this post was submitted on 29 Sep 2025
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I've recently heard the phrase "anything that can be taken sublingual can be taken rectally".

Is this true and can it be applied to estrogen tablets without a shell/coating? Seems like it would bet the swallowing effect from saliva.

And a follow up question, does it need to be jammed in all the way or just past the sphincter muscle?

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[–] dandelion@lemmy.blahaj.zone 6 points 2 days ago* (last edited 2 days ago)

one potential problem you would likely run into is spiky estrogen blood levels - oral and rectal administration is not ideal for this reason, and is a reason to use routes like injections, patches, or gel.

You ideally want gradual increases and decreases to blood estrogen levels, for so many reasons.

But yes, I think theoretically you will have better absorption from rectal administration because you bypass the liver.

But again this will cause huge and short-lived spikes in blood estrogen making it a terrible idea. Again, the best solution is to change your route of administration to injections, patches, or gel.

There are rectal and vaginal estrogen suppositories that are actually dosed and manufactured for this purpose, I would guess they would have lower doses because of the better absorption. They might be dosed much lower since usually they are supplementation for peri and post menospausal cis women who still produce some endogenous estrogen.

edit: was reading 1 mg estradiol taken rectally will send blood levels over 600 pg/mL at peak and peak is within 3 hours, this sounds like a bad time to me, and I assume oral pills are usually more than 1 mg ...

even my estradiol valerate injections that peak in 1 - 3 days feel too spikey and can create mood swings, and esters like cypionate and enenthate which have much longer half lives feel smoother and more mood-stable when taken at the right dose, frequency, and route of administration.

You will also have better feminization from consistent blood estrogen levels with less spikey methods, whereas spikey oral and rectal administration will leave you without consistently sufficient blood estrogen levels through the day and especially at night when you aren't likely to wake up to dose when you would need to.