Young woman new to HRT with questions

[Ebony]

Hi!  My name is Ebony and I'm new to Susan's Place and also HRT.  I'm 5' 9", 150 pounds, 21 years old, and from Boston.  I initiated spironolactone intake two days ago on Thursday the 16th.  I initiated estrogen intake yesterday through an injection of estradiol valerate (Delestrogen).


Questions:


1)  How do I upload an avatar on here?

2)  My testerone level prior to HRT initiation was 381 ng/dL, and my prolactin level was 6.4 ng/mL.  Would you say my testerone levels are low, average, or high for a transwoman who had not yet started HRT?  Same question about my prolactin levels as well.

3)  I have seen women who started on spironolactone with three times the dosage my physician prescribed me on.  Why is that?  Should I request my physician to increase my dosage?

4)  I want to get on progesterone, specifically the brand name Microgest, but my physician does not prescribe them to his patients since the clinic he works for believes they're an ineffective drug to add onto HRT, due to the studies they have done on it.  Are there any Boston girls here that could tell me if there's a physician in the area that prescribes progesterone for transwomen?

5)  This question is somewhat similar to question #3.  I want to take dutasteride (DHT blocker) by the brand name Avodart, but my physician says he finds it unnecessary to include them in my regimen, since he thinks that the spiro will block everything the dutasteride would.  Although, he said he would do more research on it and also ask his colleagues more information about it, since he's not aware about dutasteride and its effects.  If he ends up not prescribing it to me, does anybody on here know a physician here in the area that would?


I want my transition to be as successful and progressive as possible, so I'm really determined on adding Avodart and Microgest onto my HRT regimen.  Any suggestions?

[A]

1) When you have 15+ posts, you can upload an avatar.

2)

The normal range of testosterone is reported as 350- 1200ng/dl. Studies in the 1940's showed the average testosterone level to be at 700 ng/dl, 300 ng/dl higher than for men today. In the past, a drop in testosterone levels to 250 ng/dl was rarely reported before men were 80 years of age. Yet today, it is not an uncommon value for middle aged men!

3)

Prolactin levels in men range from 2 to 18 ng/dL (nanograms per deciliter), according to the National Institutes of Health.

4) No idea, sorry, but the info I have is that progesterone HAS been proved useful. I may be mistaken.

5) No idea, sorry, but the info I have is that DHT is produced by transforming testosterone. Spiro blocks the use of that testosterone, but not its production. Therefore,
unless spiro also blocks the receptors for DHT, it should theorically be useless. But I don't know if that drug blocks T only or DHT too. That's the key info that's missing.

As for convincing your doctor, perhaps you should try finding some reliable info and show it to him when you next meet him.

[Hikari]

I know it makes some questions like #3 difficult could you please remove specific dosage information. The levels in your body are fine to post, but the specific pill dosage can be used by others outside of doctor care, and that might not be the right levels for them.

I don't have much advice since I am not that far along but keep the lines of communication open with your endo, if you have a concern, try and explain it to them, show them examples and articles to back up your claims if you need to, try not to be afraid or intimidated by them just because they are a doctor.

[Ebony]

1) When you have 15+ posts, you can upload an avatar.

2)
3)
4) No idea, sorry, but the info I have is that progesterone HAS been proved useful. I may be mistaken.

5) No idea, sorry, but the info I have is that DHT is produced by transforming testosterone. Spiro blocks the use of that testosterone, but not its production. Therefore,
unless spiro also blocks the receptors for DHT, it should theorically be useless. But I don't know if that drug blocks T only or DHT too. That's the key info that's missing.

As for convincing your doctor, perhaps you should try finding some reliable info and show it to him when you next meet him.

Thanks, A!  I noticed you sent me a PM, but I didn't know how to reply to it since I couldn't find a "reply" link on my page.  I guess I should also wait after 15+ posts to send and/or reply to PMs as well, then?  I'm far from shy, haha.  The reason I deleted my topic before was because I noticed I had posted it on the wrong forum, so I re-posted the same topic onto the accurate forum, which is this one.  By the way, I don't know how to PM other users or reply to PMs, hence why I'm getting back to you on here.

