The things no one tells us about hrt.

[Katie M]

6 hours ago, Erica Gabriel said:

The hair on my palms thinned out considerably but it could be that I've been on HRT for a year and I've a major lack of libido and the accompanying "friction therapy"🤪.

That's hilarious, @Erica Gabriel!💜

[Jamie68]

5 hours ago, Billie75B said:

@KathyLauren Are you a DES girl? I have wondered about if I am a DES child as my mom was 35 when she got pregnate with me and back in the fifties from what I understand doctors handed that stuff out like candy, unfortunately she passed away 10 years ago so I never got to ask her( at that time I didnt know to ask) but like you hardly any chest hair arm hair or even that much leg hair. My doctor also noticed that I dindt have the typical male adams apple.

 

Hugs

Billie

I think I'm a DES girl also. Born December 1952, prime time for DES. I've never had much body hair and don't have pronounced Adam's apple. Mom died when I was 7 years old. Just have to assume she took it. 

[Jamie68]

I never really thought about it much, but if I don't eat every 4 hours I feel like I'm starving. I always feel weak now. Hopefully when the weather gets better I can be more active outdoors. I want to lose weight, but at this rate it's going to be difficult. I go for my next blood test in a little over a week. Hopefully I'll finally be in the zone. It's been a little over a year now since starting HRT. 

[Jamie68]

12 hours ago, Hannah Renee said:

I'm fortunate to be able to talk to my PA without needing to talk to a nurse first. In fact, she called me yesterday to follow up on our discussion from 2 weeks ago regarding starting on spironolactone. I hadn't been on it because right off the bat, my T went down to an acceptable level, and had been steady (9 months now 9. I was also somewhat apprehensive about it being a diuretic, and, being almost elderly 6 more months) I pee frequently enough as it is. Anyway, she said that my T could go down a little bit more, so I started today. We also chatted about my having on orchiectomy down the road, which I would like to do. And she's on board with that.

That's awesome. I think mine is too busy to answer calls. Besides being a family practitioner, I've been told that he takes care of the majority of the Transgender people in the Bloomington/Normal area. I just saw him recently, and while I was there we talked about my getting a bilateral orchiectomy if my levels aren't in the zone yet. He has no problem with that. On my first visit with him he had mentioned getting one, and asked if I wanted a referral. I didn't at the time because I didn't want to shrink too much so that I wouldn't have to have skin grafting for full depth Vaginoplasty. Now that ffffing covid has messed up timelines for elective surgeries, I may opt for shallow depth instead. ☹️

[Ivy]

15 hours ago, Jamie68 said:

I think I'm a DES girl also. Born December 1952, prime time for DES. I've never had much body hair and don't have pronounced Adam's apple. Mom died when I was 7 years old. Just have to assume she took it. 

Similar situation for me.  But no way to know.

Born '50.  My mother had problems with miscarriages before I was born.

I don't have a lot of body hair - just enough to bother me.  My kids (even some of the girls)  have way more, which I suspect comes from their mother's side.

[Jamie68]

19 minutes ago, Hannah Renee said:

Hmmm. I was born in September 1952. I have very little body hair and no pronounced Adam's apple. Never heard of DES. But you all have reminded me that, somewhere between my older brother, JAN 51, and perhaps after my sister 1956, my mother had 2 or 3 miscarriages. Again, hmmm.

There is a lot of info online about DES. some pro and some con. I tend to believe the "pro" arguments. I've seen too many examples to not believe in this effect. My therapist is a Transwoman and has a gay brother. My oldest sister has a great deal of male attributes, including a deep voice. My second oldest sister was a twin where the twin miscarried. There is a lot of circumstantial evidence out there. Almost impossible to prove.

[Billie75B]

50 minutes ago, Jamie68 said:

There is a lot of info online about DES. some pro and some con. I tend to believe the "pro" arguments. I've seen too many examples to not believe in this effect. My therapist is a Transwoman and has a gay brother. My oldest sister has a great deal of male attributes, including a deep voice. My second oldest sister was a twin where the twin miscarried. There is a lot of circumstantial evidence out there. Almost impossible to prove.

Another reason I suspect DES is my older sister that is 11 years older than me has had all sort of female issues and could never get pregnant when I told her about DES she to wanted to know more and she was the executer of my parents but nothing was in any recent medical files on my mom. So we will never know for sure but highly likely.

 

[Jamie68]

15 minutes ago, Billie75B said:

Another reason I suspect DES is my older sister that is 11 years older than me has had all sort of female issues and could never get pregnant when I told her about DES she to wanted to know more and she was the executer of my parents but nothing was in any recent medical files on my mom. So we will never know for sure but highly likely.

