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Trans-Woman HRT Journey Beginning


Mikayla2024

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Posted (edited)

Hi All,

 

So today, I finally met with my Nurse Practitioner in her office to officially go over HRT for me. A little bit of background about gender affirming care in my province I live in - Doctors and NP’s now have the authority to perform gender affirming care as per a new directive recently. I only know because 6 weeks ago when I met with her and telling her about who I truly am, she said that before our appointment she was in a province wide zoom meeting with the sexual health centre in Halifax about gender affirming care and them explaining to all the PCP’s that if they can handle gender affirming care in the community as it would help save resources to focus on the more sensitive clientele such as children and teens.
 

At the end, I had to sign a document ensuring I understood everything. I grabbed the document so fast and signed away !!
 

So, she prescribed XXmg of spiro daily in the morning (Anti-Androgen) to start for 4 weeks and then seeing how I respond to that, she’s going to then start me on Estrogen pills. I already have a follow up appointment booked at the end of June.

 

I trust my NP wholeheartedly, kinda disappointed that I didn’t get the E, but I totally understand why. I’m a little nervous with the side effects however of Spiro, but regardless of side effects I’m going ahead with the plan and trusting in process and becoming who I’m truly supposed to be.

 

Question though as I’m curious - I know it’s a low dose of spiro but even then what sort of changes can I see from just the spiro alone without the e for those first 4 weeks? 
 

thanks everyone!!

 

Kayla

Edited by Mmindy
Rule 13 Med dosage
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  • Forum Moderator

Good afternoon Kayla,

 

Welcome to Transgender Pulse Forum, I hope you find this place as helpful and fun as I do. There are so many people from all walks of life, and locations in the World. Look around and join in on any threads you find interesting.

 

Best wishes, stay positive and motivated,

 

Mindy🌈🐛🏳️‍⚧️🦋

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Just now, Mmindy said:

Good afternoon Kayla,

 

Welcome to Transgender Pulse Forum, I hope you find this place as helpful and fun as I do. There are so many people from all walks of life, and locations in the World. Look around and join in on any threads you find interesting.

 

Best wishes, stay positive and motivated,

 

Mindy🌈🐛🏳️‍⚧️🦋


Thank you, Mindy! Such a warm welcome!! I’m excited and honoured to be here !! 😊

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I can't answer your question since my doc's plan didn't start that way, but I do love to quote what she said to me when we began HRT when I see a post like this, "Let's get this party started!"

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  • Forum Moderator

Hi, Kayla.

 

Another Bluenoser!  (Actually, I'm not a real one.  I am a CFA.) 

 

I can't answer your question about the effects of spiro alone.  I started on spiro and estrogen at the same time.  I expect that spiro alone might relieve some dysphoria symptoms, but would not start any physical changes.  But that is just a guess.  The big thing with spiro is to drink enough water, since it is a powerful diuretic.

 

I started out getting my transition care from the Halifax Sexual Health Centre, but once my hormone regime was stable, I asked my GP if she would be comfortable taking over my prescription.  She was, so I no longer have to do the long commute into the city.

 

Regards,

Kathy

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Just now, MirandaB said:

I can't answer your question since my doc's plan didn't start that way, but I do love to quote what she said to me when we began HRT when I see a post like this, "Let's get this party started!"


YASSSSSS GIRL!! 🥳🥳🥳

 

Just now, KathyLauren said:

Hi, Kayla.

 

Another Bluenoser!  (Actually, I'm not a real one.  I am a CFA.) 

 

I can't answer your question about the effects of spiro alone.  I started on spiro and estrogen at the same time.  I expect that spiro alone might relieve some dysphoria symptoms, but would not start any physical changes.  But that is just a guess.  The big thing with spiro is to drink enough water, since it is a powerful diuretic.

 

I started out getting my transition care from the Halifax Sexual Health Centre, but once my hormone regime was stable, I asked my GP if she would be comfortable taking over my prescription.  She was, so I no longer have to do the long commute into the city.

 

Regards,

Kathy


Such a small world, Kathy!! If you live in NS, you’re def a bluenoser in my eyes ⛴️ !! 😊 

 

But thank you so much for the response and advice!! Everyone’s HRT path is def different and I realize that, I’m just thankful that I’m finally starting somewhere and you’re right having the script has totally relieved my dysphoria symptoms even more! It’s like a big weight has been lifted off my shoulders and I can finally start the transitioning process !!

 

The way I see it, It’s only 4 weeks or 28 days on Spiro then I’ll be on Estrogen pills along with it. So, it’s going to come much sooner than I would’ve liked to realize. I just have to trust the process as I’m her first patient ever to do a full transition from the beginning and the fact that she’s willing to take me on and learn about it at the same time makes me really comfortable and trust in her process. The thing I like about her is that she told me she took an online course on gender affirming care on her own time specifically for me. So I believe she might know a thing or two. 
 

