low dose HRT E and mental affects

[Nelsea]

hello everyone. ive been presenting more female in public in the past year and changed a bunch of behaviors and habits since then. my therapist suggested HRT and i decided to try low dose E HRT. i got an initial assessment to see see if an endo will see if its fit for me and do some of the tests related to such a procedure in a little over 3 weeks. i am a bit worried about loss of strength as its relatable to my job and the potential mental changes on a brain on E. i know alot of its is part of the package so it wont be a surprise. are mental changes developing at the same pace as a person going through normal levels of E HRT? i know YMMV as for the pace but what has been the general consensus on mental changes?

 

im an introverted persom most of the time, rarely cry and have been guilty on many occasions of dismissing/not emotionally connecting to family posts. stuff like a child doing a cute thing and i dont see the cuteness/funny factor in it what others clearly see. im sure that will change on E but i hope i dont get too many mood swings if possible. any physical changes from E will be welcome but its the mental ones that are harder to see. i dont really plan to use that down there so fertility isnt a big concern.

[Astrid]

:Hi, @Nelsea-- As a non-binary person who started HRT (E patches) just over three years ago, I too decided to start with low dose patches. As my doctor said at the time, HRT at any level produces at least *some* changes.  And you're correct, the pace of change varies for everyone. 

 

For me, the mental changes at that low level were not enough, and so we upped them higher.  I'm so happy that I did so, as my mental dysphoria pretty much disappeared. My blood tests now show that my E levels are average for a woman who is not ovulating, and my T levels are quite low.  Yes, my strength is lower, and yes, my emotions are definitely higher (I tear up regularly watching romantic comedies with my wife, who hands me a tissue with a smile). But the greater empathy that I have for others is soooooooo worth it, compared to my old (unhappy) self.

 

4 hours ago, Nelsea said:

i hope i dont get too many mood swings if possible

 

You may find yourself doing what I did, and adjusting (with your doctor/endo) the dosage levels of E to find where you are happiest.  It's not unusual at all for HRT patients to do this, particularly when they are starting out.  It can be a balancing act, for sure, to discover what works best for you.

 

Best of luck as you begin your HRT journey,

 

Astrid

 

[Nelsea]

5 hours ago, Astrid said:

:Hi, @Nelsea-- As a non-binary person who started HRT (E patches) just over three years ago, I too decided to start with low dose patches. As my doctor said at the time, HRT at any level produces at least *some* changes.  And you're correct, the pace of change varies for everyone. 

 

For me, the mental changes at that low level were not enough, and so we upped them higher.  I'm so happy that I did so, as my mental dysphoria pretty much disappeared. My blood tests now show that my E levels are average for a woman who is not ovulating, and my T levels are quite low.  Yes, my strength is lower, and yes, my emotions are definitely higher (I tear up regularly watching romantic comedies with my wife, who hands me a tissue with a smile). But the greater empathy that I have for others is soooooooo worth it, compared to my old (unhappy) self.

 

 

You may find yourself doing what I did, and adjusting (with your doctor/endo) the dosage levels of E to find where you are happiest.  It's not unusual at all for HRT patients to do this, particularly when they are starting out.  It can be a balancing act, for sure, to discover what works best for you.

 

Best of luck as you begin your HRT journey,

 

Astrid

 

Thank you for the reply. The only dysphoria I might have is with that down there and it's a mild case. I just can't connect to that at times, it still there for biological reason. I am more attentive to shaving the arms legs and chest area. Overall I exist in the world as an individual but that's the usual extent. Exploring this new side of me does bring comfort and a smile when I say my name. J gives me a neutral response, Nelsea brings a smile to my face.

 

Right now my mom knows I wear different clothing but not the rest of the iceberg. Low dose hopefully should give me a gentle transition to work things out with family. They wont take it very well...

[Astrid]

14 minutes ago, Nelsea said:

Low dose hopefully should give me a gentle transition to work things out with family. They wont take it very well...

