Topic: Randy's HRT Journal

[RandyL]

Hi all,

I began HRT on a very memorable day: US Election Day, November 3rd, 2020. So I have two reasons to remember and celebrate the day (although I voted weeks earlier).

I sought recommendations for a provider in the trans community locally, and also asked my primary care doc, a D.O. Many recommended the doctor I chose, a female Ob/Gyn, and my PCP personally knows her as they went through D.O school together. I felt a little weird going to an Ob/Gyn practice, but I was comforted to see the sign outside her office which says, "Specializing in hormone replacement therapy." Of course most of their patients are "mature" CIS women, but still...I'm mature too (67).

I didn't actually expect to get started at my first appointment. But after she took my history and went through the informed consent paperwork in detail, and perhaps because she knows my PCP, she had her nurse inject me. They also took blood for a pre-HRT baseline. I'm on estradiol valerate. Because I've been on finasteride (the larger dose) for a year, she didn't want to use any T-blocker.

Obviously we need to establish my proper dosage and frequency. So she started me at a certain level, with a followup at two weeks. She told me to expect some effects in a few days, and then she was looking for the blood level to decline and me to experience some withdrawal symptoms (hot flashes, increasing dysphoria, effects of increasing testosterone). If I didn't feel any withdrawal yet, I should reschedule for three weeks.

I didn't feel anything really until days 11 and 12, when my nipples definitely became sensitized and erect. I could feel them under my shirt. But then by the end of day 12 this effect declined and pretty much went away.

So I had a telephone consult at two weeks (their office was closed due to a Covid-19 exposure on the staff). She was pleased with my bloodwork and said my T wasn't too terribly high, so she had hopes that just the estradiol could suppress it enough. She decided to increase my EV dose to 150% of the initial dose to see if we can get longer lasting effects. Hopefully the two-week schedule can work. We'll try to reach a level where I can stabilize for a month, then she'll take followup blood work to see where my blood levels are.

Baseline blood levels:
- Testosterone, total, MS (MS means via mass spectrometry): 898 ng/dL (normal for males is 250-1100). This actually seems high to me; it was more like 500 a few years ago.
- Testosterone, free: 93.6 pg/mL (normal male is 35-155).
- Estradiol: 22 mg/mL (normal male <= 39).

[Northern Star Girl]

@RandyL
Dear Randy:
I read what you wrote on your other Blog regarding that you were going to start your very own HRT blog.... and here you are!!!

You are a brand new HRT recipient.  As so, I would like to share some of my experiences with you but please understand that HRT works uniquely for each body, we all have unique genes and unique body makeups.

I am sharing with you my personal experiences of HRT and some of the timelines you "might" expect for yourself as you continue on in your journey.
What you read about other transitioning members experiences with HRT most likely will not be identical to your own experiences.
Some will experience more dramatic changes more quickly and then some will experience less significant changes more slowly....   it is all up to your genes and how your body reacts to your own doctor managed HRT regimen.
Your doctor will  undoubtedly be continuing to look at your frequent blood test results during your journey to determine if any alterations to the medically prescribed HRT regimen are needed.

The adage that you have probably already heard here on the Forum's various threads regarding HRT and how it may work for various individuals is:
....."YMMV"  meaning that Your Mileage May Vary.
   
PATIENCE is definitely required.... usually not much happens very quickly with HRT... but changes will happen.  Here on the Forums you might want to do some reading of other transitioners posts and look at many of the posted HRT timelines of other members.

Without a doubt this can be very "EXCITING and SCARY all at the same time."   One needs to hang on for an amazing ride.  Some of my own best and most appreciated and dramatic body changes happened for me at about the  4 to 6 month point through the start of year #2 of my HRT journey. 

Regarding tracking your body measurements, it would be a good idea if you established a reference point  allowing you to judge your body changes as HRT does it's magic.   
For me, I did not gain a whole lot in my hips but my breast growth was very good and after 2 years of HRT my breasts were a full C-cup.   
Many will achieve an A or a B cup and some transitioners may possibly achieve a C-cup or even a D-cup or more.

