Author Topic: Stopping Hormones for Surgery  (Read 623 times)

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Offline Dani Rae

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Stopping Hormones for Surgery
« on: October 18, 2018, 08:26:56 pm »
I have bottom surgery scheduled for the beginning of December. The surgeon requires patients to be off all hormones and blockers for a month before surgery. I just started the taper that my Dr. laid out yesterday. To be honest, I'm anxious and kinda scared about stopping and being off hormones for a month. I'm not really sure what to expect, which I think is making my anxiety worse. Can anyone share any experience and/or suggestions. I appreciate any feedback anyone can offer.

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Online Arianna Valentine

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Re: Stopping Hormones for Surgery
« Reply #1 on: October 18, 2018, 09:13:57 pm »
I have bottom surgery scheduled for the beginning of December. The surgeon requires patients to be off all hormones and blockers for a month before surgery. I just started the taper that my Dr. laid out yesterday. To be honest, I'm anxious and kinda scared about stopping and being off hormones for a month. I'm not really sure what to expect, which I think is making my anxiety worse. Can anyone share any experience and/or suggestions. I appreciate any feedback anyone can offer.

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Honestly Dani the hormones are so much in your system that I don't think tapering off or stopping them for a month is really going to affect anything other than you having to take less medicine for a month now I can't say that I actually have experience in this but just making an observation.

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Offline Memento

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Re: Stopping Hormones for Surgery
« Reply #2 on: October 18, 2018, 09:29:32 pm »
Aside from some weirdness with excessive libido I've never had before, which I can only assume was the result of a puberty I'd delayed long ago, there were no notable changes. You might feel a little down just before and especially after surgery. Maybe a tiny bit of withdrawal, but just ready yourself for feeling a bit down and you're gonna be fine. Make sure you've got friends to talk to the month before surgery, it sure helps(I regretted that part).

Congratulations! Best wishes.

Offline Dani Rae

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Re: Stopping Hormones for Surgery
« Reply #3 on: October 18, 2018, 09:56:50 pm »
Aside from some weirdness with excessive libido I've never had before, which I can only assume was the result of a puberty I'd delayed long ago, there were no notable changes. You might feel a little down just before and especially after surgery. Maybe a tiny bit of withdrawal, but just ready yourself for feeling a bit down and you're gonna be fine. Make sure you've got friends to talk to the month before surgery, it sure helps(I regretted that part).
I'm concerned because I have struggled with depression for over a decade. It was only after starting HRT that I had any kind of appreciable remission. I'm also unfortunately in the middle of the first full depressive episode that I've had in over a year. If it hadn't already happened, I would be worried about a relapse of my depression. As it is, I'm expecting it to get worse. I've also managed to eviscerate my support network over the last month and push away everyone but my parents. So basically, I'm expecting a month and a half of hell where I want to die. I hope it's worth it.

Offline Dani

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Re: Stopping Hormones for Surgery
« Reply #4 on: October 19, 2018, 04:27:29 am »
Dani Rae,

I am post op and I look at stopping HRT for a month as just one more thing to do to keep me safe for surgery.

Yes, there is significant mental relief in HRT and stopping for one month might just cause some emotional issues, but these are relatively short and when you are post op you can look back on that month without HRT as a minor bump in the transition process.

For my self, the moment I woke from genital surgery, my dysphoria was completely gone and never returned. Given the choice of continuous HRT or genital surgery, I would have the surgery without a second thought. However, the vast majority of us go right back on HRT once we are post op.

Best wishes and good luck with your surgery.



Offline Colleen_definitely

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Re: Stopping Hormones for Surgery
« Reply #5 on: October 19, 2018, 06:54:47 am »
I was off of spiro and estradiol for a month total when I had my bottom end remodel done.  The first week wasn't really much different than any other, aside from not having to pee constantly.  Week two I was a bit moody, but only slightly so.  In the two weeks after surgery I was too busy dealing with recovery to notice much in the way of hormonal issues.  I did feel better after getting back on estradiol but it was not as huge of a change as when I first started HRT and killed off testosterone production.

