Hormones Research.

[Jenny Chen]

So I been Doing some research in preparation to seeing my Endo in 6 days. this is what i go so far, anything else i should know?

Estrogen:
+Over all feminizing effects.
-Can lead to cholestasis. Affects the production proteins including lipoproteins, binding proteins, and proteins responsible for blood clotting.

*Injectable if Possible: less Clotting tendency. IF not Sublingullar

Estradiol/Estradiol Valerate:
-Oral versions: Estrace, Estradiol acetate, Estrofem
-Transdermal preparation: Alora, Climara, Vivelle-Dot, Menostar, Estraderm TTS, EvaMist
-Ointments: Divigel, Estrasorb Topical, Estrogel, Elestrin
-Injection: Estradiol cypionate, Estradiol valerate

conjugated equine estrogens:
-Premarin

Ethinyl Estradiol:
-thromboembolic complications, Avoid.




Anti-Androgens:
+Decrease and or inhibits effects of testosterone to reduce it's level to normal female level.
+May cause Gynecomastia (breast growth).
+decreases acne and hirsutism (male pattern hari growth)

spironolactone
-High Blood clotting tendency.
-Spironolactone often increases serum potassium levels and can cause hyperkalemia.
-May increased risk of bleeding from the stomach and duodenum.
-may cause Ataxia.
-A carcinogenic effect has been demonstrated in rats.

Cyproterone
-liver toxicity (200-300 mg/day monitored for changes in liver enzymes)
-Low aldosterone levels may lead to salt loss and hyperkalemia (excess potassium).
-In combination with ethinylestradiol increased risk of deep vein thrombosis.
-Associated with depressive mood changes in some patients.
-can increase adrenal androgen production, in some cases resulting in an overall rise in testosterone levels.
-have withdrawal effects.

Flutamide
+Gynecomastia.
-may also cause gastrointestinal side effects.


Micronized progesterone:
+Can also inhibit testosterone production.
+does not counteract the beneficial effects of estrogen on blood lipids.
+Metabolized to 5-alpha and 5-beta Pregnenolone (natrual tranquilizer).
+increase breast development?

-Prometrium
-Endometrin

[CharleneT]

That's a fairly complete list of them alright. Each of those drugs of course has a long list of potential side effects and advantages. Some of what is on that list are not generally used for HRT for MFT. Your endocrinologist will likely have a preference for what she/he thinks is the most effective for a person with your particular medical history. I'm glad you are seeing a professional about this. Do you have any questions you want to ask about HRT ?

[Jenny Chen]

yeah lots of questions :P Like i herd lotfs of bad stuff about spironolactone and stuff, like i and trying to compile a list of "the good stuff". along that line, ofcouse there are other stuff as well. but i am at work right ow so i can't get in to it, i'll ake a full post when i get home.

[helenr]

you have done your homework. think spiro works like a diuretic and actually slows clotting-know that the lab tech was surprised that my blood didn't clot faster when I had recent blood drawn. good luck. helen

[Jenny Chen]

you have done your homework. think spiro works like a diuretic and actually slows clotting-know that the lab tech was surprised that my blood didn't clot faster when I had recent blood drawn. good luck. helen

yeah Spironolactone often increases serum potassium levels and can cause hyperkalemia. so in combination with Vitamin K your bloody will stop clotting. but in some cases i herd it cause blood to clot more than normal, so it's weird.

Anyways, some other questions i had on my mind are the mental effects. From some articles i have read, it messes with the head big time, or at lest for a first little while, so i was wondering if there is anyway to mitigate that effect?

And Also how long on average does it take for the change in facial features, i am pretty young so the affect would be pretty dramatic from what i have been told; but seen how i haven't told my mom yet, and won't have a chance to for 2 more months, i don't want to freak on my mom before i have a chance to tell her. you know the WTF factor involved and being at a airport might be too much for her to take all at once and i am worried about her reaction in public (Airport pick up area freak out is a NO in my books).

So yeah thoughts? suggestions?

[Hope]

yeah Spironolactone often increases serum potassium levels and can cause hyperkalemia. so in combination with Vitamin K your bloody will stop clotting. but in some cases i herd it cause blood to clot more than normal, so it's weird.

Anyways, some other questions i had on my mind are the mental effects. From some articles i have read, it messes with the head big time, or at lest for a first little while, so i was wondering if there is anyway to mitigate that effect?

And Also how long on average does it take for the change in facial features, i am pretty young so the affect would be pretty dramatic from what i have been told; but seen how i haven't told my mom yet, and won't have a chance to for 2 more months, i don't want to freak on my mom before i have a chance to tell her. you know the WTF factor involved and being at a airport might be too much for her to take all at once and i am worried about her reaction in public (Airport pick up area freak out is a NO in my books).

So yeah thoughts? suggestions?

One immediate thought is to NOT spring it on your mom. That would mitigate the chance of an airport freakout more or less completely. Some surprises aren't nice or fun or fair. Honestly, if you can't handle talking to the 'rents about this, you may not be ready for the sort of impact this decision will bring. Hormones aren't playthings.

If you are post puberty you should not see a lot of changes in your face, beyond a bit of fat redistribution. The dreaded T has already done it's damage. Bone structure, hairline, facial hair will not be affected by HRT... You will require FFS and / or laser / electrolysis for that. Your body hair should thin, and there are reports of some hip growth.