 

All the doctors that my mom saw are deceased and the hospital she died in no longer exists. Is it really important to know? I think not. Does it prove anything? No. It is interesting to think about though. We are what and who we are, no matter how we got this way. ♥️ 

[Ivy]

4 hours ago, Jamie68 said:

Is it really important to know? I think not. Does it prove anything? No. It is interesting to think about though. We are what and who we are, no matter how we got this way.

Doesn't make any difference in the end.

One more thing, in my family, a younger sister died from cancer (uterine I think).  Her twin sister had a hysterectomy to be safe.

Not really conclusive, but interesting.

[Billie75B]

22 hours ago, Jamie68 said:

All the doctors that my mom saw are deceased and the hospital she died in no longer exists. Is it really important to know? I think not. Does it prove anything? No. It is interesting to think about though. We are what and who we are, no matter how we got this way. ♥️ 

@Jamie68 you are absolutly correct on that point. Thank you. ❤️

[Bobbijean]

I am so grateful you gals brought up the subject of DES.  After researching it, I am certain my mother was taking it while I was in her womb.  My body bears the impacts that one would expect to see in "DES girl".  It explains so much about me as a person.

[Kasane]

Anyone experience E only vs E+spiro and know if the spiro was necessary in lowering t to female norms? I have looked at a couple recent studies that seem to indicate maybe e17beta alone will do the trick without a blocker. I know it's an individual response variable kind of thing, but was just wondering. Feeling like the spiro is draining all libido from life. 🙁

[Guest]

I have no point of reference. I went on Estradiol Valerate injections, spironolactone twice per day, and progesterone. Testosterone went from 550 to 37 in 3 months. 

[Heather Nicole]

1 hour ago, Kasane said:

Anyone experience E only vs E+spiro and know if the spiro was necessary in lowering t to female norms? I have looked at a couple recent studies that seem to indicate maybe e17beta alone will do the trick without a blocker. I know it's an individual response variable kind of thing, but was just wondering. Feeling like the spiro is draining all libido from life. 🙁

 

 

This is, of course, the sort of thing that tends to be highly individual. And I'm not familiar with the term "e17beta". But FWIW:

 

I started on estradial-only (using patches), getting close to 7 months ago now. (Unfortunately, they didn't do a baseline bloodtest to see where my hormone levels were pre-HRT, so I don't know that info 🙁)  After 3 months of my introductory dose of my transdermal estradial patches, my E was above cis-male levels, but below cis-female levels. And my T was still within the "normal" cis-male level, but right around the low end of it. So they increased my E.

 

After a second 3 months, there was NO meaningful change in my E or T levels, whatsoever. Basically identical to the last time. So then, at 6 months in, I started on Spiro and they also increased my estradiol patch again. (At this point, they gave me two options for the Spiro dosage.  I went with the higher one.)

 

Unfortunately, that's where my data ends so far. At this point I've been on the E+spiro combo for (almost) 4 weeks, and I haven't yet noticed any changes I've actually been certain about aside from some occasional upper-chest itchiness I first started getting around 6 weeks into E-alone. Over the same time period, there's been a few other things (like emotions, nipples, libido, skin, ability to cry) that I've been very unsure whether I've had any actual real change at all, or if I've only imagined a small change just because I was expecting to see the change. I won't know my new hormone levels until early September.

 

As far as whether or not "spiro [may or may not be] necessary in lowering t to female norms", again, my purely amateur understanding so far is that that's highly dependent on the individual. My understanding is that T and E both tend to suppress each other, so "in theory" T could be fully suppressed by E, but a couple of the factors involved that are how much T needs to be suppressed and, of course, just individual biological differences.

[Jackie C.]

11 hours ago, Kasane said:

Anyone experience E only vs E+spiro and know if the spiro was necessary in lowering t to female norms? I have looked at a couple recent studies that seem to indicate maybe e17beta alone will do the trick without a blocker. I know it's an individual response variable kind of thing, but was just wondering. Feeling like the spiro is draining all libido from life. 🙁

 

There is a doctor around here who will absolutely blitz your system with E... and I think Progesterone... without the blockers. When I say blitz, I mean he hits you with CRAZY huge doses of E. Blood levels 10x what a cis-woman has. He gets results, but he scares me. I have a friend who sees him, and I'm scared for her too.

 

Hugs!

[Guest]

The one big caution with all of these various regimens is that you need to have medical guidance. What works for one person does not necessarily work for another. Our individual metabolisms, liver function, baseline hormonal function, current endogenous estrogen and testosterone levels will vary. There is no one magical bullet. There are also some providers who use different regimens. There is no one study that has determined the best dosages to use to effect transitional changes. There is also the issue of complications. As for spironolactone, one needs to know that it may decreased testosterone levels as it has the side-effect of being an anti-androgen. The primary purpose of this drug is that it is a potassium sparing diuretic. You will excrete more fluid, increased sodium (salt) excretion, but the medication helps to conserve potassium. You may get dehydrated, have a lower sodium level, and develop a higher potassium level as a result. These effects can be good or bad within a certain range.

