Would this be unreasonable to ask?

[Guest Lizzie McTrucker]

I'm looking to start HRT again after a several year hiatus. The first time I was on HRT was for just over a year and I was taking oral estrogen and spiro. Between that time and now I've basically did a number of the other steps leading up to SRS. I've changed my name, I've come out to everyone, I've gone full time, I've secured employment in my new female role, etc..etc..

So since I'm already full time and have been full time for several months now, would it be unreasonable when I go to start HRT again (I just have to make that call to set up an appointment, my therapist already referred me after our first session). Anyway, would it be unreasonable to ask if I could just skip the oral estrogen starting regimen and go ahead and just start with injectible estrogen?

[Drea]

Well I have no clue why you think any role or transitionional steps may be relevent to oral verses injectible unless you were just mentioning such things for overall context. It is not like progressing from oral to injecitible is some sort of normal progression and that it has anything to do with stregnth or dosage..

Anyways, I don't see any reason why you can't state your preference to be on injectible and see what the doc says.

[Guest Lacey Lynne]

Lizzie:

Girl, tell you what: Oral versus injectable. No difference medically. Remember, I do frontlines medical work.

In the transcommunity, it's a "sacred cow" belief that injectable estrogen is THE BEST hormone replacement therapy going. It's simply not so. If you do oral estrogen sublingually and do not swallow it, it gets into your system in exactly the same way as by an injection; however, it's just a little slower but no more effective. My doctor agrees with this, although she offered me injectable estrogen back in June. I declined it. Same with progesterone, although that's another hot topic amoungst we T-girls. I won't go there here.

Actually, just do your HRT in which ever way you want to. It'll work for you. You'll see!

Peace Lacey

[Guest lairlane]

Lizzie,

I started on oral many moons ago. Three months in I determined depot administration would be a better choice for me (yes, a health care background leads to self diagnosis/treatment especially when you are a trained field surgeon. Different topic, deferred for now.).

Over the years I've taken hiatus from meds to test the waters and measure my well-being. On for 10 to 14 months, off for 4 to 6 months at a time. I can't imagine a several year hiatus for myself but I admire the roads you've traversed.

Spiro never agreed with me and medroxy was a better match for my chemistry, also in depot.

I feel blessed to have a well qualified trans trained PCP on my team now. We are fine tuning with lower dosing of onshore meds of better quality. If you would like more specific information you're welcome to PM me.

Much love and safe roads to you,

Lana

[Guest JennX]

It depends on the therapist and doc you see. I lived FT 24/7 3 years prior to my first therapy visit, but my therapist still did make me wait 3 months before giving me my letter for HRT.

As far as injectable E vs. E pills... its a toss up. Many docs don't like to prescribe injectables. They think we'll put our eye with the needle I suppose. Oral E taken sublingually (under the tongue) is just as effective from what I've seen. It also provides a more constant daily E level. There is no peak/valley during the time between injections. So I wouldn't worry too much on the method of delivery. Now I can say that patches (generally prescribed to people over 40) are less effective than either oral or injectable E. Good luck.

[MaryEllen]

Remember, we are not medical professionals. Be very careful of what you are giving out for advice. Should anything go south because of information received here, we could be sued for medical malpractice. So unless you have tons of money to waste on a lawsuit, keep your advice to a minimum. If you need specifics go ask your doctor. That's the best advice you can get.

There are many factions that would just love to shut us down and they will seize any opportunity to do so.

MaryEllen

[Guest Lizzie McTrucker]

Well I have no clue why you think any role or transitionional steps may be relevent to oral verses injectible unless you were just mentioning such things for overall context. It is not like progressing from oral to injecitible is some sort of normal progression and that it has anything to do with stregnth or dosage.

Well now that you mention it..

Years ago I was under the impression that starting out, you started on low dose oral estrogen, eventually the estrogen was increased, then after being on that for a year, _then_ you moved on to injections for better development once you went full time. That's pretty much what all my transgender friends were doing at the time (this was back in 06/07).

So yeah, I did think it was part of a normal progression and by stating I was already full time that I could possibly skip the low dose stuff and start with injections.

Over the years I've taken hiatus from meds to test the waters and measure my well-being. On for 10 to 14 months, off for 4 to 6 months at a time. I can't imagine a several year hiatus for myself but I admire the roads you've traversed.

