Why do i have to trash this??
Seriously? Taking the advice from my doctor, im supposed to trash after 4th shot. He says there will be a bit left, but because of contamination(???) he wants me to switch vials every 4th shot.
Like, is that the real reason? Because it physically hurts to throw this away, knowing how much i and others have worked to get this stuff in the first place, and how many sisters cant access it 😭
Also really seems like a waste of time and resources. Like people had to make this, and that required time effort and money. Are we cool with throwing away the results of so much progress and effort?
Idk, its hitting me now that i have to toss one, these are all questions i have that my doctor will probly hear next time i go in 😂😂
PS. My nails look bad, its been a really rough month, dont talk about it 😂
Someone was sloppy once, got sick and sued, they did a bunch of tests and figured that normal germs won't be possible below 5 and to cover their asses now recommend 4.
Blame the litigious system we have, same reason every plastic bag says don't put it over your head.
If you're smart about it, use the vial.
If you reuse needles to extract, use giant needles to core the hole and ruin the seal, or just keep it in filthy conditions, then that's your fault for getting sick.
Another thing to consider, some... Not all... But some are filled with inert gas that prevents oxidation or other reactions that can happen when exposed to the air.
If enough outside air gets in, there is a shot that has a reaction with the contents and you're now not getting the dose or quality you need, then wonder what's wrong.
Chemistry is a bitch, be careful and you should be ok, but just know what you're risking and check if it reacts to general outside air, or if it's really a germ contamination thing.
This is why most trans people learn to take what their doctors say with a huge grain of salt. "Trust your doctor" is shit advice when it comes to trans medicine. It's not just bad advice, it's Stockholm Syndrome.
I'm assuming you're on weekly shots? If so, the 4 week guideline comes from hospital settings. In hospitals, they'll have vials of medication shared between many patients. They're discarded after a month. But those vials aren't being used for a single injection once per week. They're often being used many times by many different patients. It makes sense to be more cautious due to the number of times the stopper is being pierced over a short period of time.
But for individual use? It's completely unnecessary. As long as your vial isn't visibly cloudy, has visible debris in it, etc., as long as everything is fine? Use it til it's empty.
As far as what to tell the doctor, simply don't tell him. If he asks, lie and say you threw it out after a month. Again, "trust your doctor" is shit advice in trans medicine. Your doc just learned in his training "throw out vials after a month" and never bothered looking in to where those rules came from.
Instead, use this as a means of building up a stockpile. Yes, there's no actual shortage of estrogen, but if you're in the US, do not assume your access to E is safe. All it would take is one illegal executive order stating that "it's against FDA policy to prescribe trans HRT," and all the insurance companies would stop covering it immediately, complying in advance with the illegal directive. Same thing with big hospitals and doctor networks. In 2026, it is nothing less a form a self-harm to be a trans person not stockpiling when you have the option to do so.
If unopened, those vials will last a decade if kept in a cool dry place. You can use what you're observing here to build a stockpile. Keep using the vial until it runs out. But actually fill your prescription every four injections as your doctor is prescribing.
Again, do not simply rely on your doctor. If trans care is severely affected, he'll simply stop seeing trans patients and be otherwise unaffected. You will be left high and dry without life-saving medication. Keep stockpiling until you have a decade or so of vials saved up. Always draw from the oldest vials first. Once you reach the maximum practical stockpile size, either only fill the rx every few months, or fill the rx monthly and give away your excess vials to local trans people in need.
This is exactly the advice ive been hearing and feels the best to me
Like, deep down in my soul i know not to just trust doctors, theres obviously horrible doctors everywhere. I just dont know enough about anything like this and im just generally doing what im told.
Plus, if im being completely honest, medical settings are my safe space and im kinda terrified that might change. I know this is not MANY peoples experience but for me, with alot of pain and struggle in almost every other aspect of my life, doctors always seemed to be doing their best to make me feel better. White "male" privilege is probly a factor, and its probly going to be a hard lesson for me overall
So much information on this thread is also just wrong. Like the comment or above said you can keep your vials and my doctor told me to as well. In my experience, Estradiol doesn’t go bad very quickly if you keep it sterile (you look at the color and throw it away if it gets cloudy or changes color). Keep it out of sunlight and follow the package instructions for a cool and dry place.
