Side effects

[somestuffp]

Hello,

New here. Simply wondering what sort of long term side effects one could expect doing hrt beyond the obvious?

Thanks.

[Jorja]

Estrogen therapy is generally considered safe for young, healthy patients, but the risks increase with age and certain medical problems. You should be on alert for any of the following side-effects:
nausea and vomiting
changes to nevi
spider angioma
galactorrhea
decreased libido

More serious potential complications include:
Prolactinoma (prolactin-secreting adenoma of the pituitary gland) growth or induction
Venous thrombus formation (estrogen increases transcription of certain clotting factors while decreasing levels of anticoagulation factors; one study [van Kesteren, et al, 1997] estimated 20-fold increase in DVT)
Pulmonary embolism
Liver damage
Pancreatitis
Breast cancer (risk of breast cancer remains much lower than for natal women. Risk is affected by the age at onset and dosing of estrogen therapy)
Hypothyroidism
Type 2 diabetes (decreased sensitivity to insulin)
New-onset or worsening of depression

The patient taking testosterone may experience adverse effects. These can include
oily skin
acne
male-pattern baldness
weight gain
headaches
edema
aggression
polycystic changes to the ovaries
menstrual bleeding

More serious potential complications include:

polycythemia
liver disease (metabolic cholestasis and hepatocellular adenoma; parenteral forms of testosterone decrease risk)
cardiovascular disease (increased TG and decreased HDL)*
stroke
diabetes melllitus type II (decreased insulin sensitivity)
breast cancer (testosterone may be aromatized to estrogen)
endometrial cancer
ovarian cancer
sleep apnea

[Rianna Humble]

Hi somestuffp, what has your endo told you about hormone therapy? Before they prescribe, they should be explaining their approach, what side effects they will be monitoring for and how they will get you up to the most appropriate dosage to achieve the best outcome for you.

[I Am Paula]

My endo and I had an hour and a half meeting the day he prescibed. We discussed what I should look out for, and what bloodwork was looking out for. He also said I could leave questions, or concerns with his receptionist, and we could tele-consult. I have a great endo!

[Ariamythe]

what sort of long term side effects one could expect doing hrt beyond the obvious?

If you haven't read them yet, you should definitely check out the WPATH Standards of Care (http://www.wpath.org/documents/IJT%20SOC,%20V7.pdf). You'll almost certainly have to know about them anyway if you decide to transition; more importanty, they have a good overview of the known biological effects of HRT beginning on page 24.

[Angela Campbell]

My therapist spent a good amount of time going over the SOC with me and that includes the effects and dangers of the hormone treatments. Once I went to the medical Dr. he also spent time explaining the same thing to me. He had me sign a paper saying I understood the benefits and possible dangers. I would worry about either a Dr. or therapist who did not do this.

The therapist should help you decide if this is something you need and that includes educating you on why someone would need it and what to expect if the treatment is prescribed. It is not a quick process.

[Ariamythe]

Once I went to the medical Dr. he also spent time explaining the same thing to me. He had me sign a paper saying I understood the benefits and possible dangers. I would worry about either a Dr. or therapist who did not do this.
This is a good point. And related to that, I would never, ever try to self-administer HRT. I've simply read too much about it to ever think I could do it without a competent doctor's oversight. Hormones more or less impact every part of your body in some way, from your brain to your bones. They are not to be trifled with.

[Angela Campbell]

The Doctor also had me sign a paper agreeing not to use any medications he did not prescribe and a warning that if I did he would no longer treat me.

[GBJoker]

I am wondering if having a severe heart condition would be a bad thing if I wanted to start hormones...

Specifically, a mutated left superior vena cava. Pretty rare, according to my cardiologists (yes, plural), and cardiac surgeons (again, yes, plural).

[Ariamythe]

The Doctor also had me sign a paper agreeing not to use any medications he did not prescribe and a warning that if I did he would no longer treat me.
Probably a wise precaution for the doctor to take. If any unforseen interaction happened between the HRT and some drug he didn't know about, he could be sued. Especially since HRT is pretty much off-label use of the drugs involved.


I am wondering if having a severe heart condition would be a bad thing if I wanted to start hormones...

Specifically, a mutated left superior vena cava. Pretty rare, according to my cardiologists (yes, plural), and cardiac surgeons (again, yes, plural).

I'm not a doctor, just making a casual observation. That said, if it's both (a) extremely rare and (b) severe, I imagine your specialists will have a hard time being convinced that your body can handle the stress of HRT.

[somestuffp]

Thank you again everyone for the comments.

I have not meet with a dr. of any sorts yet concerning this. I wanted to purely start gathering some information to see how it weighed on my decision one way or the other. I would not even consider self prescribing as like you mention, this is nothing to trifle with.

An additional question, did going on hrt affect your insurance at all in one way or another?