Patch + Sublingual E2 Combination
Transdermal patches as base estrogen delivery with sublingual estradiol tablets supplementing to reach T-suppression levels. Patches provide the lowest VTE risk of all estradiol routes but may not achieve high enough levels for monotherapy T-suppression. A middle-ground between safety (transdermal) and efficacy (injectable).
Duration
—
Steps
4
Total Weeks
6
Route
transdermal
Protocols
3
Source
community practice
Protocol Timeline
| Step | Weeks | Dose | Compound | Note |
|---|---|---|---|---|
| 1 | 6 | 100 mcg/day | Estradiol Transdermal Patch (Twice-Weekly) | 1 x 100 mcg/day patch. Vivelle-Dot: change 2x/week. Climara: change weekly. Check labs at 6 weeks. |
| 2 | 0 | 200 mcg/day | Estradiol Transdermal Patch (Twice-Weekly) | 2-4 patches (200-400 mcg/day) needed for feminizing levels. Lower VTE risk than oral. |
| 1 | 0 | 1 mg | Estradiol Oral | 1-2 mg sublingual 2-3x/day. ~25% bioavailability. Sharp peaks — split dosing smooths levels. |
| 1 | 0 | 100 mg | Progesterone (Oral) | 100-200 mg at bedtime. Sedating — allopregnanolone metabolite. Added at Tanner stage 3-4 for breast maturation. |
Rationale
Typically 2–4 patches (100mcg each) changed twice weekly as base, supplemented with 1–2mg sublingual estradiol daily if levels insufficient. Monitor at trough (before patch change day). Sources: r/TransDIY, diyhrt.wiki.
Compounds Used
Related Tools
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