As for it being sterile, it is important that you do the drawing out of the vial properly. Make sure it is a sterile needle, and that you use a small enough needle gauge (I have had the best of luck between 23g and 25g) so that you do not core your vial (little rubber pieces that fall in). Putting the needle in at an angle also helps. When you pull it out the rubber stopper is supposed to be self sealing. As another comment said you can also wipe the top with an alcohol wipe before drawing. If you are having issues with the process I would see if you can get an appointment for someone at planned parenthood to show you.
Also the month expiration is just what was tested as safe, they didn’t actually test what the maximum is as it is for the manufacturers liability, so at the end of the day it’s your decision
Yeah, it's hard. Especially if you're used to a doctor's office being a safe space. And often the docs aren't even being bigoted. Overtly bigoted docs don't tend to get involved in trans care at all. But even well-meaning ones can be ignorant. A few common doctor issues, even among well-meaning docs:
Not realizing that modern bioidentical estradiol is nothing like the premarin of decades past. It doesn't have the liver and kidney risks that premarin did.
Prescribing estradiol valerate on two week intervals (resulting in a week of menopausal E levels.)
Demanding patients stop estrogen for weeks prior to surgery. (This came out of the premarin days.)
Prescribing massive doses of T blockers with minimal estrogen doses.
Etc. And if you're just starting this, another thing to keep in mind is to always see your own blood work levels. So many trans folks end up getting screwed over by their doctors. The doc will say, "your levels are fine!" while you're actually in the menopausal levels of estrogen. Not all docs are like this, but plenty are. Do NOT simply rely on your doc telling you your levels are good. Insist on seeing the levels yourself.
I feel like this kind of thing falls more within a pharmacist's knowledge than a doctor's. But you can also try reading that tiny writing in the mini-book that might have come in the box that held the vial, see if there's anything about it and any reason for it. Otherwise you can follow the advice of isleepinahammock.
Are you doing 0.5ml injections? That is quite a bit left, but I'm used to seeing a more empty bottle after four 1ml shots.
The contamination is the little pieces of debris from the cap each time you puncture it. When there isn't much left, your needle is drawing from the bottom where they all settle.
Hypothetically if you drew another shot while keeping the tip of the needle just below the surface you may avoid this, but it's probably for the best to just use as directed.
These vials are all prepared the same way with 5ml, regardless of whether you're prescribed 4ml or 2ml. What's left is possibly contaminated, so it isn't of use to anyone at that point.
Fwiw, there isn't a scarcity of this medication, just dumb laws keeping it away from those who need it. In the same way that not finishing your dinner isn't taking away food that might have fed someone else, not emptying your vial isn't taking away treatment from anyone.
So, just passing by as a diabetic, but not trans, and I'm confused a bit about the contamination part.
I use insulin that seems to come in a vial exactly like this, and have had to only throw a vial or 2 out over the 10 years I've been type 1 diabetic, and thats been either from:
Or 2. From bacteria contamination that turned the vial cloudy.
But most or the time, I can use the vial as many times as I need until the insulin is finished. This is the first I've heard of particulate contamination being a problem like you're saying.
Is this just the difference between the liquids inside the vial, and how sensitive the human body is to the contamination? Because based on my diabetes experience, I would just continue using the vial as is, unless it actually causes some sort of problem for me.
I love having your input its great to have someone with inject experience ❤️
The contamination thing seems really strange to me too, idk it felt like a catch all reason to give people when they ask
Afaik the liquid inside is just a small amount of estradiol really overall, and its suspended in oil. I havent looked into mine that much (maybe i should) but ive heard sesame oil apparently
Its really interesting thats not been a concern for your medication, but they told me this upfront before i took any of it
I am on estradiol valerate
My Dr, the nurse, and 2 pharmacists told me to toss mine after 28-30 days because it starts breaking down after a few weeks and isn't worth injecting anymore. Nobody mentioned contamination. The pharmacists were making exrea sure I knew I needed to wipe the top of the bottle with alcohol prep wipes to avoid contamination.
