HRT information, types & methods

[RachelDee]

Could someone point me to any resources on HRT?

Specifically, I'd like to know which type and methods are best (for unwanted side effects, like blood clots, liver damage and death) and which types of esteogen/anti-androgens (is it spelled esteogen or oestrogen?) produce the best effects. I assume there are some differences? (if only in how rapidly they begin to work).

Are gels, patches, pills or injections better? I think I read somewhere that injections are done every 3 months. Where as pills are daily. So I guess injections would give you a more 'normal' sort of feeling routine since you don't have to remember to pop pills everyday (not that you'd forget!). I also read that patchs do no cause blood clots, but there must be a reason ppl don't just use those or no one would take pills or injections at all?

Any online resources someone could link me too would be helpful. I'd really like to know what I'm talking about fully when (if) it comes time to discuss these with someone. Just to note, if the resources are UK relevant that would be better. I'm sure the US has stuff that we just cannot get in the UK (and anything I may take I'd hope to get on the NHS at a later date).

Thanks :)

EDIT: Oh I'm not thinking of self medding btw!

[Deborah_UK]

As with all these matters, one size does not fit all. What is good for me may be totally at odds to what is good for you. For instance, after my first blood tests the results indicated that I had a low T count for a genetic male, so I was prescribed oestradiol valerate only (in pill form) and within two months my T count was halved and after 6 months my T count was within the same range as a genetic female of the same age.

While its good to be aware of what you might expect, I do think you can over analyse things. You really need to speak to your clinician.

[RachelDee]

Hi Deborah,

Oh I do intend to talk with them fully, should the time come, I just wanted to be well informed so they (a) Knew that I was serious about things and knew what I was asking for, and (b) Could steer them in the direction that could be better for me. It's my body and if im putting things into it, I would like to know as much about them as possible.

I am aware that dosages etc are different for different people, and that apparently if you are over 40 they recommend the patchs as they have a much reduced risk of blood clots and certain increase in fats in he blood. But other than that, im not really sure what the major differences are. There seem to be quite a few different ones out there (as well as a number of different antri-androgens).

EDIT: Also in my various watchings (hmm is that a real word?) on YouTube you often see people talking about their 'prefered' type/method. So it seems like there are differences and id be really curious to know what they are and if it makes that big of a difference.

[CharleneT]

A quick search here will get you tons of info. A lot of people like the organization of info at the Transsexual Road Map, try here for a start:

http://www.tsroadmap.com/physical/hormones.html

Both spellings of estrogen are used. In terms of "safe" routes, the biggest difference is between methods that can avoid the first pass thru the liver and those that limit it, or can't avoid it. Patches, gel and injections avoid the first pass. Oral meds do not. There are some estrogen oral tabs that you can use via "sublingual", which means it dissolves in your mouth. That can avoid a lot of the first pass. Anything you swallow does not.

The time between injections varies, but with estrogen it is normally somewhere between 5 and 15 days. The 3 months I'm not sure about, unless they are talking about some provera mix -- or subcutaneous tubes (slow release). One thing about Estradiol Valerate ( common injectable ) is that the stuff is inexpensive and safe. It takes a little to get used to poking yourself with a 1.5 inch needle, but it is not a big deal after that. Patches are safe but pricey and kinda "high maintenance"

[RachelDee]

Yeah I should have searched the forum (I should know better).

Thankyou though Charlene, for the info :)

Estradiol Valerate sounds interesting, inexpensive and safe = perfect. Is that injected daily? Im just thinking that after a while you might end up looking like a junkie or something with tons of little needle holes in your arm lol. If I can get any medications that lower the risk then thats all the better, I do not believe there are any health concerns that would stop me taking anything right now (nothing im aware of anyway!) but eitherway no sense taking risks if you dont have too.

My other query is about effectiveness. Are injections more effective? Or pills? Patchs and Gel sound like they would not be as effective somehow, is that the case? I think I read somewhere that people have been on pills, but then also used the gel to rub on their breasts to help growth there (that does not make sense to me somehow). Thanks for the link though, checking it out now :)

EDIT: Oh yeah about patches. Since I assume you keep them on until you apply a new one, thats kinda awkward. I wouldnt want to do that forever really. Suppose it depends where you have to put them lol. Seems like not all oral pills carry the same risk either, so thats new to me.

[Karen564]

Thought you said you weren't going to self medicate...

The doctor will tell you everything you need to know about what he's going to prescribe you with...

[Traci Elizabeth]

Thought you said you weren't going to self medicate...

The doctor will tell you everything you need to know about what he's going to prescribe you with...

It seemed like a "fishing trip" to me.

[RachelDee]

Hi, hm im not going to self medicate? Fishing trip? Hmmm. I'm sorry if you two have gotten the wrong idea, but you really have.

The path I'm going down is going to cost me money for both appointments (and travel) and any medication. If I was buying a car, I wouldnt wait till I got to the show room to find out about it -and im more important than a car! So research on something so important and life changing seems sensible & vital. (If I really was trying to self med I'd be asking about what dosages to take too right anyway??)

Since I have limited time in these sessions (1hr) I'd like to be as informed as possible. If the Dr has to explain everything to me from scratch it's time I've lost to talk about other things, if I'm informed on what I'm asking about, then they know I'm not asking about it on a 'whim' or taking it lightly too. Also if there are certain methods that are better and he suggests something else, I can ask about it - but if I don't know I can't.

I'm sorry if people think I'm looking for information in order to get them myself? and if that offends someone in someway?

EDIT: Also, doing research helps me feel like I'm doing something of help to myself.

[Bree-asaurus]

Sorry it sounds like people are jumping to conclusions assuming you are intending to self medicate.

I'm the same way. I did tons of research myself before even talking to a doctor. I didn't ask many questions here, but I found all kinds of info regarding types of medication, dosages, etc because I like to be informed and want info from as many different sources as possible rather than relying entirely on one doctor's education, experience and personal bias.

You can go to three different doctors with the same problem and get three different diagnoses. It's your job as a patient to educate yourself and ask questions.