I never reached that point where I thought "I'd rather be dead than ____". After one suicide attempt from a bad breakup, it dawned on me that nothing is permanent (other than death) and if I wanted to reach certain goals, I had to make some changes to get there if the current path wasn't working. So I had to go off hormones for a few years. I didn't like it but I knew deep down it wasn't permanent and I knew I would get back on HRT eventually after I made some changes and put some plans in motion. Even when I had to stop being full time, go back to living as a man and move back in with my parents, I knew it was only temporary and if I just trudge through these muddy waters, eventually I'll get to the other side and start my transition again.

[Guest Leah1026]

It is not unreasonable to request a different method of administration. The final decision is the doctors of course, but you are always free to ask.

[Guest lairlane]

Time to take off the waders Girl !!!

Welcome back to the other side

[Drea]

Years ago I was under the impression that starting out, you started on low dose oral estrogen, eventually the estrogen was increased, then after being on that for a year, _then_ you moved on to injections for better development once you went full time. That's pretty much what all my transgender friends were doing at the time (this was back in 06/07).

So yeah, I did think it was part of a normal progression and by stating I was already full time that I could possibly skip the low dose stuff and start with injections.

Yes it is very typical to be started off on low dose, but that is a doctor's descretion. Injectible doesn't necessarily mean higher dosage however. It depends on the concentration of the medication in the serum (most is just oil) and the volume that gets injected. Some docs don't like to use oral and will perscribe injectible (or patches), but like oral, it would be typical to start with low dose injectible. Sometimes docs use both oral and injectable at the same time and one would expect the combination is probably a higher dosage than just oral, but it isn't necessarily the case.

My doc has me on injectible even tho it is low maintenence dosage despite my preference and request for oral. Just the way this doc is and is a good example how injectible doesn't necessarily mean it is stronger.

I doubt being full time or not will be much of a factor. I believe the typical initially lower dosages aren't perscribed so much due to uncertainity as it has to do with finding out how your body tolerates the medication before giving more. The fact that you been on hormones before, if it is the same doc, there is some medical history so so that could be a factor.

In the transcommunity, it's a "sacred cow" belief that injectable estrogen is THE BEST hormone replacement therapy going. It's simply not so. If you do oral estrogen sublingually and do not swallow it, it gets into your system in exactly the same way as by an injection; however, it's just a little slower but no more effective.

There is lots of trans lore out there about one type of medication, regimn, or how it is taken being "better" or "safer" than another. One of those is the sacred cow mentioned, but as for the equivalance taken subingually I would also lump that under lore because while there may be similarities (I can't comment medically) logic suggests there must be some differences between something done daily and absorbtion from an injection that occurs at much longer intervals.

I've been on many different regimins and have very strong opinions on what worked for me verses what didn't. There isn't medical backing, just experience about what worked for me. I don't bring these things up as it just will add to some of the lore out there. As MaryEllen said we aren't medical professionals so it is best to rely on your doctor rather than accepting such claims/lore at face value.

.

[Guest DanD]

as the rest here, im not your doctor..

the reason most FTMs get injectibles is because then it goes straight into the blood stream, instead of taking orally...you would be taking large doses of something thats been proven to be detrimental to your liver over time.

anything you take orally goes into your stomache then your liver filters it, before it goes elsewhere into the body. so taking a lot of mediciations, or certain kinds, risks harming the liver, since its a filter, and can only do so much. without your liver, youd die.

thats another reason they liked the idea of the derma-gels, (testo cream) to apply testo onto the skin which gets absorbed into the body that way.. it never goes to the stomache, or the liver, so they claim, but they forget the spleen(lymph system) is the ultimate filter for what goes where and whether it has permission to go thru the blood stream or not.(very basic way of speaking)

but you can live without a spleen, but i wouldnt want to damage it just the same, personally.

problems with the derma gels, the way its administered itself has its own drawbacks. its not as efficient, cant be done in high doses.(not high enough for FTM needs) often causes rashes and other issues, and rubs off and gives your whole family a dose of testo in the washing machine, or shared towels, or when they give you a hug, and i'm sure the girlfirend likes the T thats rubbed off onto her, making her go thru hormonal changes lijke her boyfriend did!? i think not!

at least the patch has something to cover it, so youre not giving a dose to whatever touches it.

Patches of Estradiol, come in small doses, and they're just a waste of money for an MTF to seriously use, unless theyve been on mones and blockers a long time, had a orchiectomy.. then they dont have to fight off the natural Testo so much, and sometimes a patch is sufficient dosage. patches can also of course irritate the skin, the chemicals in it, and the adhesive as different things to consider too.

Michelle (an MTF) started off with estrogen with methyltestosterone, some doctor prescribed them to her which she took for ages and did not see any difference with. she didnt realize it is the wrong drug for this purpose.

