or is there... Maybe androgen level with straight ADT without abiraterone - androgen level via straight ADT/abi.

Anyway I'm finding a number of studies. Here is one: clincancerres.aacrjournals....

in reply to noahware

Apparently the government thinks that there might be an association. Look at this study:

clinicaltrials.gov/ct2/show...

My DHEA levels used to be high but I haven't had them measured in years.

lancer82801 profile image
lancer82801 in reply to

I have been using Dotti 0.1mg patches twice weekly for a year or so. Except for one month when I received the mylar 0.1mg patch. This patch did not hold my testoserone down or my estrogen up. i also tried decreasing the dotti patch to one patch twice weekly and saw my PSA start to increase. Went back to the Dotti twice weekly and all is well, at least the last two months Testosterone has been 20 and PSA dropped from0.26 to 0.04 Estrogen is now 364 I also track D-Dimer and alkphos. both have been in normal range. As with all of us, more to the story but thought I would share my experience with the Dotti patch

A lady friend says she cannot use the Dotti patch because it causes her to itch

I have not had any reaction to the Dotti patches and had at least one on me for the past year.

Good to hear of others trying this protocol. I have certainly had less obnoxious side effects from the Estradiol than I did from Lupron.

Best to all

Lance

noahware profile image
noahware in reply to lancer82801

How many Dotti patches are you putting on 2x weekly? Four?

lancer82801 profile image
lancer82801 in reply to noahware

I am putting 2 0.1mg patches on twice weekly

noahware profile image
noahware in reply to lancer82801

Wow... and that's enough to keep T around 20. No such luck for me!

How long did it take for you to reach a castrate state with Dotti, and did you start with a higher induction dose and then step it down, per PATCH protocols?

lancer82801 profile image
lancer82801 in reply to noahware

Yes when i started it was double 4 patches changed twice weekly it took 2 months to take my PSA from 0.40 to 0.04 I was just coming off of Casodex which had dropped the PSA from 1.29 to 0.06 in about 6weeks. Then I started the Estradiol (Dotti) when PSA had bounced back to 0.40. The 4 patches took the testosterone to 7

Did you have your estrogen checked when you were using the patches? That is the only way I could think of to tell whether the patch was delivering or not.

i just (11/18/21 ) received 800mg Testosterone cypionate injection

will see

if you would like we could continue this privately rather that take up space on specific protocols

I would be interested in finding how you are doing and what you are doing as well

must be a way to get in contact privately

Lance

noahware profile image
noahware in reply to lancer82801

Sure, I'll send you a PM through the "chat" function.

in reply to lancer82801

Can you add me to the chat?

EdBar profile image
EdBar

Interesting post since about a month ago you posted that you were doing a form of BAT using SARMSa form of legal or illegal steroid (depending who you talk to) which is the substance body builders use.

Ed

in reply to EdBar

I'm doing BAT. 3 years ago I did estrogen ADT and I'm using estrogen patches during the low T phase of BAT.

BAT is going excellent so far. I'm reducing the SARM doses since they appear to drop my HDLs considerably. Deca reduces them but not nearly as much and is very effective for me. I'm zero T and in the last 34 days, I've put on 11.5 lbs of lean weight and lost 2.04% bodyfat. Those numbers are ridiculous but even if I retain just a quarter of them it's quite the body recomposition. And, yes, all of my shirts are too tight now. This is the downside since you need to buy new clothes and people know that you're doing something... Upside is that nobody is going to think that you have cancer.

in reply to EdBar

This is the BAT to date. I might pull the end of the ADT phase in. My PSA already went to zero but it might be good to extend that a bit. I don't know.

ABAT
in reply to EdBar

I think that the illegal/legal confusion stems from the fact that it is legal for research purposes. It is illegal for off-the-shelf human use.

By the way, I always thought that Deca was illegal but it isn't. I have a prescription for it. The side effects and efficacy of Deca appear superior to SARMs but I am not sure yet about the androgenic effects.

Scout4answers profile image
Scout4answers

Great discussion guys!How did you find MD.s willing to work with you?

Is there a book or relevant articles that I can read to get up to speed on adaptive BAT?

I have read the story about Gatenby and found it very interesting.

in reply to Scout4answers

Adaptive BAT is something that I'm working on. When I get it fleshed out a little I'm going to write a free manual about it (takes some time to verify that things are going as planned).

in reply to Scout4answers

To get the scripts I found a men's clinic and got to know their doctors. Then I provided studies and research. After a month or two they trusted me to know what I was doing (or maybe not know, but so stupid that I wouldn't know how to sue :)

Men's clinics usually specialize in hormone replacement so they are halfway there already.

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A small trial but if ADT fails perhaps something to look into.

https://clinicaltrials.gov/ct2/show/results/NCT00887458?term=Itraconazole&cond=Prostate+Cancer&draw=

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