Sublingual E2 + Spironolactone
Sublingual estradiol tablets dissolved under the tongue — bypasses first-pass hepatic metabolism, producing sharp peaks followed by rapid decline. Lower VTE risk than oral. Requires 3–4 daily doses for stable levels. Popular in the US/Canada community.
Duration
—
Steps
4
Total Weeks
4
Route
Sublingual
Protocols
3
Source
community practice
Protocol Timeline
| Step | Weeks | Dose | Compound | Note |
|---|---|---|---|---|
| 1 | 0 | 1 mg | Estradiol Oral | 1-2 mg sublingual 2-3x/day. ~25% bioavailability. Sharp peaks — split dosing smooths levels. |
| 1 | 4 | 50 mg | Spironolactone | 50 mg 2x/day (100 mg/day total). Monitor potassium at 4 weeks. |
| 2 | 0 | 100 mg | Spironolactone | 100 mg 2x/day (200 mg/day total). Standard therapeutic dose. Take with food. |
| 1 | 0 | 100 mg | Progesterone (Oral) | 100-200 mg at bedtime. Sedating — allopregnanolone metabolite. Added at Tanner stage 3-4 for breast maturation. |
Rationale
Blood draw timing critical: draw at trough (longest interval between doses) for consistent interpretation. Peak E2 after sublingual can be very high — trough level is the meaningful number. Some users combine with patches for a stable base.
Compounds Used
Related Tools
Track this regimen in Doseline
Adopt Sublingual E2 + Spironolactone as a template, set reminders for every step, and log doses as you go. 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.