HRT and heart disease

[Charlize]

Hi, I have no intention of self medicating. I used to do that with drugs and alcohol and am still a very active member of AA. I do have coronary artery disease and have both stents and open heart surgery. I have not come out to my family Dr. although that may happen soon. I have heard that HRT is not recommended if you have heart disease and before I bring it up with the Dr. any feedback out there? Thanks, its great to have this support.

Charlie

[Sally]

Hey Charlie,

Not being a doctor I can only say that yes I have heard that HRT and heart disease are not a good mix, however you should talk to your doctor because there are many different types of heart disease and it is possible that some are not really effected by HRT - only your doctor and an endocrinologist can give you any specific answer.

Love ya,

Sally

[Charlize]

Thanks, This is important for me as it seems that HRT is so much a part of trans. Dressing up is just not enough any more. Even if I pass i'm only an actor and not a woman. It may be that that is all i'll get and if so contentment will have to come from within.

Hugs, Charlie

[KathrynJulia]

Charlie:

Your doctor is the best person to decide on your risk factors. He may put you on an aspirin regimen with HRT to help prevent clots. Blood thinners may also be an option. It all depends on your doctors judgement. Dosage and delivery will also be a consideration as method of delivery. Transdermal is safer for a woman over 40 than taking a pill sub lingual or under the tongue. So there will be a discussion and you will be given information on the risk versus benefit. Katheryn

[Ravin]

Whether or not you smoke is also a factor. The risks increase if you do.

[Guest again]

Hi Charlie,

Definitely speak to your doctor about it! If you go with the HRT ask to be put on bioidentical hormones. Estradiol gel as estrogen source (that you can rub on your arms or legs) and prometrium pills as progesterone source (not sure if they use progesterone in MTF HRT treatment?). Both of these forms of HRT are the safest available and were NOT included in the warning several years back about increase in heart disease risk with HRT. The added benefit of the gel is that it only makes one trip through the liver, rather than two, so it is easier on the liver also. Good luck!

[Guest Melissa.1957]

Dr. Becky Allison discusses the study and how it relates to MtF woman. Dr. Allison is a cardiologist and a transwoman. It is a very good read

http://www.drbecky.com/hormheart.html

[Carolyn Marie]

Thank you very much, Melissa. That was extremely valuable information, especially for someone who has a family history of heart disease and who is diabetic. It is very encouraging and reassuring.

As a matter of fact, I think this info is so valuable I'm going to pin this topic.

HUGS

Carolyn Marie

[KathrynJulia]

Thanks Melissa for sharing this article. It's the best that I've ever read on hormones and MTF. I'm scheduled for a lot of labs in August and I'm curious as to the effect HRT will have on my cholesterol levels. I had only been on HRT for just a month and I saw a small improvement. HRT has had a very positive effect on my blood pressure and I've had to call my doctor to have my blood pressure meds reduced. My blood pressure last night was 116/69. Like you Carolyn, I worry about diabetes. But the risk benefit for me is a positive one. Kathryn

[Guest Donna Jean]

.

Wow, Melissa.......

Very good stuff...thanks for that!

Dee Jay

[Charlize]

Thanks for posting and pinning that link. My GT recommended that i contact Dr Allison. She is hard to get through to for a one on one. This is almost as good.

[Guest lairlane]

Thank you Melissa for posting Dr. Becky's page. It has been years since I read the Grace Letters.

A flood of memories would be an understatement as I reflect on the past 20 years of transition.

I'll leave the rest for another topic.

Once again, thank you all for being here.

Lana

[Flint]

You know I don't want to hijack this post. But does anyone know about any information about heart disease and FTM's taking testosterone?

[Charlize]

Sorry Matthias i don't know. Your MD is the best place to start but they are often adverse to approving any risk.

As an aside i was able to start HRT using a low dose gel and close monitoring. I am waiting for the results of my first blood test but think it must be ok has i have not been contacted. It took some time but the primary, Cardiologist, Gt and Dr McGinn's office worked things out. It took time but amongst other things is very self confirming. I feel more like me or perhaps its easier to accept me.

thanks for all the help and suggestions.

Charlie

[Charlize]

Here is an update and some new information. I was taken off of HRT after having to get some new stents. My Cardiologist is a bit transphobic. I took him reprints of Dr. Allison's work. I also was able to contact her in person and she was kind enough to respond. Unfortunately there are few trans knowledgeable cardiologists. I have been working toward getting myself back to where i was before surgery and was finally put on a modified program by Dr. McGinn.

Interestingly Estrogen has been shown to cause blood clotting when given to women at meta pause. This is the main research that was used to withhold HRT from me and is certainly a concern. I am on two medications to counteract that possibility and have been well before starting HRT, but this has never been a problem for me.

Testosterone has been shown to cause hardening of the arteries which is my problem. FTM patients are warned of this possibility when on HRT or should be according to DR. McGinn's office. I just could be that i should be on E for my heart! Regardless it will certainly help with the stress i have felt been relieved of and then experienced again.