Offline Dani Rae

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Re: Stopping Hormones for Surgery
« Reply #6 on: October 19, 2018, 09:08:04 am »
Thank you all for sharing your experiences. I'm still anxious. I tend to assume the worst about my mental health. I'll try to temper that with the knowledge that other people's experiences haven't been nearly as bad as what I've been expecting. I'm also trying to remind myself that, while it feels insurmountable, it really is a short period of time in the grand scheme of things.

Offline Memento

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Re: Stopping Hormones for Surgery
« Reply #7 on: October 19, 2018, 09:20:39 am »
I'm concerned because I have struggled with depression for over a decade. It was only after starting HRT that I had any kind of appreciable remission. I'm also unfortunately in the middle of the first full depressive episode that I've had in over a year. If it hadn't already happened, I would be worried about a relapse of my depression. As it is, I'm expecting it to get worse. I've also managed to eviscerate my support network over the last month and push away everyone but my parents. So basically, I'm expecting a month and a half of hell where I want to die. I hope it's worth it.

I actually did exactly that, deleting all of my social media accounts. And I made it through just fine.

I do very much recommend talking to a therapist during this time and soon after surgery if you're able(but it'll be fine even if you don't). Everyone's different, but I'm a pretty emotional person in my mid-twenties and a perpetual pessimist. If that sounds anything like you, I hope this advice helps. As obvious as it sounds, immerse yourself in positive things. Happy, nonsense media is really therapeutic during prep/recovery and it can help keep you in a good headspace. If you're ever feeling very down, talk to anyone. A pleasant nurse or your parents can really bring you back up.

But remember, all this worry *is* in your head. The above's just precautionary advice, of course. Once the smoke clears, you'll feel better than ever. That's a good thing to keep in mind!

Offline Dani Rae

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Re: Stopping Hormones for Surgery
« Reply #8 on: October 19, 2018, 09:53:26 am »
I do very much recommend talking to a therapist during this time and soon after surgery if you're able(but it'll be fine even if you don't). Everyone's different, but I'm a pretty emotional person in my mid-twenties and a perpetual pessimist. If that sounds anything like you, I hope this advice helps. As obvious as it sounds, immerse yourself in positive things. Happy, nonsense media is really therapeutic during prep/recovery and it can help keep you in a good headspace. If you're ever feeling very down, talk to anyone. A pleasant nurse or your parents can really bring you back up.

But remember, all this worry *is* in your head. The above's just precautionary advice, of course. Once the smoke clears, you'll feel better than ever. That's a good thing to keep in mind!

Seeing my therapist regularly is one of the few positive things I've managed to keep doing over the last month or so. I haven't been having very productive sessions, but I keep showing up. I've been struggling to conceptualize what the smoke clearing looks like. It's almost like the future after surgery and recovery isn't real. Depression also makes it incredibly difficult to imagine feeling better. So those make it really hard to remember that it will be worth it.

Offline PurplePelican

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Re: Stopping Hormones for Surgery
« Reply #9 on: October 20, 2018, 12:50:06 am »
Stopping estrogen before surgery is actually unneeded, assuming you don't take it orally. And at this point, there's almost no reason at all for you to still be taking an antiandrogen. (Assuming a sufficient E level.)

And just a comment, it's almost certainly not the surgeon who has requested you stop HRT, the anesthetist will be the culprit - they'd prefer you didn't have anything at all in your system, but then, they are the person responsible for you not ending up dead, so I'd listen to them.
This is not medical advice. Always consult your doctor.

Online Devlyn

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Re: Stopping Hormones for Surgery
« Reply #10 on: October 20, 2018, 03:26:11 am »
Coming off HRT will make you anxious and edgy, and a little oily and greasy, but..

Stopping estrogen before surgery is actually unneeded, assuming you don't take it orally. And at this point, there's almost no reason at all for you to still be taking an antiandrogen. (Assuming a sufficient E level.)

And just a comment, it's almost certainly not the surgeon who has requested you stop HRT, the anesthetist will be the culprit - they'd prefer you didn't have anything at all in your system, but then, they are the person responsible for you not ending up dead, so I'd listen to them.

.. everything I've mentioned is better than dead. The safer a surgery can be, the better.

Good luck!

