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is 69 years of age to old to start HRT mtf

debbie jones

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ive been on herbal estregens off and on for about 6 years the most effective herb for me has been puraria mirifica but i have had side effects from it mainly being moor sensertive to things people might say to me in every day life also had a sore mouth with it in the past.

this time around ive started with a low dose and am graduly increaseing it but doing it slowly .

ive grow a B cup breasts so far and they are starting to look very fem just lately and ive only been back on the puraria a couple of months .

so im thinking at the mo i might never need to go on prescription HRT if progress continues as its going .

i know a lot of mtf say puraria is not any good but for some reason it works on me could be my age im 69 so i dont supose my T levels will be very high anyway .

ive seen where i can buy perscription estregen on line and i am tempted to try it as in self medicating but not realy shure how safe it might be at my age does any one hear have any knoleg of starting hrt later in life ?


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Hi, Debbie...


The VA had no problem with prescribing me HRT at that exact age.


Prior to that, I had been on the same regimen for a couple of years with their knowledge and was being monitored appropriately. That was before they had a formal policy in place regarding the treatment of transgender patients.


My first episode of bilateral pulmonary embolism in 2015 was attributed to estrogen, and so I stopped taking it. But I had a recurrence in 2020, and that time the doctors opined that I simply have a genetic tendency to develop blood clots. 

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69 is NOT too old to start HRT. That's when I started HRT with monitoring and it has been a lifesaver.

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I, too, started a couple of months before turning 69. I have as family history of cardiac issues, no including heart attacks, and my I have 3 cardiac stents myself. I'm on a blood thinner, and I take me estrogen pills sublingually to minimize adverse effects. Working well for me so far, 15 months in. Cardio workup in the spring was all systems go.

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I started on estrogen patches at 71, 2 3/4 years ago. No problems, but it's important to do this under a doctor's supervision with tests to monitor E & T levels.

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No age is too old to start HRT.  I am 68.  I was a but younger, but not a lot, when I started HRT: 62.


It is much better to be under medical supervision than self-medicating, and much better to be on prescription meds then on herbals.  It is important to have your blood levels monitored to avoid complications.


I know the MHS is a nightmare of waiting lists, but get your name onto the list right away, to avoid further delay.  I believe there are private options with shorter wait times, though they can be expensive.



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Self medicating with herbals and E prescription medications is dangerous at best at any age.  The person who founded this forum some years ago suffered from the near fatal results of self medication.  Please do see a doctor whether you are 68 or 16.  




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I was 68 when I got on estradiol patches with the VA.  I've had no problems with them, but TBH I would prefer better boobage growth.  

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OMG, y’all are just lifesavers!!   For sooooo many years, I’ve just considered it out of the question due to age.  Thank you from the bottom of my heart!

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4 minutes ago, AshleighMarie said:

OMG, y’all are just lifesavers!!   For sooooo many years, I’ve just considered it out of the question due to age.  Thank you from the bottom of my heart!


There are health risks though. They can be mitigated, but let me share the best piece of advice I got from a doctor during my transition: "Be in the best shape of your life."


Best of luck and big hugs!

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On 9/28/2022 at 9:31 AM, Ivy said:

I was 68 when I got on estradiol patches with the VA.  I've had no problems with them, but TBH I would prefer better boobage growth.  

Maybe it's TMI, but I can report that "my cups runneth over" from the recommended VA HRT regimen. 

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My endocrinologist refuses to give me progesterone.

I'm considering going outside for it.

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My cardiologist was extreemly upset as I'm started HRT because of the studies dome using progesterone so i've been using topical e as it is the safest.  I've come to accept what i've got up top.  After all big won't do me much good if a blood colt ends it all.





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I do have the E patches.   I have heard that the progesterone helps it work.

The first clinic I went to (PP) gave me progesterone, but no estradiol.  They said I was too old for their protocol.

My boobettes are barely A cup.  They are quite real though.  If that's all they do, I mean, okay then.  But just a bit more would be nice.  I would not do surgery for them though.  I'm 72 now anyway.

I'm trying some OTC cream stuff.  It's not as strong as Rx stuff, but perhaps it might help a little.  IDK

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Did your endocrinologist give you any rationale as to why he/she would not prescribe progesterone? The medroxyprogesterone acetate is dangerous, but the micronized version is much different. A while ago before I was purged from the system, I had posted a note and some references regarding micronized progesterone. The reality is that if you are an adult of sound mind as well as having been given the appropriate information, you should be able to give consent in what is known as shared medical decision-making. 


Things to ponder. You may want to share these with your endocrinologist:

Researchers in Scandinavia report a decreased incidence of heart attack in women who were on transdermal estrogen. In addition, the use of transdermal estrogen (TE) is linked with reducing both the systolic and diastolic blood pressure. The addition of micronized progesterone (MP) reduced blood pressure as well in women who took both TE and the MP. Further research demonstrated improved fasting blood glucose levels in those who used transdermal estrogen. As for venous thromboembolism (VTE), also known as blood clots, there was a decreased incidence with TE. Other conclusions were that TE does not increase the risk of stroke (L’Hermite, 2013). Micronized progesterone can be safe.

There are many benefits of progesterone. According to Prior (2019), the following benefits occur:
•    More rapid feminization.
•    Progesterone suppression of gonadal androgen production.
•    Leads to optimal breast maturation and size when given with estrogen.
•    Progesterone has an additive effect to estrogen in improving bone mass density.
•    Improved sleep and vasomotor responses.
•    Improved mood and decreased anxiety.

Prior (2019) notes that there was not an increase in venous thromboembolism when micronized progesterone is used in conjunction with transdermal or injected estrogens.

