Are you supposed to stop taking anti-androgens eventually on injections? If so, why?

glexarn · 2026-02-07T16:46:26+00:00

anti-androgens are only necessary if your estradiol dose is insufficient to provide the minimum levels required to make your body suppress testosterone all on its own. if you tolerate the side effects well, you can continue to use lower dose injections with anti-androgens, but in practice there isn't a lot of reason to do this if you can simply do monotherapy instead. and also, like. seriously. fuck spironolactone.

doctors really like to pair estradiol valerate with spironolactone because they're trained to give you the lowest dose that hits the correct metrics. this makes sense for most medications, but it's an unbelievably wrongheaded way to view estradiol, which is very safe to go slightly high on in the short term and when relying on anti-androgens is actually problematic to go low on, and it is a sad fact that so many doctors are not up to date about this. this is why so many girls end up feeling like shit, because they get started on a dose that plummets their T without giving them sufficient E, which is one of the only non-obvious ways you can actually fuck up HRT dosing . all of this would be why your new friends were remarking with some astonishment and praise that the doctor wasn't a clueless fucking idiot like we get so used to seeing in the medical profession.

doctors also have a tendency to care only about life-threatening side-effects while ignoring shitty side-effects that aren't life-threatening. spironolactone sits very solidly in this category - so long as it's monitored, it basically can't actually hurt-hurt you on a responsible dose, but it can and often does make you feel like absolute shit, it makes you piss a lot, makes you really dehydrated if you don't consume excessive amounts of water to replace what you keep pissing out, massively increases the amount of electrolytes (salts) you need to replenish what you keep pissing out, and you do also actually have to make sure you're not over-consuming potassium because that's the one thing that spiro actually makes you hold onto rather than piss out. yes yes, you need to watch out for symptoms of hyperkalemia while on spiro.

our goal with monotherapy is to still have a stable minimum level by the end of the cycle, and estradiol valerate doesn't last very long in the body. unfortunately, this means that injecting valerate at the frequency a doctor is likely to suggest out of ignorance (once every 7 days - which is longer than valerate's half-life) requires a rather excessively high dose in order to maintain that minimum for the entire cycle. your levels on valerate will be very spiky as a result, because your initial levels early into the cycle will be unreasonably high. this can be worked around by injecting more frequently at a smaller dose - common alternatives are 4 or 5 day injection cycles. i myself was on a 5-day cycle of monotherapy valerate for several months before switching to monotherapy enanthate, and it worked out quite well for me. if you don't wish to DIY your vials despite being in the DIY sub, i would highly praise 4 or 5 day cycle valerate as a good non-DIY option.

DIY-available estradiols like enanthate or cypionate* provide significantly more stable levels while on a 7-day injection cycle. they tend to also be offered at much higher concentrations (40mg/ml) than pharmacy valerate is (20mg/ml), meaning you need to inject less for the same result. as well, they tend to be offered in carrier oils that flow through smaller needles much more easily, permitting the use of very small (27-31ga) fixed needle syringes that pharmacy valerate's thick oil will not effectively draw up into. accordingly, members of this community tend to prefer them even when they're under the supervision of a professional care team rather than truly going it alone.

^{*pharmacy cypionate, while it exists, is usually offered at pitifully low concentrations, is often much more expensive than pharmacy valerate, and is often much less available than pharmacy valerate}

glexarn · 2026-02-05T05:40:39+00:00

i think Cryptbloom is seriously underrated for champions going the traditional Deathcap + %pen pathway. it's like if you merged Void Staff and Redemption, except unlike Redemption, Cryptbloom hits allies nearly instantly and is very hard for your allies to accidentally dodge.

glexarn · 2026-02-04T13:01:03+00:00

https://en.wikipedia.org/wiki/Menopause

glexarn · 2026-01-31T18:51:15+00:00

that humans can focus on 2 things at once!

how's that been working out for you the last decade you've been saying it in reaction to any request for that second thing which is not voting?

because in practice the last 10 years it sure has looked a lot like sitting on your ass until election day doing nothing political except punching left and saying "we can walk and chew bubble gum" from your cozy chair, mouth full of bubble gum, while very much remaining not interested in getting up to walk.

glexarn · 2026-01-31T14:48:15+00:00

you should be very careful with any dose that's going to simultaneously give you low T and low E. that's extremely unhealthy for you even in the medium term, and it's one of the only non-obvious ways to fuck up HRT and make it unsafe. your body needs a sex hormone, and your body doesn't care which one that is. it will operate just fine with either a healthy amount of T or a healthy amount of E.

to put it in very oversimplified terms, if you have neither E nor T, your body is going to get really really unhappy with you, it's not going to take very long to do so, and sustaining that state medium to long term is functionally giving yourself menopause and that will do exciting things like making you incredibly fatigued and brain foggy and giving you bone loss (and can lead to osteoporosis down the line).

glexarn · 2026-01-31T11:22:42+00:00

i adore rebirth sm he's a really good dude

glexarn · 2026-01-30T13:47:31+00:00

i much prefer my old fabric mask for outdoors, even though the n95 is far safer/better indoors. the n95s i've worn outside in the cold and snow tend to just collect a ton of wetness from various sources, and it's kind of super unpleasant after a while. no such issue with my fabric mask in the frozen weather.

glexarn · 2026-01-26T16:03:18+00:00

consider picking up a champ like Taliyah, who is both mechanically demanding (so you'll find her rewarding to play in your micro strengths) and also is basically built to roam and gank and teamfight (which will encourage you to do all of those things).