As for mental effects... It will literally change the structure of your brain, which is startling. If you are up for reading an academic paper on the issue check this out:

http://www.eje-online.org/cgi/reprint/155/suppl_1/S107.pdf

[Jenny Chen]

I am am fully ready and committed, i just didn't want to give me mom the shock of her life in the air port. But from what you said i don't have to worry too much. and it's not so much talking to them about it as they finding out before i do "talk" to them about it, either way she will NEVER forget this Christmas i can promise her that much. :straightface:

[CharleneT]

These *are* risky drugs we're talking about. So if you decide to go ahead with HRT, you should do so with the knowledge that bad things could happen. Unfortunately, there is no way to know which ones may happen to you ( hence why it is risky ). A couple of things. It sounds like you've done some reading... I'd try doing some more - especially in the forums here. You can learn a lot about HRT, while reading it in "lay speak".

Ok, Spironlactone. It is a blood pressure med that has some side effects that are useful for feminization - hence why perfectly healthy people like me take it. The concern about Potassium retention is quite real, and part of the design of the drug. Yes, you could have that happen and that is why you need to be under a doc's care while you take it -- and that doc is hopefully checking your blood values every 3 months or so to see you are ok. At least in the first year. If your kidney's are normal and healthy this potassium risk isn't large. Your body will likely handle it. As far as I know, it won't "mess with your head". Spiro will aid in breast formation - just a little - and knocks out your testosterone production (sorta). You will likely need it, but not for a long long time though. It isn't going to change your outward appearance at all.

Other drugs in the HRT group are what will "mess with your head" - in a way that many of us *like*. Specifically Estrogen. You get rewired in a more female mode. As others have mentioned. BUT, everyone's millage varies on this issue. You may not notice much at all at first. This is definitely not a like light switch. In fact, it will take months before there are large changes: if at all. Age is important and the younger you start, the more likely you'll get bigger changes. Still... you never really know what you will get till you do ;)

If you go this route, you should do so under a doctor's care. Now that doc will have opinions about which drugs etc... they may even advise you to go with just estrogen. Given time, it will knock out the testosterone production all on its own. Hence you do not have to take Spiro. Another option is to combine estrogen with a DHT blocker. DHT blockers don't really bother testosterone production, but rather block its ability to be used by your body. It is better to have something like Spiro though.

One thing I feel I should say, and I bet you already know this ... but just in case: HRT should be thought of as a one way street. Once you start, you can't really go back. It is true that up to a point you can. BUT you can't tell when you cross the border as it were, and you're stuck on the other side. Go into it - IF you do - with that thought in mind. This is definitely not something to do on a whim.


Here is a good description of a program for physical transition:

http://www.transgendercare.com/medical/resources/tmf_program/default.asp

I'd check out the HRT info there, information packed but still in lay-speak.

[Jenny Chen]

Reality stinks that is for sure, i mean i would love for my loved once, Closed friends and family, to be able understand, but truth is i would just be fooling to my self if i tell my self nothing will change.

The truth is i am afraid, over my whole life i have been pretty withdrawn from general social group around me leaving me with only 5 Really close friends. These friends means the world to me it pains me to even consider losing 1.

So this is no easy path, and there is no turning back, not that i want to but the matter at hand is that i have been repressing my true feeling for so long that it's effecting me emotional. Like i am very easily angered, i am always annoyed at some thing and cause i this i said and done hurtful thing that i hate my self for. So one way or another things have to change, and i have chosen this path, for the better or worst i am sticking with it, i just hope my family and friends understand.

But yeah that aside, the main reason i am doing this research now is my Endo have to been known to sent his patient out to do their own research. His idea is so that we'll be knowledgeable and have a full understanding on what we are doing. So from that point of view i understand where he is coming from, since there are "TOO MANY" people that would simple do as they're told and have no clue what they are doing or butting them self through, and when something unexpected happens they freak on the doctor.

Therefore the point of this is so that I will be educated and ready when i meet him, saving time for both of us so he can get down to the doing and planning of the treatment.

AS for thinking more like a girl, I can't wait! I am already a bit girly but i can do with more ^^

[Karen564]

I think you need to do more research...

Your missing many of the side affects caused by Estrogen..it's a very large lists. some are very good for us, & some are very bad..

And just seems you make Spironolactone look scarier than it really is, the good part about it is, it's a diuretic, which is very good for treating hypertension, among other good things, but I never heard of it causing blood clots, I always thought it did just the opposite..and is why it's a good choice to be taken with estrogen, high doses of E CAN cause clotting, among many other complications..

The bad thing about Spiro is, it can raise your potassium levels which can adversely affect your heartbeat..which is one of many reasons it's very important to be monitored.. and watch what you eat..

***mg per day is considered a normal dose, and it's been reported that many have taken it in much higher doses with no ill effects..

Spiro may cause you to feel a bit exhausted for a while at 1st, until your body adjust to it, which can take months to do..

Adrocur is widely known as the most toxic on the liver, but is also known as the most effective anti-androgen..but not used in the US..

Your also missing Dutasteride, generally known to treat an enlarged Prostate, but it's very effective for blocking DHT, & will stop & reverse male pattern baldness to some degree on some..

Basically, the more you block Testosterone, the more effective Estrogen will be to do it's job, without the need to take higher doses which can cause problems.

As far as Progesterone,
All I can say is it doesn't agree with me at all, I get way too emotional & depressed every time I've been on it, but some can tolerate it very well with no bad effects..



Of course ANY medication/chemical we put into our bodies can have bad effects & risks if not taken in the proper dosages & proportions, but that even applies to vitamins.. Except for C, take All you want..

Here's a great book to read if you want to really learn about HRT, from a doctors point of view. it's kinda old now, but still very informative...Ask your therapist or doctor for a copy..(shes written & published many good books & journals on this subject)

Good Luck!! :hugs:

[Hope]

Thanks for the suggestion of a good text.

[Jenny Chen]

Good idea, thanks for the great info! I will go look up that book right now and do some reading on it.