Thanks for answering my questions, though!  You were really helpful.  I feel like my physician is set in his opinions, so I don't know what else to do.  I really do want to add progesterone and dutasteride onto my HRT regimen, but it seems like the only way getting to it is by finding another physician who prescribes them.

[Ebony]

I know it makes some questions like #3 difficult could you please remove specific dosage information. The levels in your body are fine to post, but the specific pill dosage can be used by others outside of doctor care, and that might not be the right levels for them.

I don't have much advice since I am not that far along but keep the lines of communication open with your endo, if you have a concern, try and explain it to them, show them examples and articles to back up your claims if you need to, try not to be afraid or intimidated by them just because they are a doctor.

Aw, ok, I will.  Can you tell me where I can ask dosage-related questions online, though?

[Ebony]

I deleted the dosages I had previously included in my opening post.  I wanted to know if the way I reworded question #3 is okay?  Or is it also against the guidelines?

[Padma]

Doctors seem to differ in their approach to starting people on HRT/AA - there's some evidence that you get a better result if you ramp up the dose slowly from a low one, as if you start on a high dose, the body just makes a big effort to regain the equilibrium that's suddenly been rudely disturbed, and fights the hormones harder.

So maybe what you're seeing is people whose doctors don't hold to that theory, and who are therefore on a higher dose earlier. No reason not to discuss this with your doctor, see what (s)he says.

[Ebony]

That makes sense, Padma.  Thank you for your input.

[Ebony]

I got your PM, Hikari.  Unfortunately, I'm not yet allowed to send or reply to PMs.  I don't know why that is, though.  Thank you for PMing with answers.

[Hikari]

I got your PM, Hikari.  Unfortunately I'm not yet allowed to send or reply to PMs.  I don't know why that is, though.  Thank you for PMing with answers.

I think there is a post count minimum, no problem about the answers, if you ever need any advice I am here for you, not that I know very much, but I try to be helpful.

[A]

Yes, PMs require 15 posts.

Apart from that, I think you should be able to convince your doctor with sufficient information. Going to many doctors at once is probably not a good thing: they will not be happy.

[Nicole99]

my spiro level was about a third of what other trans girls take. But it was perfectly fine. I have really good development all around. E knocks your T down too. Eventually my T production kind of just shut down and I had practically none. As a result I did not need to take propecia anymore.

My advice, don't jump into more homones, wait and see what these do, see what your next blood levels say and adjust things from there. There is no need to take more homones if you don't need them, more is not always better, they don't work that way. you can't push your body to develop faster. It is more about balance.

Trust your doctor, see how you develop, see what your next blood results say. Everyone reacts differently to hormones and have different sensitivities.  It sounds like they are willing to do research and work with you which is great.

congratulations on starting!!! now you need a lot of patients!

[Ebony]

I think there is a post count minimum, no problem about the answers, if you ever need any advice I am here for you, not that I know very much, but I try to be helpful.

Thank you, Hikari!

Yes, PMs require 15 posts.

Apart from that, I think you should be able to convince your doctor with sufficient information. Going to many doctors at once is probably not a good thing: they will not be happy.

Yeah, but unfortunately, my physician and clinic in general are completely against prescribing progesterone to transwomen.  They feel it to be an unnecessary additive.  It would be futile for me to try to talk him into it.

my spiro level was about a third of what other trans girls take. But it was perfectly fine. I have really good development all around. E knocks your T down too. Eventually my T production kind of just shut down and I had practically none. As a result I did not need to take propecia anymore.

My advice, don't jump into more homones, wait and see what these do, see what your next blood levels say and adjust things from there. There is no need to take more homones if you don't need them, more is not always better, they don't work that way. you can't push your body to develop faster. It is more about balance.

Trust your doctor, see how you develop, see what your next blood results say. Everyone reacts differently to hormones and have different sensitivities.  It sounds like they are willing to do research and work with you which is great.

congratulations on starting!!! now you need a lot of patients!

