estradiol injection, after failed on patches

Just got estrodial injection after failing to maintain an estradiol blood level over 24mcg while on 0.225mpi vivelle dot (three patches). I was hoping to get a big boost and then maintain with the patches, but my doctor seems to have changed his mind and plans to keep me on the injections. He gave me a lower starting dose because I had been using the patch. I wonder why he started me out at a lower dose when he new my levels were so low. Is there an increased risk for a PE? I am 42 y/o post laproscopic supra-cervical hyst with BSO and appendectomy, thin, active, non-smoker. Why is my doctor being so conservative? I will let you all know how the injection works out. Has anyone else out there had estradiol levels continue to drop while on the massive doses of the patch?

I think your doctor starting with a lower dose is prudent, since you can't undo an injection once it is done. It's not like a patch that you can just rip off if it is too much, you would have to wait it out and if the symptoms were unpleasant it would be a long wait. Best to go slow.

I agree, better to start low as you can always supplement. I had the exact same issues with the patches - just could not absorb the E. Vaginal estrogen was the answer for me!

Thank you for the info it certainly makes sense. I went back to the doc yesterday and he got more estradiol levels, they are now 734!!!! Crazy stuff going from too little to way too much in one day! Don't know what the plan is now doc has not called. My husband is concerned about the vaginal estrogen since apparently he can absorb the estrogen during intercourse. Please let me know if anyone one else has gone through this and managed to get EST to work out.