Even though I was able to very successfully pass before I went full-time... when I did go full-time at the 1 1/2 year mark in December 2016 I had been passing 100% of the time.  Of course that is just my unique experience, I suppose I can thank my body makeup and my genes for all that.

We are here to rejoice with you in the good times and to support you in the not so good times.
One more time.... PATIENCE is required.   The attitude of many people these days is "I want it all and I want it now" ... that will not apply to HRT. 

I will be looking forward to your updates as you feel free to post them.  Please hang in there for an exciting ride.!
Hugs and well wishes
Danielle

[AnneK]

Welcome to the club.  I've been on HRT for over 1.5 years.

[Megan.]

Hi Randy,

It's been 3.5 years for me now, and still very happy with it.

For me personally, it was the final confirmation that transition was right for me.

I had a few bumps on the way, the biggest being several months in, when my new found emotions emerged, and I struggled for several weeks to learn to live with them. Being originally a very logical person, I found this hard, but I think I now have a healthy balance.

Good luck and enjoy the ride! X

Sent from my MI 9 using Tapatalk

[RandyL]

Thank you Danielle for your perspective, wisdom and encouragement. I will be patient. I will. I will. I will...

Thank you also @AnneK and @Megan. I hope for some emotional changes, but not having experienced them (yet?) I don't know what I might be in for. My wife thinks I just want boobs, but I've tried to explain that the somewhat mysterious mental and emotional change (not experienced by all) was really a more important goal for me. I'll just have to wait and see. Wait and see. Wait and see. Wait and see...

[Rakel]

... but I've tried to explain that the somewhat mysterious mental and emotional change (not experienced by all) was really a more important goal for me...

This is exactly how I felt when I first started taking Estradiol. I never felt so good about myself before. My experience was nothing like euphoria, but it is such a positive feeling that this is how I should have been all along.

Life is worth living. 

[Margrit]

This is exactly how I felt when I first started taking Estradiol. I never felt so good about myself before. My experience was nothing like euphoria, but it is such a positive feeling that this is how I should have been all along.

Life is worth living. 

I am absolutely 100% agree!

I do remember, I felt and thought totally the same, when I first started HRT.

[RandyL]

I had my second shot yesterday, 150% of the dosage that they used in the first shot 3 weeks ago. They were going to train me to do it myself, but my usual nurse was out on Covid-19 quarantine (her husband was exposed) so it'll have to wait. No effects noticed yet 32 hours later. Huh. Wait, wait, wait 

[Steph1967]

I know I am a new to the HRT world since I am about to start my 3rd month in a little over a week so I am still figuring things out but I do know I have never been happier and also never felt better.  Welcome to this awesome transformation and wish you all the best!

[pamelatransuk]

Congratulations Randy on starting HRT on November 3rd. Not only will you remember your first dose, but I'm sure you'll really enjoy the rollercoaster ride!

As others have said, I knew very early into HRT (started Feb 2018) that Estrogen was and is the right fuel for me and confirmed my decision to transition.

As you mention the US election, I must say I absolutely love elections and psephology and like you, I vote in UK in advance by post. I look forward to 2024 when we have elections both in UK (May) and US (November).

Wishing you every happiness and success on your HRT journey.

Hugs

Pamela xx

[RandyL]

Thank you all for your encouragement and happy thoughts.

Not feeling much yet after my second shot, just some erect nipples. After the first one the activity kicked in at day 10, and I'm only at day 6 after the second one. Since I went 20 days between shots due to Covid interference, I think I came down completely between shots, so now I'm starting over.

I suspect the E is fighting the T and it may take some time to stabilize. I'm not using any blocker.

