update estradiol delivery method blog post

site/blog/estradiol-delivery-methods.md

@@ -1,30 +1,64 @@
 ---
-title: Estradiol Delivery Methods
-timestamp: 2023-05-28T16:00:00.00Z
-tags: [trans, hrt]
-desc: A comparison of the various ways I've taken estradiol since starting HRT.
-header_image_file: cat.jpeg # TODO: placeholder image
-header_image_alt: placeholder
+title: estradiol delivery methods
+timestamp: 2023-11-12T20:00:00.00Z
+tags: [trans, hrt, estradiol]
+desc: a comparison of the four forms of estradiol i've taken since starting hrt
+header_image_file: 2023/11/syringe.jpeg
+header_image_alt: A photograph of a syringe for instramuscular injection with needle still in its wrapper.
 draft: true
 ---
 
-I thought it might be useful to write out my experiences with the four methods of taking estradiol I've tried.
+i started estradiol injections a few months ago and felt it might be useful to write out my experiences with each of them for posterity
 
-- patches
-  - wouldn't consistently stay on me
-  - could feel the effects wearing off 3-4 days after application
-  - insurance sucks
-- sublingual pills
-  - worked alright, except:
-  - could feel them wearing off ~5-6 hours after taking a dose
-  - apparently hard to measure levels? had one test at ~200 mg/ml and another at 400+ mg/ml at same dosage
-- swallowed pills
-  - could not get ideal levels with a reasonable number of pills, but:
-  - couldn't actually feel them wearing off even at 12 hours between doses
-- injections
-  - holy shit these are great
-  - was kinda nervous the first few times I injected myself, but I got used to it
-  - cannot feel it wearing off between doses
-  - levels are actually good??
-  - insurance sucks pt. 2
-  - insurance sucks pt. 3
+## patches
+
+my endo started me on estradiol patches. these definitely work, but only if you put them in the right spots and also if they stay on
+
+i had trouble with both of those and found it pretty annoying
+
+aside from that, i could feel them starting to wear off 12-24 hours before it was time to replace the patches. definitely not ideal
+
+additionally, insurance sucks and regularly caused me to be a couple days late on replacing a patch because they wouldn't cover it in time
+
+## sublingual pills
+
+these are pretty neat. easiest and cheapest of the bunch
+
+unfortunately, i could feel _these_ wearing off too, at about 5-6 hours after a dose. apparently this isn't common, but it affected me sooo
+
+i've also had problems with getting accurate estradiol level measurements since it flucuates so much. definitely my preferred method if they worked better for me
+
+## swallowed pills
+
+before switching to injections my endo had me try out swallowing my estradiol pills instead of dissolving them. the results for me were that i couldn't feel them wearing off anymore, BUT i couldn't get my levels back up either. not an ideal solution
+
+## injections
+
+these are _great_
+
+i was super nervous before starting them but turns out it's actually not that hard to inject yourself if it's your only option
+
+cannot feel these wearing off at all between doses _and_ i get good estradiol levels
+
+my E levels are so consistently good now that i don't need a testosterone blocker which is _very_ nice
+
+however!
+
+## insurance _sucks_
+
+my insurance filled my first three-month prescription of estradiol valerate for around $120. this is absurd.
+
+then they failed to fill my prescription when i was out. when i called to ask for a fill, they told me they couldn't. doing the math from what they told me i found they expected me to around 16 and half doses out of a vial, which would be an extra 3-4 weeks over what the prescription from my endo actually said
+
+so instead i went out of pocket and through discount programs get my estradiol for cheaper than with insurance and (importantly) _on time_
+
+loooooove insurance.
+
+## conclusions
+
+- injections rock if you can get insurance to cover them
+- sublingual's good too and works great for most people but didn't for me
+- avoid swallowing them
+- patches are ehhh
+
+that is all.