We have a plan to do that for 6 months to 1 year and if everything is good with my labs then it’ll be injections and I hear that alone is enough to suppress T once it’s suppressed by the original regiment. 

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Congrats on this step of your journey... will be interesting to see how things go for you as I am only about eight weeks ahead and doing a little different plan... I did a lot of reading on estrogen monotherapy (no spiro) and my doc was OK starting me on an E patch alone. I have already stepped up the dosage once... I have experienced some mild effects thus far. Some "plumping" in my chest (that at least I have noticed) and a little more roller coaster emotions being the biggest...

 

Enjoy the ride. Welcome to the party. As others have shared, there are a lot of great, thoughtful people on here. I like to draw from the many varied experiences others have had and am learning a lot from that! Blessings to you!!

 

Easy

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6 hours ago, Mikayla2024 said:

The thing I like about her is that she told me she took an online course on gender affirming care on her own time specifically for me.

 

Now that is what I call service!  Congratulations on your HRT and on having such good patient care.

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Spiro by itself may induce some feminizing effects by suppressing T and allowing natural E in your system to bind. Just make sure you drink enough water! 😀

 

I specifically chose not to use a T blocker, I’m already on blood pressure meds that are effective and I did not want to risk greater sexual dysfunction of my lady stick 🤭. My labs on one shot of a “introductory” dose of estradiol velerate saw my T plummet within the first three months regardless, down to cis female levels. I have more labs in a couple weeks to check on things after titration of dose and perhaps a step up in dose. 

 

6 months flies, girls!

 

It sounds like you have a wonderful NP and I’m so glad you were able to start GAHT. I’d love to keep hearing about your journey. 

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Just now, KathyLauren said:

 

Now that is what I call service!  Congratulations on your HRT and on having such good patient care.


Thank you so much, Kathy! 😊

 

Just now, MaeBe said:

Spiro by itself may induce some feminizing effects by suppressing T and allowing natural E in your system to bind. Just make sure you drink enough water! 😀

 

I specifically chose not to use a T blocker, I’m already on blood pressure meds that are effective and I did not want to risk greater sexual dysfunction of my lady stick 🤭. My labs on one shot of a “introductory” dose of estradiol velerate saw my T plummet within the first three months regardless, down to cis female levels. I have more labs in a couple weeks to check on things after titration of dose and perhaps a step up in dose. 

 

6 months flies, girls!

 

It sounds like you have a wonderful NP and I’m so glad you were able to start GAHT. I’d love to keep hearing about your journey. 


Congrats Girl! Your T levels plummeting from just estradiol velerate alone to cis female levels is amazing!! Sounds like you chose the right introductory method!! 
 

This mono-therapy thing has gotten me so interested now! I’ve only been here less than 24 hours and from what I’ve been seeing and hearing it seems to be the way as of date from what I have gathered as GAHT treatment seems to be from out-dated treatment data. 
 

Regardless, yes she’s a wonderful NP, I’m going to risk taking the spiro despite the possible side effects and see where things go. Such an exciting journey for everyone here, and yes, I too also want to keep hearing about your journey as well! 😊

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  • Forum Moderator

Hi Kayla,

Glad to see your wonderful reception so far. You've met but a few of the wonderful people here already.

Hugs,

Heather

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Hi Kayla!

Welcome.

Sounds like a good NP you are with. 

I am another one that just took estradiol.  Worked for me.  My T went away from the first dose of E.  
 

Makes sense the way you’re going to try the spiro and see where it leads.

 

best to you 🌈🌈

 


 

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1 minute ago, Mikayla2024 said:

Regardless, yes she’s a wonderful NP, I’m going to risk taking the spiro despite the possible side effects and see where things go.


Everyone’s path is unique to them. What works amazing for one person may not work well for another (one reason why this forum has rules against sharing dosage information). So, each of us are experimenting in a way. Just create a plan, including options for changing things up if that plan is causing harm or not working, communicate openly and clearly with your provider, and stick with it. Body changes won’t happen overnight, so it’s good to remember you have time.

 

💜

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1 hour ago, Maddee said:

Hi Kayla!

Welcome.

Sounds like a good NP you are with. 

I am another one that just took estradiol.  Worked for me.  My T went away from the first dose of E.  
 

Makes sense the way you’re going to try the spiro and see where it leads.

 

best to you 🌈🌈

 


 


That’s so wonderful! I’m glad to hear that mono-therapy worked for you!


But Thank you, I’m def trusting the process and seeing where it leads. 😊

 

 

52 minutes ago, MaeBe said:


Everyone’s path is unique to them. What works amazing for one person may not work well for another (one reason why this forum has rules against sharing dosage information). So, each of us are experimenting in a way. Just create a plan, including options for changing things up if that plan is causing harm or not working, communicate openly and clearly with your provider, and stick with it. Body changes won’t happen overnight, so it’s good to remember you have time.