I forget what the name of this drug was, but thats what it was, actually, those two things mixed.

Always read the paper inserts and get the papers from the pharmacist, (theyre free, so why not) and also check things online, so you know as much as you can about anything you take, even before you take it. sometimes they make mistakes.

in this case, the doctor used to always tell michelle how she was such a handsome man, she really shouldnt be doing this etc..so her guess was he did this to make her happy while it did nothing to change her.

So then she learned to learn everything she can on this stuff. She got other doctors and was prescribed the Estrace and Euluxin? (i forget the spelling.)

Estrace is brand name for Estradiol (congugated estrogens) Eulexin was a blocker they used.. Later on they came up with some other blocker ..i forget the word...

She got injectible for Provera later on for a while. She liked it and had no obvious problems with it, but another friend (MTF) became extremely moody on it, and weird. So, she discontinued that, but an injectible is usually in your system longer, so if you'd have a bad side affect youre stuck with it longer, which is not a good thing.

Also, im not a doctor -- but i do know that the body does not like to adjust to rapid hormonal changes, and can cause problems of all kinds, both males and females, doesnt matter which.

So, it would seem very likely that a doctor would start you off on lower doses which increase, and if a long time of not taking it had lapsed, the logic would be to do the same again. That's the usual practice.

You cant just drop out then drop back in at the same place you were before, and not expect to experience some real problems.

thats why youre supposed to take a specific amount at a specific time and do it all the time on a regular basis, and if you miss one you cannot simply take extra; that would harm your body.

My advice, ask about the mediciations, anything you want to know they should be willing to teach you, and even give you broshures and other source matierial.

[Guest JennX]

as the rest here, im not your doctor..

anything you take orally goes into your stomache then your liver filters it, before it goes elsewhere into the body. so taking a lot of mediciations, or certain kinds, risks harming the liver, since its a filter, and can only do so much. without your liver, youd die.

Not true. If you take a medication that is micronized and take it sublingually (allow it to be absorbed through the skin under your tongue), it goes directly in to your blood stream due to the dense capillary network found under the tongue. It is the same method of delivery as an injectable. Sublingual administration avoids liver metabolism as well.

Now if you just swallow a medication, then what you state above is true.

[VickySGV]

Ask the doctor how they want to do it, and also how much his Errors & Omissions insurance will pay your estate if he is wrong, tell him what YOU want to do, and then both of you make the choice. You won't know until you ask.

[Guest JennaMarieTX]

Patches of Estradiol, come in small doses, and they're just a waste of money for an MTF to seriously use, unless theyve been on mones and blockers a long time, had a orchiectomy.. then they dont have to fight off the natural Testo so much, and sometimes a patch is sufficient dosage. patches can also of course irritate the skin, the chemicals in it, and the adhesive as different things to consider too.

...Sorry, but I have transitioned quite successfully, entirely on transdermal patches; as a matter of fact they are available in different dosages and with appropriate medical supervision you can use more than one at a time to achieve the desired blood level of Estradiol.

[VickySGV]

I am going to reissue a warning here on the claims that any one medication does or does not constitute effective dosage rates or safety limits. NONE of us are Doctors Of Medicine or Doctors Of Pharmacy. There is very little hard and conclusive research into cross gender hormones although it does keep getting better. This is information from a panel of pharmacists and M.D.s of WPATH.

ONLY the doctor of the Transsexual patient, based on personal MEDICAL JUDGMENT supported by medical research, and followed up with monitoring of the patients health can end up concluding that a medication is ineffictive in any way shape or form. A deviation from that premise is an invitation to self medication which is completely against the rules of this Forum.

[Drea]

Patches of Estradiol, come in small doses, and they're just a waste of money for an MTF to seriously use, unless theyve been on mones and blockers a long time, had a orchiectomy.. then they dont have to fight off the natural Testo so much, and sometimes a patch is sufficient dosage. patches can also of course irritate the skin, the chemicals in it, and the adhesive as different things to consider too.

...Sorry, but I have transitioned quite successfully, entirely on transdermal patches; as a matter of fact they are available in different dosages and with appropriate medical supervision you can use more than one at a time to achieve the desired blood level of Estradiol.

Yes I would amplify. I have no idea where this conclusion about patches being worthless came from. I too know people who been on patches and exclusivly patches and have gotten the desired effects so them being "worthless" would seem to be incorrect. As stated there are lower and higher dose patches available like injectible and like pills. It is just a different way of administering the medication.