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?
Can and should are two very different things. The two have different absorption rates for different things. You may overdose or it may be totally ineffective. There may be toxic contaminants that taken orally might not be absorbed much, so its relatively safe, but taken rectally might be absorbed into the blood stream. There’s also the sanitation issue. The mouth is generally better at capturing and keeping infections out of the body than the rectum, so you may need to sanitize the pills which might be difficult if you don’t want them to dissolve. And relatedly, there’s the matter of the inactive ingredients. They’re designed to be swallowed, but may cause issues left behind in the rectum. Most pills that are swallowed just use starches which isn’t a big deal, but to make things dissolve quickly there are other ingredients including sometimes sugars which could encourage microorganism growth if you don’t sanitize them or some ingredients may trigger diarrhea or other reactions.
There’s usually not research done on a drug taken sublingually as to how it would affect a person rectally, so it’s usually not going to be well known.
That said, ask your doctor. If there is any data about doing it, they would be more likely to know.
It is very, very, very difficult to overdose on oestrodiol. Some quick research showed that the LD50 is >2000mg/kg. For reference, most oral oestradiol tablets are 2mg. 50kg is apparently the average weight in most places, so OP would need to shove 50,000 oestrogen tablets up her butt to have just a 50% chance of overdosing. As for the rest, plenty of people boof their progesterone pills just fine. Please try and be less alarmist.
Overdose doesn’t mean die, it means getting a larger dose in your blood than the labeled dosage. Over a long period of time dosing too high, there may be side effects. Sorry if I used medical terminology, but I work in healthcare so it’s common terminology there. I sometimes forget that the media has warped the meaning of some of these terms.
Even in medical parlance, it doesn’t just mean a larger than labeled dosage though. It means a large enough dose to cause adverse effects, or at the very least a quantity that is much greater than recommended. You are still being alarmist, and the fact you work in healthcare explains a lot honestly.
Source.
Again, adverse effects doesn’t mean death, the fact that the description you posed has that last sentence is the alarmist thing and only applies to certain drugs, of course.
The difference in absorption rates between oral and rectal administration can be as much as double or triple or more in some cases. For example I remember reading a study from the 70s or 80s on methylprednisolone. The absorption rate orally was about 90%, but rectally was only around 35% likely due to bacteria in the rectum decomposing the drug before it could make it into the blood.
So, over the long term the difference in dose could have a significant impact on health. Getting 3 times more or less of any drug, even something relatively safe, will likely mean “adverse effects”. With estradiol this could mean greatly increased side effects for overdose like nipple soreness or mood swings, or greatly decreased effect for underdose meaning testosterone takes over again and hair loss and body hair growth restart. These are “adverse effects”, but are not likely to be deadly, but still considered overdose/underdose.
The whole point of sublingual is to extract the maximum amount of available estrogen from the pill. So my bigger worry is that it would be totally ineffective.