this post was submitted on 16 Feb 2025
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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.

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[–] alyqz@lemmy.sdf.org 11 points 6 days ago (1 children)

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.

[–] major_jellyfish@lemmy.ca 6 points 6 days ago (1 children)

Thanks for explaining it. That makes good sense!

[–] dandelion@lemmy.blahaj.zone 1 points 5 days ago

+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?