A year into my transition, my hormone levels are worse than when I started

I had my first blood test since switching to estradiol injections and the results are absolutely terrible. I switched to injections to improve my hormone levels since pills were not doing enough, but it has actually done the opposite. My hormone levels are worse than prior to starting HRT and I don’t know how that is possible. In the span of 2.5 months, I have gone from an estradiol level of 132 pg/ml to 23 and from a testosterone level of 81 ng/dl to 653. My levels were not good before, but they were miles above what they are now. I don’t know what to do at this point.

I don’t know what the point of doing things the “right way” is anymore. I have been on hormones for an entire year as of this week and my hormone levels are somehow worse than when I started. It is incredibly frustrating. Trying to get anything about my hormone regimen changed is an uphill struggle and any concerns that I have about the logic behind my doses are dismissed as unreasonable. Their approach to issues with HRT seems to be to just keep trying the same things and it just doesn’t work. I know what I would do if I was DIYing, but modifying my dosages without approval from my doctor will create friction (it certainly did last time). I just don’t know if I see any value in working with them if they keep refusing to adapt. So far the only result of listening to my provider has been lackluster hormone levels. I don’t know if I am willing to keep following their guidance if they won’t adapt in light of my lab results.

I have a couple of options for how to address my levels. My next appointment with my hormone provider isn’t for a month, so I won’t be able to discuss these results with them until then. My current desire is to decrease the time between estradiol injections from every 2 weeks to every week. If I am returning to my natural hormone levels in the time between injections, then the estradiol is being metabolized far too quickly for biweekly injections to ever be viable. I doubt that my doctor will approve this change, they were completely opposed to doing so when I started injections. The other option is to keep the schedule the same and just increase the dosage. I suspect this will be what my HRT provider prefers but it doesn’t seem like the right choice to me. Upping the dosage will increase the peak of my levels considerably but likely won’t do much to address my trough levels. My trough levels are the problem right now so the priority should be improving those.

I should be devastated right now, but I just feel numb. I am barely even disappointed, I am just kind of resigned to the fact that my first year of HRT has likely been squandered. It is unfortunate, but there is nothing I can do about it, instead, I need to figure out what to do now. I am strongly considering just switching over to injecting every week in the interim until my next appointment and seeing how it goes from there. I can’t keep doing the same thing and hoping that it will be different this time and I certainly can’t keep waiting and seeing. Something needs to change and I can’t afford to wait until others come to the same realization.