I'm getting refills every 4th injection anyway, but there's so much left inside, I kind of wish I could independently verify it is breaking down (not just find info online, actually have it tested somewhere or something idk) because I know someone who would absolutely want the extra...
I also find it strange. I'm on a medication in a very similar vial, maybe a bit larger, and I was told to use it for 8 weeks, 2 injections a week. I was only instructed to throw it away if it appears cloudy or discolored.
You know, I may be wrong. That's what I was told and have seen repeated. Maybe I'm spreading misinformation without realising 😩
.25ml
Idk its not that im worried about scarcity, just access for others. I know and have that mindset with food too but its a bit harder to translate that into medication, maybe cause i cant hold this much value in food with 3 fingers lol. I guess in this regard im more concerned about just the sheer level of manufacturing waste, especially if im not the only one throwing away this much. Eventually youd be able to fill pools with the thrown away stuff 😂
I mean, ill probly just listen to doctor, after i ask, cause end of day i always do but its just hitting me with a level of sadness i didnt expect
Really want to be mad? That vial only costs a couple of bucks to manufacture.
Well now it does, but doesnt it cost more than a couple of bucks to get to the point where its so cheap to manufacture
US medical system is garbage, we all know this, thats a whole different post tho 😂
You know home brew HRT vials? Those are made by folks in labs they set up in their basement. They're able to make vials for a couple dollars. The home brewers usually charge $50+ for a vial, but most of that cost is just finding a way to get it to you without revealing the identity of the seller. They have to use really elaborated and convoluted shipping/reshipping methods.
But the actual pharma companies? They have even better economies of scale. No way it's costing them more than a few dollars per vial. If random STEM nerds can do it in their homes, I'm sure they can pull it off.
That is baseless bullshit. I have been using the same 10mL 40mg/ml vial for over a year and there is no "contamination". If you're drawing with a huge needle (think 18G), then u can core the vial, but I draw with a 30G needle and there is essentially zero risk of that. All you need to look out for is if the solution turns cloudy, which indicates that the oil (castor, cottonseed, sesame, or sunflower oil, usually) is breaking down, and the estradiol is precipitating out of solution. Unless you get a really bad/old vial, or you leave it somewhere that it isn't protected from UV, or that isn't properly temperature controlled (estradiol precipitates out of solution at cold temperatures), that won't happen during the time you have the vial. Shelf life is 3-5 years for well formulated estradiol.
The reality of the situation is that insurance and pharmacies only operate on a monthly basis, so they dispense you a new one each month. It's laziness and wastefulness.
Psst.. You don't! Shelf life is at minimum 1 year if kept in a cool dry environment. I typically get my refill each month but use each vile for twice the stated length - thus building a decent personal backlog. Dont store a used vile for long-term, but rather use each vile fully until you move to the next most recently prescribed. Given the current state of affairs it doesn't hurt to hold a small backup for yourself or to support other girls during anticipated hardships <3.
Thats what ive been reading! Some people use every last drop which feels nicer to the process of making the stuff. My partner (nurse) also says shed keep using just sanitize after use and watch discoloration or cloudiness or anything floating in it or gathered at the bottom, as well as storing properly. Its hard to disagree with
do you? i definitely use mine until the liquid is gone. theres never been any rubber or anything visible in the fluid, and all of the needles i use are sterile. it kinda feels like big pharma bullshit tbh. prescribe x amount, but then you pay for way more, and they tell you to throw it out before its even half gone. id say go ahead and use it, but im not a doctor do grain of salt.
Youre not alone, many people have been telling me this one way or another. Even a peek at the other side trans reddit seems to agree as well
holy moly, this dumb as hell, you can do to the end, especially in vial, we often use full glass!!! ampules and using it to the end just isnt touching much bottom, also use good syringes with low deadspace, are u IM or subq? if subq there are insuline syringes with low deadspaces and thin needless
also i have in a gel paper, that i shoudnt use after 64 pumps, INACCURATE DOSE, yeah there is much less less w one pump, but i just adding remaining pumps to archive same gel amount
also fun from gel paper, i shoudnt touch ppl(and ppl shoudnt touch application area) 1 hour after application either i will forcefem them, sooooooo smash gel on hands, and forcefem ppl :33333