I had posted here earlier this year about getting a script for estradiol patches. I'd started out with 1 mg patches 2X per week then reduced to .075mg 2 X per week. I ended up pausing the experiment after 37 days due to nipple tenderness along with back pain and muscle pain in my thighs in back that was hindering my mobility.
I'm thinking of restarting using .025 strength patches. But what I'm wondering if back and leg pain is a potential side effect of E2 or was that coincidental? I'm already in a lot of pain from arthritis and other issues and any more is unacceptable. At the same time, I have osteoporosis and would like to try to protect my bones with E2 rather than other options.
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NewPotatoCaboose
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I had a lot of arthritis pre-ADT. I've been on warfarin for 10 years and there are studies about what it does to knees and hips. It sure trashed my knees. And then ADT made it worse. So I get it from both warfarin and ADT.
Cardio issues should not be a problem with the E2 patch since it is transdermal as is the E2 gel that I have been using for about 5 years. DR. Richard J. Wassersug is the authority on tE2. Osteoporosis can definitely be a SE of LUPRON or ZOLADEX jabs since they eliminate estradiol by suppressing T. E2 is eliminated when T is suppressed. I have no arthritis or osteoporosis and I just turned 80.
Strong evidence that patches do not cause cardiac issues. Oral E2 goes through the digestive system and the liver. The liver reacts with a response that increases a clotting factor. (I am not a medical expert, so do not have the language/terminology, but that is the gist of what I read describing the process.)
It’s interesting that this E2 post appeared today. As I have been reviewing my notes of my last appt [2017] with Dr Myers [just before his retirement], focusing on his recommendations, if my then Xtandi mono therapy failed. At that time, his main approach would be to first use “hormone therapy” (assumed ADT) to regain control of the Pca but then switching to E2 patches beyond that. In his waiting room, many times, I saw patients when leaving, being given these patches with instructions. Apparently he had been using this approach successfully with relative few problems.
After his retirement I was transferred to Dr Drake, who received a number of Dr Myers patients. I then learned he had to deal with at least one such patient who developed blood clots [and/or other cardio issues] on this long term E2 patch therapy.
I am therefore interested in our large HU base and their experiences with these patches, especially cardio SEs. Guess need to put E2 risk against ADT risks of say, Lupron and firmagon.
I’ve been using E2 patches for almost two years with no cardio issues whatsoever. And I apply four 0.1mg patches twice a week! Btw, my mets and prostate have reduced in mass considerably. No longer using a catheter.
I use the oestradiol gel 17b. I purchase it online out of India. 25 tubes for 330.00 last me about a year. Much better than the patch. Less to deal with.
I think the responses here are coming from 2 different perspectives---those using E2 patches or gel in place of ADT and those using the patches as as adjunct to ADT to potentially improve bone health. I believe that NewPotatoCaboose (hell of a name) is in the second category, as am I. NPC, I started at 0.025 2x/wk, but my E2 barely moved; went to 0.050 2x/wk, and it moved a bit; went to 0.075 2x/wk, and E2 normalized, but I got lots of nipple tenderness just like you. Have now decreased to 0.050 2x/wk, per doctor's order, and nipple tenderness has significantly improved, do not know yet about the effect on E2 level.
I've been using 0.1mg patch 2x per week almost 3.5 years. I have had no cardio issues, though I would expect those issues more from lupron/Eligard than the e2. A year into this, before e2, I was struggling at work, wife said I was grumpy, and sleep was terrible, as were hot flashes. I learned on this forum that killing testosterone also killed estrogen. When I added back the e2 life got better at work, at home, with sleep, and no more drenching hot flashes. I have never associated any aches and pains with e2. I was ready to try large dose e2 as adt, but the doc who was going to help me died, then mets showed up in my spine. I've been holding steady for about a year and a half, so I may yet find a way to give big e2 a shot. Grateful wishes, Will
The nipple tenderness took me by surprise but only lasted a couple of weeks. I joke that I might want a training bra, but it's not much really, and some guys get the same with the usual adt's. I consider it a small price for the benefits.
I haven't checked in a good while. I think it was about 45 two years ago. One thing I also do, that I picked up from other posts, is take a nattokinase supplement daily. It is not to thin blood, but to dissolve fibrin and discourage clotting which can lead to dvt and cardio issues which is a potential problem with e2. At least that is my understanding, for better or worse.
If you are using estradiol patches to suppress your testosterone, the estradiol level is not an issue. If you are using estradiol patches to off set SE's such as hot flushes, bone loss etc. you should try to maintain your estradiol E2 level at a given range. Life Extension came out with a simple guideline:"We have recommended that ideal ranges for estradiol for most aging men are between 20 and 30 pg/mL of blood. Below 18 pg/mL increases osteoporosis risk, while levels greater than 32 pg/mL increase heart attack and stroke incidence." [2]
There are numerous post on the site that address the issue in much more detail.
So far, I have not found a Dr. that will prescribe me the E2 patches...not SOC.
Exrunner, where was that quote from? Life Extension, "We have recommended the ideal range..." if you have access to the entire document (via a link) please share it.
TallAllen rightly points out that there are no full-on clinical trials confirming that transdermal estrogen/estradiol (TDE) used as a monotherapy is as effective as Standard of Care (SoC) Androgen Deprivation Therapy (ADT). But there does seem to be plenty of anecdotal evidence and long-term users that have convinced me of three things and brought up an interesting question.
TDE does not have the blood clotting problems of orally administered estrogen therapy, due to the fact that TDE (or injections) bypasses the digestive system and liver.
TDE almost certainly has one side effect on most men. Breast enlargement and sometimes breast/nipple pain.
TDE has a track record of effectiveness at suppressing (NOT curing) prostate cancer. And this seems to be effective over the long term (unlike SOC ADT, to which prostate cancer often develops resistance).
The interesting question begged by my last sentence above is, "Can TDE be depended on in the long term as a life-long way of suppressing prostate cancer, allowing a man to permanently avoid radiation, chemotherapy, even surgery?"
I did run across one clinical trial study that asked the question if TDE can boost a man's immune system to fight the cancer. There was some evidence this could be the case, along with some other benefits. The study was never published and I contacted the lead researcher to find out why; the hoped-for changes in immune response was not evident. Too bad.
But the evidence is piling up, prompting me to inquire of my oncologist if I could get TDE instead of the Orgovyx being recommended. Orgovyx has side effects troubling to me as a long-term diabetic.
So, I posed another question, hoping to get some real-world (albeit anecdotal) reports of just how troubling is the gynecomastia (which seems to be a virtually certain side effect of TDE).
It is a long post. So, I will put it in another reply.
I am considering asking my oncologist for transdermal estrogn (TDE) therapy instead of Orgovyx to combat my prostate cancer. Since gynecomastia and breast pain are pretty much the only bad side effects from TDE and less troubling to me than metabolic disturbance,liver problems and effects on blood lipids/triclyceride.
But enlarged breasts from TDE are forever (without surgery afterwards or radiation beforehand). So, a concern.
My question is, "How large?"
I know from reading about male to female transgender persons that breast size one or two cup sizes smaller than one's first-order female relatives can be expected from the hormone therapy normally given to M-F transgenders. Of course, their desire would be to maximize the effect.
What is the experience of men being treated with estrogen (either as a monotherapy or adjunct to standard ADT) or men experiencing gynecomastia from standard ADT?
If you are comfortable with it, please report how your breast growth compares to your female relatives.
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The Use of Low Dose Estradiol to Ameliorate the Effects of ADT on Bone Mass Density