Hugs, Devlyn


Offline Cindy

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Re: Stopping Hormones for Surgery
« Reply #11 on: October 20, 2018, 04:08:03 am »
I remember my psychiatrist saying if I would like to book an appointment for 6 weeks after surgery, when I asked why she said that she suggests it for her post natal women and her post surgery women because that is when a post euphoria/surgery depression can sneak in. It was excellent advice.

As for recommendations. It is easy to argue against them and say things are unnecessary, when I had my throat removed the last thing on the surgeons mind was my E level! I've also heard of a surgeon crack a chest with no anesthetic to get to a burst aortic aneurism. What can be done and what is best practice are often different!

In general a cosmetic surgeon takes about 14 years minimum and an anaesthetist about 12 years in training before specialising. I would sort of tend to take their opinion about how they want to conduct their craft and just try and relax and make sure that you do your part in being fit and healthy in body and mind and determined to make a good recovery. It will all be good then.

Relax and enjoy and be determined!!

Offline LizK

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Re: Stopping Hormones for Surgery
« Reply #12 on: October 20, 2018, 05:41:40 am »
Que the worst patient in the world...ME

I know enough medically to be dangerous to myself and others but not enough to always save my own backside. I know what the research says and I can mount an argument for continuing to take HRT as a gel on my skin but there are two reasons why I don't and Cindy explained the first eloquently and the second is apart from anything else in the scheme of things the tiny amount of time you need to abstain from your hormones to ensure you have the lowest risk factors is miniscule. I have to do it in a few weeks myself and I am not looking forward to it at all but I refuse to increase my risk factors for something so simple. It will pass


Take care

Liz 
HRT since 17 May 2016, Fulltime from 8 March 2017, Transition Begun 25 September 2015 
GCS 4 December 2018,

When I let go of what I am, I become what I might be – Lao Tzu

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Offline Memento

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Re: Stopping Hormones for Surgery
« Reply #13 on: October 20, 2018, 06:26:09 am »
Seeing my therapist regularly is one of the few positive things I've managed to keep doing over the last month or so. I haven't been having very productive sessions, but I keep showing up. I've been struggling to conceptualize what the smoke clearing looks like. It's almost like the future after surgery and recovery isn't real. Depression also makes it incredibly difficult to imagine feeling better. So those make it really hard to remember that it will be worth it.

Now this I can relate to. My old friend clinical depression decided to pay me a visit at the point you're at now. I *refused* to believe surgery was happening, because it seemed like a darn miracle and I'd convinced myself I'm not the kind of person good things happen to. When it got moved to the very next month instead of a 5 month wait, I nearly lost my mind. I kept looking for any excuse to believe it wasn't happening. But it did, and it's gonna go fine for you too. The hormones and everything. The doctors know what they're doing.

Keep talking to your therapist, be as open as possible and try your best to relax. That's your most important job right now. There's nothing to worry about. Seriously, you'll feel so silly in a month or two.

(Looking back at my posts here the last six months, I just feel like an idiot for all my worry.)

Offline Becca Kay

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Re: Stopping Hormones for Surgery
« Reply #14 on: October 20, 2018, 10:50:58 pm »
there are clotting risks associated with doing major surgery on HRT, estradiol specifically. 

I was off for 18 days last month.  two weeks prior to surgery and 4 days post op.  Started getting regular erections within the first week.  I had a dull headache for about 10 days prior to surgery. I had mild hot flashes. My anxiety got a bit worse.  But that could have been because of the stress of the upcoming surgery. 

Thinking back on it none of it was really that bad.  What upset me more was the simply worrying about it being bad.  It wasn't that bad.  It was unpleasant but I would do it ll over again.  And I will next year for GCS.  Next time I won't worry about it though. 

Offline Dorit

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Re: Stopping Hormones for Surgery
« Reply #15 on: October 21, 2018, 12:17:02 pm »
My surgeon asked me to stop HRT for three weeks for FFS.   This was only six weeks ago ago.   While the emotional changes I experienced, like post surgery depression were expected, I was surprised by the physiological changes.  I had night erections for the first time in years, and dark hairs in my mustache grew back after having had six laser treatments that I had thought had finished them all off.  The worst part was that after I resumed estrogen (I am using transdermal patches), my breasts broke out in a rash that is only finally gone three weeks later.

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