Thank you, Nicole!  And thank you for the informative reply as well!

Believe me, girl, I'm patient as can be, so, it's not that I'm trying to accelerate my physical transition.  My intent is to have the most successful transition possible.  As far as I've been told, progesterone really helps in achieving a better, more complete, and more well-rounded full development in the long run when it comes to breasts, curves, and buttocks.

As for the dutasteride, I simply want to prevent anymore possible DHT damage.  DHT allows the continuation of a receding hairline, which I'm petrified of.

[A]

I don't think dutasteride is actually used except in very special cases. Though progesterone, I agree it's more than useful, as it gives breasts a natural form instead of
what they call the "classic transsexual breasts" that are elongated and point sideways, which E alone has a chance to cause.
I personally will be sad if it doesn't come with my HRT, unless I'm presented with concrete evidence that I am wrong.

[Nicole99]

Interestingly my endo said that if your E is too high this can mean you grow the odd shaped elongated boobs.  You don't need a lot of E, just unopposed E.

Oh if you are worried about hair, you could always get rogain over the counter (minoxidil). Supposed to be good for the hair line.

Definitely the hormones are going to help with any male patterned baldness, see what your T levels are next blood tests.  If they are really low then you won't need to worry about it,

The progesterone debate is interesting, some girls swear by it and others have no affects. Who knows.

[Renate]

Most doctors don't like to simultaneously introduce multiple drugs because then they can't tell what caused what.
Progesterone, when prescribed at all, is usually prescribed after a good run of estrogen, it does kind of oppose it.
Doctors have diverging opinions on the use of progesterone. Some say, "Why not?", others, "No proof of effectiveness."
Sometimes you can only vote with your feet.

[Ebony]

I don't think dutasteride is actually used except in very special cases. Though progesterone, I agree it's more than useful, as it gives breasts a natural form instead of
what they call the "classic transsexual breasts" that are elongated and point sideways, which E alone has a chance to cause.
I personally will be sad if it doesn't come with my HRT, unless I'm presented with concrete evidence that I am wrong.

That's exactly what I mean.  I call them shallow tits.  I would really rather a nice and plump full cup, like my mother's, she's a full/large B.

Interestingly my endo said that if your E is too high this can mean you grow the odd shaped elongated boobs.  You don't need a lot of E, just unopposed E.

Oh if you are worried about hair, you could always get rogain over the counter (minoxidil). Supposed to be good for the hair line.

Definitely the hormones are going to help with any male patterned baldness, see what your T levels are next blood tests.  If they are really low then you won't need to worry about it,

The progesterone debate is interesting, some girls swear by it and others have no affects. Who knows.

I don't really have a bad hairline.  I simply have thinning temples where I want regrowth.  Dutasteride could possibly aid me in thickening and regrowing some recession that recently occurred in those areas.  As for minoxidil, I feel like it doesn't compare to the potency of dutasteride.  Dutasteride is also good for eliminating and decreasing some body hair.  I read a claim by a transwoman who says it stopped chest hair growth for her.  Luckily, I don't have chest hair, but I have a lot of hair below the waist that I would like to reduce.

Most doctors don't like to simultaneously introduce multiple drugs because then they can't tell what caused what.
Progesterone, when prescribed at all, is usually prescribed after a good run of estrogen, it does kind of oppose it.
Doctors have diverging opinions on the use of progesterone. Some say, "Why not?", others, "No proof of effectiveness."
Sometimes you can only vote with your feet.

I know, but that's true for synthetics/progestin.  I'm seeking to get on micronized progesterone, like Prometrium or its generic counterpart Microgest.  Micronized progesterone is safer than synthetics like Provera, and as far as I'm aware it doesn't oppose estrogen like synthetics do.

By the way, Renate, I'm not yet allowed to reply to PMs, since I haven't yet reached 15+ posts on here, so as soon as I do, I'll be able to get back to you.

[pebbles]

your T level is on the lower end of normal for a male.