this post was submitted on 29 Jan 2026
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Oral should be the last thing considered on that list right after sublingual.
A better way to determine what HRT to take is this linear list:
Injections can be scary but they are very convenient. With valerate you take injections every five days, with enanthate you take injections every 7 days. Undecylate can be taken once a month.
Most routes require that you take blockers which can come with their own side effects and risks. Injections and implants do not need this, and some can even do HRT without blockers on patches, gel, or spray, but this depends on the individual. I therefore recommend injections as the safer and most comfortable option.
If you do patches I recommend building a stockpile of reserve HRT in case patches are hard to get for a while. This has happened many times and will happen again. You should ideally have a little stockpile for every route, but it's extra smart on patches.
Gel/spray is a great option too, but you do need to apply it once or even multiple times per day. It can be a bit of a hassle.
Most pills can be taken sublingually but not all. If they can be taken sublingually then there's really no reason not to. You might need to take less pills this way too meaning pills become cheaper in practice, or that you can build a stockpile easily if they are prescribed.
All routes are equally effective in terms of results.
Also visible scarring from needles is not much of a thing.
Scarring from implants/pellets can happen, though, but that's very minor.
Yep, that's true
Another question, I realise: how do you know when a method isn't "effective"? That might probably vary a lot by person, but I'm interested for others.
For some like patches it's pretty clear, the skin having an allergic or sensitive reaction. But what with the others?
Low levels on blood tests compared to what is expected. Now gel and spray kinda give very varied results on blood tests, but if you get consistently low levels then likely that means that transdermal might not be that effective for you
honestly just wish it were possible to live measure your estradiol levels, that'd be nice
also just read on the spray for my specific method on that transfem science site, and it says it tends to yield lower estrogen levels, but research is insufficent for three doses a day (which i do).
according to this site, symptoms of low estrogen seem to be problems with sleeping, dry skin, hot flashes.
for high, it'd be anxiety, more tiredness, depression, headache.
seeing as i seem to lack either low and high E symptoms, though i sometimes have headaches and dry skin, i've no idea what i then have. i dont do progs yet, and have been doing anti-androgens for ten months now (started hrt that long ago too).
ironically (a bit nsfw), but ive noticed my libido rising rapidly whenever i take anti-androgens, only for it to subside after a week. So perhaps the body tries to produce more T at first, as a reaction?
Spray has low half life so levels tend to fall quickly. If you're doing three spritzes a day you're avoiding the half life issue at least. Do you have access to blood tests? That's the best way of measuring.
There are these little home test kits you can get so you could do multiple over some stretch of time to see. They're less precise than a proper blood test, but if blood tests are hard to get then this is an option to consider.
Make sure you're measuring at the point when your E levels would be at their lowest (this will be right before you take your next dose), and don't get any spray/gel on the arm or hand you will be taking the test from. It can impact the results from the test.
Edit: I would love a little pressure dial but for estradiol on my arm or my thigh or something :P