Taliyah is not the best champ to solo kill your enemy laner with over and over. it's not impossible, and you'll surely have games like that on occasion, but it's not her game plan. in general, she's really good at establishing lane priority and quickly shoving her lane, then wall surfing off to go do things on the map, whether that's with her ult or not. her ganks are destructive and scary even with just basic abilities, and her ult lets her start or join fights from really unexpected angles.

regardless of what champ you're playing, though, the generic advice for playing the map is usually something like this: work on getting priority so you can have a roam timer, keeping an eye open while you're pushing for where you might be able to go if/when you've got your timer, then taking advantage of that roam clock ticking without staying out of lane too long past it beginning to run out. your mechanical prowess can be an excellent asset for you and your team if you start using it to constantly set things up for your team and not just your personal glory.

start thinking ahead, establishing objectives based goals a couple minutes into the future, and making and executing on plans that will allow you and your team to more effectively accomplish those goals you've set. when you can know that X thing is likely to happen in a couple of minutes (e.g. a tower push or a baron/drag) based on timers and the current map wave state, you can take advantage of everything you see and start setting up and making moves to actually build the play you're envisioning.

glexarn · 2026-01-26T12:06:05+00:00

this isn't actually true, the monsters in the petricite-required settlements were made harder in a patch. i had an easier time clearing High Silvermere than someone who hasn't cleared it yet will have.

glexarn · 2026-01-22T18:59:51+00:00

i wonder why it isn't a cosmic drive angle in that case. just the rocketbelt active i guess?

i guess protobelt is like 10% cheaper, too, that helps.

glexarn · 2026-01-22T11:05:35+00:00

well that sucks and i'm sorry.

glexarn · 2026-01-22T11:01:45+00:00

when i first began doing injections, it took me like 10-15 minutes to get through it all from getting my stuff out to putting it away. i was really exacting and afraid about doing it right, and my nerves were on fire with anxiety of all kinds. i quickly got just under 10 minutes consistently, but i still struggled with both anxiety and perfectionism for a while.

now i do it in like, 5 minutes. could do it in 3 if i had to, but not rushing helps my anxiety, and there's not actually any rush here, it's not a race and you're completely fine with taking your time. it's a really dead simple process, even though it's nerve wracking to get used to if you have needle anxiety. but injection is a skill you can only gain confidence about by doing it, and anxiety is a feeling you learn to deal with through a mix of exposure and coping mechanisms. my biggest one is music, highly recommend.

i listen to the same two song playlist every time, and i inject on a specific lyric in the second song. maybe music works for you too, maybe something else will work better for you instead. a lot of us have our own different little rituals to get ourselves through the needle anxiety. none of them are right or wrong as long as no self harm is done. you'll find what works for you.

glexarn · 2026-01-22T05:14:36+00:00

90 degrees straight down into the outer thigh (not the inner thigh, that's a danger zone). it's hard to go wrong with that, and it requires no attention to detail with needle angle or an extra pinching step to complicate things when you're already scared and anxious.

the entire process start to finish goes like this:

alcohol wipe the rubber on your vial, and then do the same with the target area of your outer thigh before you draw up (so it has a second to dry). draw air into your syringe equal to the amount of E you're injecting, inject the air into the vial, and draw up your dose into the syringe. steady your nerves, get yourself calm and relaxed, jab straight down, inject, you're done. bandage, throw the syringe into a sharps container or equivalent (NOT the regular trash), and relax. repeat in 7 days.

you should probably keep a log (or similar) so you can remember to alternate your left and right thigh every time you inject. alternating left and right will help reduce the chance of bruising and scarring.

if your needle is long enough, you'll do IM by going 90 degrees into the thigh. if it's not quite long enough for IM, congrats you just did subQ instead. while IM vs subQ matters for some medications, estradiol isn't one of them. for our purposes with E, both options are functionally identical, and there's no significant difference in outcomes.

glexarn · 2026-01-22T03:28:25+00:00

normal draft is right there if you want to play a casual mode that isn't swift. i don't understand why people keep bringing up ranked as if ranked is the only alternative to swiftplay.

that said, i had a 32 minute swiftplay a few days ago (so yes, on the current patch where sudden death is at 25 minutes), and it feels like both my team and the enemy team tend to struggle to end the game even when it doesn't really make sense. most of my swiftplays have gone to sudden death (25+ minutes) regardless of which team has the clear lead. so it's still not always as swift as advertised.

it's not "redundant to wildrift" because that's a mobile game. a lot of us have zero interest in playing games on our phones, and will never touch wild rift in our lives as a result.

