HRT vs BHRT questions!

[Cecilia]

Hi ladies.  I will meet with my Trans MD in August to discuss starting HRT.  My wife (a Physician Assistant / PA) says I should ask about bio identical plant derive (or BHRT) hormones and try to avoid using synthetic hormones.   It seems like such a benign and wise advice since natural may be safer than synthetic. She said the drugs typically pushed on us by big pharma are made out of pregnant horse urine and that our bodies would be much better off with plant based bio identical hormones.    Is there a plant version of the estrogen, anti-androgen, progesterone, etc.?    Would the cardio vascular dangers, gastro-intestinal dangers, and hormone-sensitive cancer risks be less if the drugs are bio-identical instead of synthetic?   Does big pharma not offer bio identical alternatives because they cannot license and patent natural drugs?  In our medicine closet at home she has biestrogen and other bhrt's and says I should ask my Trans MD about those.   Has anyone had any experience with HRT vs BHRT?  Please advise!  I don't want to take unnecessary risks with my health if I can avoid it,  and I think my BCBS Advantage Blue PPO insurance plan probably doesn't care if the drug is all-natural or synthetic;  though is it possible that my prescription plan won't cover BHRT because of pressure from big pharma?  Will my Trans MD know about all this stuff?

[MarcieMarie12]

Your Trans MD might know, you could probably also ask the pharmacist.

[DenimAndLace]

What Marcie said.

However, so you can be "internet educated" before you have that conversation, Google Estradiol and Premarin. 

As I understand it: Premarin is derived from pregnant horse urine and WAS popular for transgender HRT in bygone days.  Today, however, it is more common to be prescribed Estradiol which is derived primarily from Soy and Yams and is then altered in a manufacturing facility to have a chemical structure which is "bio-identical" to that of humans.  Whatever else they stick in those little blue pills and how good or bad it is for us is beyond me.  I've come to peace with the fact that messing with my endocrine system may shorten my life by a few years or have other unknown consequences but it's a price I'm very willing to pay to live out what years I have left in peace with myself.  Had I not transitioned, I probably would have ended my life anyway.

[Cecilia]

16 hours ago, DenimAndLace said:

What Marcie said.

However, so you can be "internet educated" before you have that conversation, Google Estradiol and Premarin. 

As I understand it: Premarin is derived from pregnant horse urine and WAS popular for transgender HRT in bygone days.  Today, however, it is more common to be prescribed Estradiol which is derived primarily from Soy and Yams and is then altered in a manufacturing facility to have a chemical structure which is "bio-identical" to that of humans.  Whatever else they stick in those little blue pills and how good or bad it is for us is beyond me.  I've come to peace with the fact that messing with my endocrine system may shorten my life by a few years or have other unknown consequences but it's a price I'm very willing to pay to live out what years I have left in peace with myself.  Had I not transitioned, I probably would have ended my life anyway.

 

I forgot where I read the study,  but I read that life expectancy while on HRT was the same or better than when we were males. I think it was an article that was backed by insurance company actuarial tables.  For life insurance purposes we get the extended expectancy.  Google came up quickly with this:  

 

The Journal of Clinical Endocrinology & Metabolism Vol. 93, No. 1 19-25
"Long-Term Treatment of Transsexuals with Cross-Sex Hormones: Extensive Personal Experience"

Results: Mortality was not higher than in a comparison group. Regarding morbidity, with ethinyl estradiol, there was a 6–8% incidence of venous thrombosis, which is no longer the case with use of other types of estrogens. Continuous use of cross-sex hormones is required to prevent osteoporosis. Androgen deprivation plus an estrogen milieu in male-to-female transsexuals has a larger deleterious effect on cardiovascular risk factors than inducing an androgenic milieu in female-to-male transsexuals, but there is so far no elevated cardiovascular morbidity/mortality. Low numbers of endocrine-related cancers have been observed in male-to-female transsexuals.

Conclusions: Cross-sex hormone treatment of transsexuals seems acceptably safe over the short and medium term, but solid clinical data are lacking.

 

[Charlize]

This is something best discussed with your doctor.  In saying that i have to remember that at the least pharmacy derived drugs have to pass through some protocol and testing to be considered safe.  Most non pharma drugs never undergo such testing and any information is usually anecdotal.   

I have severe coronary artery disease and have had trouble over the years getting any form of HRT.  Persistence helped.  I am now using a spray form of estradiol and being post orchiectomy i've found that quite sufficient.  Interestingly i feel great and my cardiologist has me on yearly visits instead twice a year as i was when male.  

We can transition safely at this point and safety is much better especially if we go to knowledgeable doctors.

 

Hugs,

 

Charlize

[Cecilia]

6 hours ago, Charlize said:

This is something best discussed with your doctor.  In saying that i have to remember that at the least pharmacy derived drugs have to pass through some protocol and testing to be considered safe.  Most non pharma drugs never undergo such testing and any information is usually anecdotal.   

I have severe coronary artery disease and have had trouble over the years getting any form of HRT.  Persistence helped.  I am now using a spray form of estradiol and being post orchiectomy i've found that quite sufficient.  Interestingly i feel great and my cardiologist has me on yearly visits instead twice a year as i was when male.  

We can transition safely at this point and safety is much better especially if we go to knowledgeable doctors.

 

Hugs,

 

Charlize

I don't think I have heart disease,  but I am not sure.  When I was about 25,  I developed atrial fibrillation.  I am not sure, but maybe that's residual from having a heart murmur as a child?   I seem to get a bout of A-fib maybe once every five or so years, and it self corrected within 48 hours.  Last time I was at a client site in Colorado,  and when I was at the hospital in Boulder they did an ultrasound and said my heart wall was a bit thick but working perfectly.  Every time I see my cardiologist he says the same thing:  lose weight and do more cardio.   Now my intent is to lose 100 lbs.  I am down 10 as of today with 100 more to go.   My cardiologist said all his really old patients living into their 80s and 90s are thin as a rail.  My pop made it to 94 and my grandma to 92; my great grandpa to 88, and my dad is 80 and never seen the inside of a hospital.  My mom is 77.  So if I get active and shed this weight I think I am helping my own cause! 

I am so spooled up about HRT I think I might take my Trans MD's offer to see her husband next week.  She cannot see me until mid August because she just had knee surgery and isn't going into work for six weeks.  ;-(    I see my internist next week,  and will ask him to do a full blood workup so I can hand it to my Trans MD or her hubby.  Then maybe I can go right onto HRT.   I am hoping though that she can ask Blue Cross for a waiver saying I need my Orchi now instead of in 12 months;  citing that I have a medical contraindication that would preclude me from safely taking the t-blocker and AA.