02/20/2026
🧊 Troches (oral dissolvables)
⚠️ Safety: Variable absorption
🎢 Peaks/Troughs: Spiky
📆 Dosing: Daily–2x/day
💬 Fast up, fast down. Some gets swallowed → liver impact.
💉 Injections
⚠️ Safety: Effective but can overshoot
🎢🎢 Peaks/Troughs: Big swings (especially if spaced out)
📆 Dosing: Weekly (sometimes split 2x/week)
💬 Strong highs… possible crash before next dose.
🧴 Topicals (creams/gels)
✅ Safety: Avoids major liver first-pass
🌊 Peaks/Troughs: Steady
📆 Dosing: Daily
⚠️ T gels can transfer to partners/kids
💬 Smooth operator.
🩹 Patches
✅✅ Safety: Lower clot risk vs oral estrogen
🌊🌊 Peaks/Troughs: Very steady
📆 Dosing: 1–2x/week (T often daily)
💬 Set it + steady it.
🔘 Pellets
⚠️ Safety: Minor procedure + hard to adjust
🌊 Peaks/Troughs: Fairly steady (can front-load)
📆 Dosing: Every 3–6 months
💬 Low maintenance… not easily reversible.
🚨 Why “Oral” Can Be Risky
💊 Oral estrogen → ↑ clot risk (liver first-pass)
💊 Some oral testosterone → liver strain or ↑ BP
💬 Route matters just as much as dose.
Hormone therapy isn’t just what you take — it’s how you take it.
🎢 Want fewer mood swings?
🌊 Prefer steady levels?
⚖️ Safety depends on delivery method.
Always individualize + monitor.