 

💜


That’s really kind of you to say all of that. It makes me feel better that the plan I’m sticking with is unique to me as every plan each and every one of us is on is unique. And yes, I absolutely echo your sentiments about communicating clearly and openly with my provider if something doesn’t feel right or not working. Very good advice! 😊
 

I told my provider at the appointment that my plan was to do mono-therapy once my levels were good. She said when that time comes it will definitely be considered, but for now it’s getting my levels where they need to be is her main concern.

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On 5/29/2024 at 7:37 PM, Mikayla2024 said:

Hi All,

 

So today, I finally met with my Nurse Practitioner in her office to officially go over HRT for me. A little bit of background about gender affirming care in my province I live in - Doctors and NP’s now have the authority to perform gender affirming care as per a new directive recently. I only know because 6 weeks ago when I met with her and telling her about who I truly am, she said that before our appointment she was in a province wide zoom meeting with the sexual health centre in Halifax about gender affirming care and them explaining to all the PCP’s that if they can handle gender affirming care in the community as it would help save resources to focus on the more sensitive clientele such as children and teens.
 

At the end, I had to sign a document ensuring I understood everything. I grabbed the document so fast and signed away !!
 

So, she prescribed XXmg of spiro daily in the morning (Anti-Androgen) to start for 4 weeks and then seeing how I respond to that, she’s going to then start me on Estrogen pills. I already have a follow up appointment booked at the end of June.

 

I trust my NP wholeheartedly, kinda disappointed that I didn’t get the E, but I totally understand why. I’m a little nervous with the side effects however of Spiro, but regardless of side effects I’m going ahead with the plan and trusting in process and becoming who I’m truly supposed to be.

 

Question though as I’m curious - I know it’s a low dose of spiro but even then what sort of changes can I see from just the spiro alone without the e for those first 4 weeks? 
 

thanks everyone!!

 

Kayla

They start you off with a low dose to see how the body reacts. It takes time for any results to actually take effect. There might be a placebo effect for now. Trust the process and know it’s not a sprint it’s an endurance. I would ask the NP to see about patches, gel or injections. The pill has known to be worse in the side effects. In my first year I have gained some breast growth. I started as a 42C and now a 42 DD but it’s also probably because I’m big. Weight loss for me is almost impossible. If I could get off my gut and go to hips and breast I wouldn’t mind. Enjoy and congratulations on the start of your new life. 

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13 hours ago, Ashley0616 said:

They start you off with a low dose to see how the body reacts. It takes time for any results to actually take effect. There might be a placebo effect for now. Trust the process and know it’s not a sprint it’s an endurance. I would ask the NP to see about patches, gel or injections. The pill has known to be worse in the side effects. In my first year I have gained some breast growth. I started as a 42C and now a 42 DD but it’s also probably because I’m big. Weight loss for me is almost impossible. If I could get off my gut and go to hips and breast I wouldn’t mind. Enjoy and congratulations on the start of your new life. 


Hi Ashley,

 

Thank you so much the reply !!!

 

That makes total sense with trusting the process and knowing that it’s not a sprint but rather like a marathon like you were saying. 

 

So far so good with the Spiro 2 days in. Other than peeing a lot lol. But, no other noticeable side effects which I’m happy to report. However, I am MUCH happier that I’ve started at least somewhere. Gender Dysphoria symptoms are VERY real and starting treatment has made me SO much happier.

 

But, I will definitely look into the other options for E as you mentioned as there are definitely other options to consider other than the systemic route, thank you!! 
 

p.s also trust in the process yourself and don’t be too hard on yourself. You’re a beautiful girl inside and out no matter what. “Patience is a virtue” is a proverb I’ve always lived by.

 

Much love girly 😊❤️

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1 hour ago, Mikayla2024 said:


Hi Ashley,

 

Thank you so much the reply !!!

 

That makes total sense with trusting the process and knowing that it’s not a sprint but rather like a marathon like you were saying. 

 

So far so good with the Spiro 2 days in. Other than peeing a lot lol. But, no other noticeable side effects which I’m happy to report. However, I am MUCH happier that I’ve started at least somewhere. Gender Dysphoria symptoms are VERY real and starting treatment has made me SO much happier.

 

But, I will definitely look into the other options for E as you mentioned as there are definitely other options to consider other than the systemic route, thank you!! 
 

p.s also trust in the process yourself and don’t be too hard on yourself. You’re a beautiful girl inside and out no matter what. “Patience is a virtue” is a proverb I’ve always lived by.

 

Much love girly 😊❤️

Thank you! 

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