L’hermite, M. (2013). HRT optimization, using transdermal estradiol plus micronized progesterone, a safer HRT. Climacteric, 16, 44–53. doi: 10.3109/13697137.2013.808563

Prior, J. C. (2019). Progesterone Is Important for Transgender Women’s Therapy-Applying Evidence for the Benefits of Progesterone in Ciswomen. Journal of Clinical Endocrinology & Metabolism, 104, 1181-1186. doi: 10.1210/jc.2018-01777




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I will say this much about progesterone, I take it regularly and wow, it has been amazing for my skin between the progesterone and estradiol valerate. I could never go back to running on testosterone full-time. My skin has become buttery soft and smooth. Your mileage may vary. I am seeing more post-menopausal women on micronized progesterone as well. Good luck. Talk to your endocrinologist as well as your primary care. Your primary care provider can prescribe meds too. There is no hard rule that you have to stick with an endocrinologist. 

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One precaution I will add to any medication, do not try to get the stuff on the black market. It can be dangerous. You need a qualified provider who can carefully evaluate your present condition, and obtain labs including a comprehensive metabolic profile (CMP) which includes the usual electrolytes, glucose, renal functions, and liver functions. You should also have a complete blood count (CBC), PT/INR, lipids, and baseline testosterone levels, although this may vary from provider to provider. Some advocate baseline estrogen levels, but many providers do not get this testing until after three months of therapy. 


Again, it is highly dangerous getting anything on the black market. You never know what you are getting, or whether it is contaminated. 




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I would like to add that I think a lot of us have tried something when we were unsure or unwilling to talk to a doctor about our issues.  That said, I agree with Charlize and others who caution against taking herbs or other medicaitions found on the internet.


Answering the original question, is it too late to start, I didn't figure out I was positively Transgender until I was 69.  another year before I was allowed to begin HRT starting with Spiro, then 6 months before Progesterone and finally several months later, or almost another year past before Estradiol injections.  


currently I am on Estradiol patches because the injections aren't currently available.  my T is too low to measure but my E levels were insufficient to cause any growth.  basically, the older you are the less chance of growth according to my endocrinologist.  I will have to continue to take E the rest of my life even if it doesn't cause all the changes I was hoping for.


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Hi Debbie,


Just came across your question.  


I am 60 and seriously considering HRT, although i have not been taking any herbal or medicines that come close to HRT.


I think it would be too dangerous at any age but more so the older one is and ensure go the proper route through GP and clinic.  As i have what i belive is a form of gender dyshoria as i detest my genitals and facial hair (although fair its still noticeable) i am also undergoing gender therapy  for additional guidance.


Although likely to delay any HRT treatment i hope for i just want to ensure carried out safely which means i will be older should i hopefully start HRT. 


Best wishes to you and would love to hear about your journey to womanhood.


Warm regards


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I started with informed consent.  If I remember correctly the increased risks were not really that much more than what was already there due to my age.  Yes a little higher, but not as much as I had been led to believe.

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On 9/30/2022 at 3:01 PM, Jackie C. said:


There are health risks though. They can be mitigated, but let me share the best piece of advice I got from a doctor during my transition: "Be in the best shape of your life."


Best of luck and big hugs!

I second the opinions of working with a doctor and also being in the best shape of your life. I started  HRT 18 months ago. I’m 67 and I plan to live to a hundred, I hope. I’m looking to get a 30 year return on my investment! I’m also doing something really crazy this year. I’m training to hike the pacific crest trail and I’m getting in shape. I’m amazed how many female hikers there are. Almost 50%. They are my role models. I might not be able to do the whole trail from Mexico to Canada next year depending on what dates I get for surgery now that I have my letter. Maybe just Washington or just Oregon in the summer. We’ll see. 

As far as the question of age, it’s never too late. Here’s some advice a hiker gave me on getting started that applies to life in general. “Take the first step. The momentum will carry you through.”




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4 hours ago, Sarah Victoria said:

I think it would be too dangerous at any age but more so the older one is


I'm happy to report that for me, starting HRT at an older age has not been dangerous at all; on the contrary, I started at age 71 and, at 2 yrs. 10 months now, it has been transformative!  But let me add that it's very, very important to work with an experienced doctor/endocrinologist.  They'll monitor your reactions and your blood levels of testosterone and estrogen, among other things. It's not uncommon to adjust the dosage, especially at the beginning.  They did recommend the most conservative and safe approach for me, which is biweekly estrogen patches. No progesterone.  I am so much more happy these days!  It was not a trivial decision, but for me definitely the right one.


With best wishes,





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My issue, and I know this has to be consulted about with an endocrinologist, is that my underlying endocrine status is so complicated.   I had a tumor a few years ago that destroyed the function of the pituitary gland, and I have to take all of the hormones artificially.  

I’m concerned about the stroke risk associated with estrogen replacement, so I will thoroughly discuss that prior to any treatment. 

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Hi AshleighMarie..... i hope you get the answers and results you want and desire with being able to take the hormones with as little stroke risk as possible. Maybe a very low dose all the time, if so although your journey will take longer you will still achieve being the woman you feel in your soul  safely. 


Stay strong with warm hug and regard to you


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Self medicating is not the way to go hun, The hormone management system will not favour HRT at a later age group. Honestly private is the way to go and no it’s not expensive it really isn’t. Avoid estrogen tablets at all costs! Stick with patches as a precautionary as they are the slowest release form of estrogen.  Your t levels usually need suppressing but that comes after the introduction of estrogen usually a three month period to check the blood levels and assist making sure lactane levels and estrogen are within the female puberty range and t is lower than 3 you should be good 😊 


Try the London transgender clinic I believe a 3 to 6 month wait at the mo, I got on well with them on the whole.  

I find the science of it fascinating any questions just ask I’ll always give honest answer 🤩

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