 

From my personal perspective, HRT is not related to working things out with your family.  Most folks work on the (difficult) milestone of coming out prior to starting HRT, and whether or not you've already started low dose estrogen would be just a part of what is a significant, extended conversation with whomever you choose to come out to about your gender identity.  We're happy to share resources that assist with coming out, if and when you believe it's time for coming out.  

 

Hugs and best wishes,

 

Astrid

[Nelsea]

2 hours ago, Astrid said:

 

From my personal perspective, HRT is not related to working things out with your family.  Most folks work on the (difficult) milestone of coming out prior to starting HRT, and whether or not you've already started low dose estrogen would be just a part of what is a significant, extended conversation with whomever you choose to come out to about your gender identity.  We're happy to share resources that assist with coming out, if and when you believe it's time for coming out.  

 

Hugs and best wishes,

 

Astrid

thank you, im thinking more along the lines of them maybe noticing a few things and cluing in themselves and getting it normalized. something like seeing some changes and that they might be for the better as compared to previous base line. it might be a bit of a reach logic wise but if they see some improvement from those changes on E then they might not be so hard to accept it. i might be a bit naïve here but i do need to see what E does to me before i come out and make the decision. i feel like i need to give myself the chance to try it rather than wonder what might've been. i cant say im on the fence but i feel like HRT will give me a better perspective on what the changes im going through really mean and whats behind it that made me wear different clothes and present differently.

[Nelsea]

got an update on my situation. i had an appointment with an informed consent clinic. i got my prescription of ---estradiol, ---- spiro. need to do my baseline blood test this friday then i can finally start by picking up the prescription and take them. i forgot to mention low dose and she usually starts with ---- estrdiol and --- spiro. i might just forget about low dose option and do regular dose, the result will end up in the same direction..

 

seeing my name and chosen name (typoed to Neilsea...) and the things to test for on paper makes it much more realistic.

Edited February 14, 2023 by Carolyn Marie
Dosage info deleted per Community Rule 13. Please read the rules, newbies! Thank you.

[Nelsea]

thank you Carolyn for correcting my error, forgot that part of the rules.

 

took the baseline blood test and got the prescription. took the first dose around 1hr ago.

[Carolyn Marie]

Congrats, Nelsea!  You're on your way!  That's wonderful to hear. 

 

Don't worry about the error; it happens all the time.  You're good.

 

HUGS

 

Carolyn Marie

[Nelsea]

15 hours ago, Carolyn Marie said:

Congrats, Nelsea!  You're on your way!  That's wonderful to hear. 

 

Don't worry about the error; it happens all the time.  You're good.

 

HUGS

 

Carolyn Marie

 

thanks, i took the opportunity, well more like settled for a name/pronoun at the pharmacy. the lady was kind enough to ask that out of courtesy or seeing my general appearance, hair nails and Bra (if she noticed the shape outwardly). the pharmacist was another story, young man in 20sto 30s or something around there. he was a bit off step seeing the prescription for me and stumbling a bit in the explanation of the effects of the drugs.

 

if my current Dr for the HRT doesnt lower the dose, i might skip low dose all together. its all going to end up the same way. though if the pace of change is a bit too fast maybe lower dose but otherwise its the starting dose that got prescribed that i will stick with.

[Nelsea]

LOL though it seems my name is a bit complicated to spell if i dont specify it. it was misspelled Neilsea at the informed clinic and it carried over to the prescriptions. i did correct that at both clinic and pharmacy.

[Louise B]

Ms. Nelsea,

 

I do not think you need to worry about mood swings.  That term, referring to a back-and-forth in moods, is typically caused by fluctuating hormone levels within the menstrual cycle.  Some transwomen "cycle" their hormones in effort to match this effect, so they can have the most genuine female experience possible for them.

 

In contrast, it seems that you...like most of us on HRT...take a constant dose of hormones.  The growth you may experience in emotional range is a single path; it should not be a back-and-forth.  So your emotions may change, and presumably you want that, but mood swings are not necessarily your destiny.