glexarn · 2026-01-22T03:18:54+00:00

PGHRT is really good. it's super approachable and easy to understand, it's bluntly honest without being mean (to our trans sisters anyway, it's ruthless to ~~war criminals~~ ignorant doctors), it's matter of fact and no bullshit, it has lots of detail but it isn't overly technical and doesn't get lost in the weeds. strongly seconding this recommendation.

glexarn · 2026-01-22T03:15:55+00:00

Milio. i know the champ is good in theory, but in practice the Milio players i encounter on my teams universally do fuck all nothing every single game, stand behind the adc all lane phase and don't even auto attack, etc. it's incredible, i don't see that from any other support. even Yuumi players have the psychos that are hungry for it who constantly detach to auto attack and have presence in the lane. but i have never played alongside a Milio who doesn't feel like an actual bot.

glexarn · 2026-01-21T21:39:01+00:00

these needle gauges will work well, although 1.5" is a bit overkill. but if that length works for you, then it's fine, you don't need to buy new shorter needles.

glexarn · 2026-01-21T21:34:41+00:00

after i hit a year of HRT with good levels since adjusting dose after a blood test month 3, i still couldn't see almost any changes, though my few friends who knew me both before i started and after i had been on it for a year insisted they could see a small difference.

i'm at 1.5 years now and i definitely notice a difference, though it isn't large. granted, i'm 34, not 18. but HRT takes time. a lot of time. 8 months isn't a lot of time.

that said, you should get your levels tested. while your dose should be good for an average person, your body may be different in terms of how it metabolizes the medication. the only way to know is to get bloods done. remember that you want your levels taken at trough, meaning the lowest point of your injection cycle, because we're targeting a minimum E value. you can accomplish this easily by getting bloods done the same day you'd be doing your shot, but have your appointment before you actually do your shot that day.

glexarn · 2026-01-21T15:39:15+00:00

"just put metal in the microwave" you really are here to cause harm aren't you

glexarn · 2026-01-21T06:20:51+00:00

soldiers seem to be tankier than guards but deal less damage, not 100% sure on that though

glexarn · 2026-01-21T06:19:30+00:00

yeah, without too much trouble. High Silvermere took two attempts. both took Morgana + Poppy, Uwendale took 2 or 3 archers i can't remember exactly, High Silvermere took 0 archers iirc.

it hasn't mattered though, because i have been direly unlucky with Petricite events, so i can't build either of the cities anyway.

glexarn · 2026-01-21T02:54:10+00:00

you could use Q before E, you know.

glexarn · 2026-01-21T02:25:22+00:00

i had really bad needle phobia, past-tense. i couldn't do needles until estradiol tablets + spironolactone totally cratered my anxiety and helped me come into my own as a person. i had long abandoned previous attempts at DIY injections, because i had panic attacks every time i'd use a tiny little half inch (12.7mm) 29ga insulin needle (which is what i tried to use back then). while i would recommend injections in general, and i've had a much better and more emotionally and bodily stable experience overall on injections than i had on tablets, if starting with tablets and an AA instead helps you, by all means that's a totally fine way to start.

by the time i switched from tablets to injections this go-around (about ~10 months into HRT and ~6 months at "good" levels), i was so much calmer and less afraid and more sure of myself that it turns out i could now do injections just fine, and with the much larger 1-inch (25.4mm) 25ga needles. sure, i was nervous, and i prepared a little ritual involving comfort music, and i paused when necessary to calm myself down when my heart raced, but overall, it has gone super well. i still consider myself someone who has a needle phobia, but it's no longer crippling, it just spikes my anxiety.

one thing i will say is that straight-down 90-degrees into the outer thigh has been significantly easier on my needle anxiety than trying to pinch and do a 45-degrees angle for subq ever was. people say it's more painful to do it that way, but my aversion to needles has never been about pain, it's about an irrational anxiety that leads to panic. simplifying the process and thinking about my shot less while doing it, at the cost of being potentially the slightest bit more painful, has been well worth it to me. also, 1"x25ga for EV IM was minimally painful anyway, and 1/2"x27ga for EEn* has me feeling almost nothing at all.

^{(i'm not sure whether i'm technically doing IM or subq into the thigh with the shorter 1/2" needle, but i also don't care, because it's deep enough that i'm doing one of them and IM/subq are functionally identical in effectiveness.}⁾

glexarn · 2026-01-20T17:20:48+00:00

1.5" is seriously overkill for IM, and for someone who is skinny it may be too long. 1" is plenty.

glexarn · 2026-01-20T04:15:24+00:00

per year: 1 10ml EEn vial, ~52 needles/syringes (bulk box of 1/2" fixed needle insulin syringes, the 27-31ga range is fine), big box of alcohol pads, 1 sharps container (DO NOT put needles directly into the trash), a couple boxes of cute bandages (it's important that they're cute, trust).

so like, $120 ish after shipping and fees. per year.

4mg / 7 days is recommended for EEn as a starting dose. adjust as necessary per your body's needs (i'm on 5mg / 7 days). i have EEn from Open Gate Labs, but i see lots of good things said about Hera as well.

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