Sent from my dual-floppy Victor 9000 using Tapatalk

[Laura1951]

Welcome to the HRT clubhouse. It's a really slow slog between day one and finding out you have boobs. Be patient (well, that's easy for me to say because it drove me a bit nuts the first few months waiting for things to happen.)

Hang in there and congratulations.

Laura

[RandyL]

Well it's been a week, so time to report. Right after I made my previous post my nipples got all sensitive again. And then a few days ago I began to detect buds forming under there. Definitely a more solid feeling where there used to be a depression. The sensitivity has declined over the past few days, indicating the downward slope of the estradiol valerate curve.

Interestingly the past few days I've had trouble with urinary leakage during my runs. I've never had that before. Is this an effect of E? Anybody else experience this? Guess I need to start doing kegels! I might buy some mini pads.

Next injection is tomorrow!

[AllieSF]

If you are taking Spiro, it is a diuretic and thus produces more urine to get rid of.  So, it could be that.  Otherwise, from estradiol, I never had that problem.

[Rakel]

I agree with AllieSF,  Estradiol has not been reported to cause urinary leakage.

Something else must be going on. If this is a one time thing, no big deal. If it happens frequently, you need to see a Urologist.

[RandyL]

Thanks @AllieSF and @Rakel  That helps clarify anyway. I'm not on spiro, so it's not that. Maybe I need to drink less, or maybe it's one of those unrelated aging things. I'll see how it goes and check in with my doctor if it gets worse. Here in Colorado, fluid intake is pretty crucial especially for endurance athletics.

[RandyL]

Day 4 after my 3rd injection. My nipples sometimes ache when I run, but I think it's from the cold rather than from any kind of bouncing or friction. Guess I need to layer up a little more in the torso, which is new for me.

Definitely have buds in there under my nipples, and my nipples are usually erect.

The nurse began training me at my injection on Monday, but she had already filled the syringe beforehand. Next time I'll ask her to wait on that and show me how she does it. Then I guess we have to wait for blood work to find out if my levels are good. That might happen in a couple more weeks.

I notice with this 2-week schedule that my effects ramp up around day 6 or so, then taper off after day 10 or 11. I'll see if this one does the same, but so far it feels about the same as after the second injection. I'm guessing this is not optimal? I think people strive for a more steady regimen. I suspect we'll have to find out if my T is still too high, as I wonder if it's fighting the E and causing this.

[Rakel]

I notice with this 2-week schedule that my effects ramp up around day 6 or so, then taper off after day 10 or 11. I'll see if this one does the same, but so far it feels about the same as after the second injection. I'm guessing this is not optimal? I think people strive for a more steady regimen.

Many people inject Estradiol Valerate once a week, but with a lower dose. This should give you a more steady blood level.

Even with more frequent injections, it takes time to build up to a stead blood level. The general rule is you reach steady state in 5 half lives of the product you are injecting. Each product has their own half life and each individual has their own rate of metabolizing the hormone. Both of these factors affect when you will reach your stead state blood level.

[RandyL]

Thanks Rakel, that's helpful information! This helps explain why we have to go on a constant dosage for at least a month before checking blood levels.
Randy

Many people inject Estradiol Valerate once a week, but with a lower dose. This should give you a more steady blood level.

Even with more frequent injections, it takes time to build up to a stead blood level. The general rule is you reach steady state in 5 half lives of the product you are injecting. Each product has their own half life and each individual has their own rate of metabolizing the hormone. Both of these factors affect when you will reach your stead state blood level.

[RandyL]

Fourth injection today, continuing on the 2-week schedule. Looking back at my journal, I can see that the effects begin a downward slope at the end of day 6. So I will see about getting onto a weekly schedule as Rakel suggested. I think this will require me to self inject as well. I'd guess my doctor wants to see bloodwork before we make any changes. I'll inquire about this.

I definitely have breast buds under my nipples. The male cavity under there is completely gone and I can feel a firm mass about 1.5" diameter under both sides.