 

Even the increase in dosage you are contemplating is a single change.  You may or may not feel that impact emotionally, but it should be linear rather than back and forth.

 

As for losing physical strength and its impact on your job, the loss of upper body strength is your destiny the more physically you become a woman.  But there are two caveats:  

 

1) The change is gradual, and you can stop HRT if you decide this loss in muscle mass bothers you too much. You can begin to regain that mass once the hormones leave your system.

 

2) The biggest impact is upper body.  I once read that women have 67% to 85% of the lower body muscle mass that men have, so the difference in your legs will not be as significant as your arms.  This ratio considers height and weight.  So also consider that your final strength level will be comparable to a woman of your size rather than the average woman.  If you are taller than average for a woman, you should be able to be stronger than the average woman...but no longer as strong as a man.

 

What you can do is keep working out (or start working out) so that you can be the strongest woman reasonably and appropriately possible for your body.

 

Best,

Louise

[Louise B]

Here is a great article for you to consider on the question of mood swings:  https://getplume.co/blog/estrogen-and-emotions-during-gender-affirming-hormone-therapy/?utm_source=Email&utm_medium=Promo&utm_content=Blog4&utm_campaign=Conversion5e

 

[Nelsea]

On 2/27/2023 at 5:00 AM, Louise B said:

Ms. Nelsea,

 

I do not think you need to worry about mood swings.  That term, referring to a back-and-forth in moods, is typically caused by fluctuating hormone levels within the menstrual cycle.  Some transwomen "cycle" their hormones in effort to match this effect, so they can have the most genuine female experience possible for them.

 

In contrast, it seems that you...like most of us on HRT...take a constant dose of hormones.  The growth you may experience in emotional range is a single path; it should not be a back-and-forth.  So your emotions may change, and presumably you want that, but mood swings are not necessarily your destiny.

 

Even the increase in dosage you are contemplating is a single change.  You may or may not feel that impact emotionally, but it should be linear rather than back and forth.

 

As for losing physical strength and its impact on your job, the loss of upper body strength is your destiny the more physically you become a woman.  But there are two caveats:  

 

1) The change is gradual, and you can stop HRT if you decide this loss in muscle mass bothers you too much. You can begin to regain that mass once the hormones leave your system.

 

2) The biggest impact is upper body.  I once read that women have 67% to 85% of the lower body muscle mass that men have, so the difference in your legs will not be as significant as your arms.  This ratio considers height and weight.  So also consider that your final strength level will be comparable to a woman of your size rather than the average woman.  If you are taller than average for a woman, you should be able to be stronger than the average woman...but no longer as strong as a man.

 

What you can do is keep working out (or start working out) so that you can be the strongest woman reasonably and appropriately possible for your body.

 

Best,

Louise

 

thank you for the reply, its almost 2 weeks since i started HRT and its still a bit early but i havent noticed that many changes to my mood or atleast none that are more powerful than before. sensitive moments or situations havent yet shown my changes yet. im not really empathetic and emotional so its one thing that might be noticed as time passes. right now im in pretty good control of my emotions and i hope that trend continues.

 

i know i will lose some strength, just hoping it wont be too much tp make my work difficult. im not the strongest but im not that weak. i do need to hit a gym or some weights when i remember to do so.

[Nelsea]

so im 2 months on into HRT. my E dose was adjusted a bit higher after 5 weeks. in the first 5 weeks my T dropped 82% from baseline and E went from 102-233. with the adjusted dose im expecting a bigger gain in E and near 0 T by the end of of may. the chest might've gained a bit of volume but the top half of the area contoured in nicely.i can see breasts on me now, still on small side, 2" difference from underbust measurement.

 

put my hair in a messy low twin tail and i saw Nelsea come to the surface for real and i dont automatically see a male face when i see my reflection. its like a switch flipped and my appearance real or fake brings Nelsea to the surface much easier.

[missyjo]

Nelsea

 

Congratulations dear. It sounds like you're well on your way. I am envious and hope to join in soon. 

 

Good for you dear.

 

Enjoy your journey. 

 

Hugs