Estradiol Valerate
Delestrogen · Progynon Depot
Half-life
3.5 days
Time to Peak
2.5 days
Steady State
~18 days
Bioavailability
100%
Dose Range
2–10 mg
Frequency
every 3 days
Overview
Estradiol Valerate is an injectable estrogen ester commonly used in feminizing hormone therapy. It provides stable estradiol levels with a half-life of about 3.5 days, typically dosed every 5-7 days.
Mechanism of Action
Prodrug: valerate ester is hydrolyzed in vivo, releasing active 17β-estradiol. Binds estrogen receptors (ERα and ERβ) to produce feminizing effects.
Dosing Information
| Route | Dose Range | Half-life | Tmax | Frequency |
|---|---|---|---|---|
| Intramuscular (IM) | 2–10 mg | 3.5 days | 2.5 days | every 3 days, every 5 days, Weekly |
| Subcutaneous (SubQ) | 2–10 mg | 5 days | 3.5 days | every 5 days, Weekly |
Common Side Effects
- · Breast tenderness and development
- · Mood changes
- · Headache
- · Nausea
- · Injection site pain
- · Weight redistribution
- · Decreased libido (variable)
Monitoring Recommendations
Estradiol and testosterone at trough every 3 months for first year, then every 6-12 months. Prolactin at baseline and annually. Lipid panel and liver enzymes annually. Potassium if on spironolactone.
Storage & Handling
Room Temperature
Store at 20-25°C.
General
Protect from light. Do not freeze.
Community Notes
IM injection in the thigh or glute is standard. Many trans women prefer every-5-day dosing to minimize end-of-cycle lows. Drawing labs at trough (just before next injection) gives the most useful reference point. SubQ is off-label but increasingly used with good results.
Used in Regimens
6 regimensEV + Bicalutamide Pathway
Estradiol valerate with bicalutamide non-steroidal anti-androgen. Bicalutamide blocks androgen receptors without affecting LH/FSH or testosterone production — testosterone remains high but its effects are blocked. Liver monitoring required. Growing in popularity as a spironolactone and CPA alternative.
EV injection as primary oestrogen.
EV + CPA (European Pathway)
Estradiol valerate injections with low-dose cyproterone acetate (CPA) anti-androgen. Standard in Germany, Netherlands, and much of Europe. CPA at low dose (6.25–12.5mg/day alternate days) provides potent androgen suppression with significantly lower meningioma risk than legacy high doses.
EV injection as primary oestrogen.
EV Injection Monotherapy — DIY Community
Estradiol Valerate injection monotherapy per community consensus: 4–7mg every 5 days (IM) targeting trough E2 >200 pg/mL to suppress testosterone without an anti-androgen. The community-driven approach to transfeminine HRT — higher estradiol targets than clinical guidelines. Every-5-day schedule is community standard; clinical biweekly schedule causes unacceptable level swings.
4–7mg IM every 5 days. Trough target: >200 pg/mL. Adjust based on trough bloods.
EV Monotherapy (High-Dose Clinical)
High-dose estradiol valerate monotherapy targeting oestradiol levels high enough to suppress testosterone without any anti-androgen. Clinical version — biweekly schedule as prescribed. See community regimen C4 for DIY every-5-day variant.
EV monotherapy high dose targeting trough E2 >200 pg/mL.
Transfeminine HRT — Classic Stack
Estradiol valerate injections with spironolactone anti-androgen and progesterone added after 3 months once oestradiol levels are stable. The most common transfeminine HRT regimen globally.
Transfeminine HRT — Powers Method
Dr Will Powers' EV monotherapy pathway. High-dose injectable oestradiol to suppress testosterone without anti-androgens, progesterone added rectally for bioavailability. Evidence-based and widely used in the DIY community.
Data Sources
- Peer-reviewed Oriowo et al. — Serum estradiol-17β concentrations following IM injection of estradiol valerate in oil
- meta analysis Transfeminine Science — Informal Meta-Analysis of Estradiol Curves with Injectable Estradiol Preparations
- FDA Label Delestrogen (estradiol valerate) — FDA Prescribing Information
- Community estrannaise.js — Open-source estradiol PK simulator (MIT licensed)
Related Tools
Track Estradiol Valerate with Doseline
Reminders, medication level charts, injection site rotation, and protocol tracking — all free, all private.
Join the waitlistDoseline provides informational tools only. It is not a medical device and does not provide medical advice. Always consult a qualified healthcare provider.