This has been such a ride. I have learned a bit more about acceptance. On then off, into the hospital and out to learn how to live with a different set of hormones again. Frustrating but at least in this age we can have the kind of care that not only allows us to be alive but to live as ourselves. I'm glad to be alive and when the prescription comes in i'll be on a slightly different path. More bumps will come. HRT won't change that but if i'm lucky i'll be at peace any way. That's the biggest gift of all.

Hugs,

Charlie

[Guest Paradox]

I am rather rare in me endocrine system, so I don't have many choices in the ride my body takes me on. I died and was revived on the table in an emergency room of a large hospital system known for heart care. My responce to medicines and pulse rate interested the Head of the Cardiology Department, so that is who took me on as his patient, eventually removing an 85% blockage in a heart artery and putting in a stent. Two years later, my encrine system simulated a heart attack and after angioplasty showed nothing wrong, the cardiologist called in a kidney transplant specialist, whose tests eventually revealed my endocrine challenges. After consultation with my cardiologist, drum roll please, I was put on a medication to help stabilize my endocrine system. This medication is also often used in MTF hrt.

This is a long way to say that each individual needs to be seen and evaluated by a medical doctor before hrt. Heart conditions mean more careful care by a doctor, but do not necessarily mean you cannot get where you want to be; the road just may be different.

[Charlize]

As a further update I have been back on HRT with a different form of E from a spray and although it is fairly early the results seem good. At this point just being full time for over a year now has taken much of the anxiety away. HRT is a nice benefit to just living as myself for a change but i have learned that i can be happy anyway.

I did have a chance to communicate with Dr Allison and she was great but unfortunately didn't know any cardiologists with trans. knowledge on the east coast. My Cardiologist is accepting my decisions but he is at best skeptical. I am trying to be a good girl and do as much right as i can to keep healthy so i can grow into a still older woman with grace.

Hugs,

Charlie

[Charlize]

Well i'm back to this topic after a week in the hospital after another heart attack. The path i've taken i feel is going to work for me. I was only off of E for less than a week this time. The problem was (hopefully) caused by stopping aspirin which i have taken every day for years. I stopped because i was scheduled for an orchi today and had stopped for the surgery. Several cardiologists in the hospital agreed that stopping aspirin was the probable cause. Dr McGinn has also cleared me to continue HRT and my Doctor did so as well today. It is a risk but with the support i have i feel it is best for me. I am so glad to have MDs who do seem to understand. For a few days i felt i would be back to T again and all the discomfort that would bring. I'd miss how i look and feel now but would and will quit if i have too. Just living as myself and being accepted is such a wonderful change.

Hugs,

Charlize

[Charlize]

Over two years have passed since the last post i made here. I've been on HRT throughout. I have a new cardiologist who is GLBT friendly and who also gives me strong advice suggesting i stay on the smallest dose of E that i can use. It has been fine and now post surgery with no T to block i feel great on a small amount of E that actually comes in a daily spray.

This has been a difficult journey medically but amazingly my cardiologist set my next visit to a year out. He would only do that if he felt i'd be ok. My heart isn't all that much better. Bypasses and multiple stents have done damage as has the accumulation of plague but between medication, diet and exercise i'm still moving.

Please do get the help of a doctor. This living thing is beautiful.

Hugs,

Charlize

[Jani]

Charlize, thanks for the update, an interesting read. And thanks for taking care of yourself; for you, for your family and your friends. I know we appreciate having you around!

Hugs,

Jani

[Guest KerryUK]

I second that Jani, thanks Charlize.

[MariPosa]

Thank you Charlize.

I will be starting on HRT before the end of the year.  I have had Aortic Valve Replacement (AVR).

Since I was so young at the time I was given a St Jude Valve.  (non-bovine) Along with

that comes a lifetime prescription for Coumadin (Warfarin).

The link that was posted is a resource I'll have to remember as I start out.

http://www.drbecky.com/hormheart.html

What a wonderful place!

[Kelly w]

I too have had several stents and, most recently, bypass surgery last year.  I am just beginning my journey so what I am reading here is very encouraging.   I will soon be be meeting with a trans friendly endocrinologist and am excited about the prospect of beginning HRT.

[Jani]

Hi Kelly and welcome!  Why don't you post a short intro?  We'd love to hear from you.

Jani

[Kelly w]

Thanks Jani

I am married, two adult daughters and  new to this forum. My employer is LGBT friendly which makes my journey that much easier.  The biggest struggle I face is the tension around beginning this journey for myself and how it will impact everyone in my life.  

For a long time I thought becoming a eunuch would be enough but what intrigues me the most is the transformation to becoming a woman. I am enraptured with adopting the physical characteristics of a woman and my early morning walks with my dogs have turned into public displays of my femininity.  It is desirable and exciting.  

Coming out publicly strikes fear in my heart. For nearly 60 years I have lived as a male but not felt manly.  There has been a feminine, nurturing side to my personality I have suppressed.  

Learning about the resources available today have empowered me to dare to think I can make the transition.  Time will tell.  Will I have the courage?  Can't answer that question yet...