Surprising Changes

[Constance]

I've been on HRT since 5 June 2011 and already I've noticed changes, albeit not visible ones.

My libido has dropped off, not that the interest is completely gone. This surprised me as I'd had a very high libido before starting things. I think it was 3 weeks in when I noticed this.

My emotional responses have changed dramatically, too. I'm finally able to cry when I'm upset and while I usually don't enjoy the crying while it happens, I feel much better afterwards. This morning at work, I read a message from a coworker who had helped me with an end-user's question.  This coworker's answer made me so happy that I was moved to tears. I feel like this is getting a bit silly, but at the same time the aftermath of the tears is usually relief.

[mechakitty]

It astonishes me how everyone gets such wildly different results with HRT. 

I've been on HRT since May 31st, and I've gotten lots of physical changes already. Are you on an androgen blocker yet, or just the estrogen?

[Constance]

I'm on estrogen, progesterone, and Spiro.

[mechakitty]

I wonder if your hormone levels are where your doctor expects them to be.

I mean, I guess for some the changes are more gradual. I guess it must be my naturally high metabolism?

[Constance]

Well, my next endo visit is tomorrow and he had me go for another blood test last week. So, this next visit should decide if my dosages need to be adjusted.

Also, my breasts (or maybe it's better to say what will become my breasts) have been sore and tender since Monday. That's new.

[JungianZoe]

How long are you going between appointments here at the start?  I'm starting to question my doctor's approach of only doing three-month followups because I've been on HRT for a year, only two months of it has worked, and I've only seen the doc three times.  I need some serious adjustments but the waits in between visits are unbearably long and I'm not having very good results compared to others since my numbers are out of whack.

[Constance]

My first appointment was in late May, and I started the HRT on 5 June after a blood test. Tomorrow is my first follow-up appointment. The endo wants to compare the before-HRT blood test with the 2 month's HRT test to see if things need to change.

He's worked with TG folks before, but for maintenance. I'm the first TG person who's started with him.

[regan]

How long are you going between appointments here at the start?  I'm starting to question my doctor's approach of only doing three-month followups because I've been on HRT for a year, only two months of it has worked, and I've only seen the doc three times.  I need some serious adjustments but the waits in between visits are unbearably long and I'm not having very good results compared to others since my numbers are out of whack.

I just got my script for Sprio yesterday (yay!), I'm supposed to go back to see him in two months.  He said it takes that long for Spiro to drop the T levels to make it worth testing for.  So three months doesn't sound unreasonable, but if you feel like its not working, yeah I'd be in there every month appointment or not.

[JungianZoe]

So two months for both of you...?   Wow!  When I started, my doc was only going to test at 6 months (the second appointment).  I had absolutely no changes in anything after the first three months... no breast development, no loss of sex drive, no anything.  So she tested me at the three-month appointment and found my T was 650.  She declared that spiro wasn't working (maybe too hastily for the dosage, so I've found out) and put me on depo, which is killing my brain and my moods.

This is the top-recommended doc in my area for HRT, but her approach is far too hands-off for what's proving to be a difficult case like mine.

Maybe I should be lining up more appointments on my own?

[Constance]

I wonder if age plays a role, too. I'm nearly 42 so manly things might be declining for me anyway.

[regan]

So two months for both of you...?   Wow!  When I started, my doc was only going to test at 6 months (the second appointment).  I had absolutely no changes in anything after the first three months... no breast development, no loss of sex drive, no anything.  So she tested me at the three-month appointment and found my T was 650.  She declared that spiro wasn't working (maybe too hastily for the dosage, so I've found out) and put me on depo, which is killing my brain and my moods.

This is the top-recommended doc in my area for HRT, but her approach is far too hands-off for what's proving to be a difficult case like mine.

Maybe I should be lining up more appointments on my own?

I'm not on E (yet), so the 2 months is just to check my T levels.  PM me and I can give you the upper limits my doc suggested for Spiro (if that's not violating the no dosages rule).  So you may want to consider alternatives, like I said in a different post he uses Androcur as his last resort, but admits you can't get it in the US (I don't know how he gets it).  I think, in that same thread, I also mentioned that it takes more then just following normal male/female levels in order to "overpower what the male body is programmed to do".

[Bird]

@Zoe

It sounds to me she is following the HRT protocol to the letter, with no flexibility. If you wish to compare, I had my T levels into female range at the 2nd month of Spiro and had changes within 2 weeks of use.

In your case, she should have more flexibility because it seens to be a complicated case, but she seens stuck with whats written "in the book"

[Ann Onymous]

This is the top-recommended doc in my area for HRT, but her approach is far too hands-off for what's proving to be a difficult case like mine.

Have you had discussions with her about your metabolism?  Good MD's will take that into account while others just sort of overlook a patient's comment about having quick (or alternatively, extremely slow) metabolisms.  It took a few visits before my doc of many years ago realized I was not joking about a rapid metabolism and that I usually took at least three times a normal dose on ANY medication...once he realized it was not just a comment, it changed the manner in which he considered ANY prescription for me, no matter whether a run of the mill antibiotic, HRT or painkiller (hydrocodone worked wonders during those hours of electrolysis but I digress). 

Top-recommended does not always mean the best when it comes to dealing with the patient as something other than just another file...

[JungianZoe]

Oh, my metabolism is a lightning bolt.  Took four months to gain 25 pounds when I was eating 4000 to 5000 calories a day (every day).  If I eat 2500 calories a day, I actually lose weight.  But still my doc has me on some pretty low doses compared to what I've heard from others.  Like you, Ann, I have to take mega doses of everything.  And because I also have a superhero liver, my body flushes out and and compensates for anything I take with utmost efficiency.  I've literally had the strongest dosage of the strongest medication stop working in four days.  Baffled my gastro doc to no end.

Yes, my HRT doc is extremely conservative in her approach, but I don't think conservative will work in my case.  She's also not willing to get experimental.  She told me that if her two regimens don't work (spiro/low-dose E or depo/low-dose E) then I'm one of the unlucky ones who can't expect benefits from HRT.

It's maddening because I'm just not seeing any of the changes everyone else talks about.

[Ann Onymous]

Oh, my metabolism is a lightning bolt.

But how much time have you and the doc spent TALKING about it? 

It's maddening because I'm just not seeing any of the changes everyone else talks about.

Trust me, I understand.  I was fortunate to have had an MD who was willing to think outside the box.  I've mentioned in the past that I found gay-friendly docs from a gay/lesbian yellow pages directory and went from there...with the exception of surgery, none of my involvement with the medical community all those years ago involved persons who were associated with the 'gender community.'  It made a tremendous amount of difference IMO...

[Bird]

I will say what I said in another topic.. I seriously think you need another doctor Zoe. I mean, even I know different things she could try and I'm not  graduated!

[regan]

And because I also have a superhero liver, my body flushes out and and compensates for anything I take with utmost efficiency. 

Everything eventually passes through your liver, but if you take it by any other means then orally, at least you skip the first pass.  As for E not working, an absolute "immunity" to it is almost unheard of.

I would seriously consider finding another doc.

[madirocks]

This is interesting to compare the changes between people. I'm expecting to start in January, and therefore I will have two and a half months of HRT while still a government employee.

Should I delay starting? I don't want people questioning me.

[JungianZoe]

Should I delay starting? I don't want people questioning me.

Nobody can give you the absolute answer that fits your unique circumstances, but my opinion is no.  Delay kills.

[madirocks]

Nobody can give you the absolute answer that fits your unique circumstances, but my opinion is no.  Delay kills.

Thanks! That is what I am thinking right now too hehe. I suppose I can always come up with excuses too.