 

The one big thing is that this is a marvelous drug for management of high blood pressure, however, many guys will either not take it, or stop taking it because of the potential for erectile dysfunction (ED). Of course some guys already have ED. 

 

Bottom line: Find a qualified provider who actually has some knowledge of what they are prescribing and can monitor you appropriately to ensure you survive your transition without serious harm.

 

Sincerely

Katie

[Guest]

7 minutes ago, Jackie C. said:

 

There is a doctor around here who will absolutely blitz your system with E... and I think Progesterone... without the blockers. When I say blitz, I mean he hits you with CRAZY huge doses of E. Blood levels 10x what a cis-woman has. He gets results, but he scares me. I have a friend who sees him, and I'm scared for her too.

 

Hugs!

Jackie,

 

Without getting into a deeper discussion, this can be done. Nobody has identified the ideal dosing range, although, there are places that have identified a dosing range. The use of higher dosing causes a faster suppression of testosterone, and the progesterone works as an GnRH inhibitor. The big issue is whether someone has risk factors. Going that high on the estrogen level may have issues in someone who is not appropriately evaluated. If someone is a smoker, has obesity, has any risk factors for blood clots, they could face significant harm. My current levels are higher as well (by design-but not 10 times as high,) and I have had great success, but this was done only with medical guidance, and I knew full well what the risks were. I also have no risk factors. I also had extensive screening before treatment. 

 

Again, one needs to be under care of someone who really understands and can manage the meds and the patient. 

[Jackie C.]

1 minute ago, Katie23 said:

Without getting into a deeper discussion, this can be done. Nobody has identified the ideal dosing range, although, there are places that have identified a dosing range. The use of higher dosing causes a faster suppression of testosterone, and the progesterone works as an GnRH inhibitor. The big issue is whether someone has risk factors. Going that high on the estrogen level may have issues in someone who is not appropriately evaluated. If someone is a smoker, has obesity, has any risk factors for blood clots, they could face significant harm. My current levels are higher as well (by design-but not 10 times as high,) and I have had great success, but this was done only with medical guidance, and I knew full well what the risks were. I also have no risk factors. I also had extensive screening before treatment.

 

I am WELL aware. As an example, one of the girls he did that too got amazing results, huge breasts, etc... Except now she has breast cancer. My point was that being patient is safer. You might not see HUGE results, but you are much less likely to have your liver and/or kidneys shut down. This guy doesn't do incremental doses so much as he lets you drink from the firehose. In the medical community, he's considered something of a loose cannon, but his patients DO see results so he's popular in the trans community, especially with girls who have decided that they can't wait. He's better than self-dosing, but he's got some pretty wild theories.

 

Hugs!

[Ivy]

Don't have anything to add here.  

But I can say that I use estradiol without Spiro.  The Spiro does not agree with me - kills my sodium levels.

[Heather Nicole]

3 hours ago, Jackie C. said:

This guy doesn't do incremental doses so much as he lets you drink from the firehose.

 

Puts me in mind of one of my favorite movies, UHF:

 

 

[Marcie Jensen]

2 hours ago, Jandi said:

Don't have anything to add here.  

But I can say that I use estradiol without Spiro.  The Spiro does not agree with me - kills my sodium levels.

Me too. Right now I'm on estradiol, progesterone and duatesteride. Seems to be working for me, and my doctor is pretty cautious.

[Ivy]

I love that Weird Al flick.

[Kasane]

Thanks for the insights. I know this is all individual differences kind of stuff, but it helps to get a little perspective.

 

Sorry about the confusion - 17-b estrogen is what they measured in serum in the study; they gave the participants an estradiol, pill form. (I'm personally patching it at low dose.)

 

I want to be safe about things, so am in no rush to bump up e (and def not firehose). Wait on the next blood work and reassess is the plan.

[stveee]

"I'm 24, just started HRT and I have a hot date next week, need tits NOW, long-term health issues be damned "

 

 

[Saoirse 2]

On 7/18/2022 at 12:22 PM, Marcie Jensen said:

Me too. Right now I'm on estradiol, progesterone and duatesteride. Seems to be working for me, and my doctor is pretty cautious.

Same for me, estradiol and progesterone only. Apparently spiro is inappropriate with some of my blood pressure medication. In any case, this seems to adequately reduce my testosterone to cis-female normal levels (ymmv).

 

So all the more reason to consult with your PCP and endocrinologist!