Conundrum

[SusanK]

My transistion is on the slow road because of finances to afford my new career/business and my transistion in retirement, but after the first six months on hrt (3 months ago) I had to reduce and level off my dosage to the minimum of Spironolact and estrodiol because the former severely excerbates my dysthymia into depression and the latter physically crashes the body. So the effects are minimal now at best, and while it's my interest and desire to continue, it sure does create cause for rethinking what's realistic. Going back isn't a desire, and going forward is the question. It's something I (obviously) can live with, it's just disappointing, kinda' like those detour signs on highways but the detour road isn't on the map going in a direction you say to yourself, "WTF? Where is this road headed?"

Anyway, I'm just thinking out loud, so you're more than welcome to suggest or comment.

[Kimberly]

Something to keep in mind, I think, is that sometimes going forward is not a question, but rather an ultimatum.

I wish you luck

[Julie Marie]

Susan, please forgive my ignorance but I was unclear about parts of your post.  You said the estradiol physically crashes the body.  Is that in specific reference to you or a general statement? 

Something else that I'm confused about is the onset of depression while on HRT.  Usually depression lessens or vanishes once one begins HRT.  In my ignorance, I would have thought whatever physical reaction HRT is causing to increase the depression, just the relief of being on HRT would offset that. 

But if it's the spiro that causes depression, is there another androgen blocker you can use?  Or maybe you can go without one altogether?  I went for about 6 months on estradiol only and I realized physical feminization that I found very satisfactory.

Getting back to the estradiol, if your reaction is specific to you, maybe you can use another estrogen enhancing medication.  When I was on transdermals (Estraderm) I achieved practically all the breast growth I have today but my blood test showed the estradiol level at 24, a more than 50% drop from my initial blood test.  Yet I was experiencing physical feminization.  When I began injections (estradiol valerate) my blood tests showed estradiol increases to normal female levels but my breasts stopped hurting and I no longer saw any physical changes.  No one can explain this.

What I'm getting at is each one of us reacts differently to a given medication.  There may be other options you want to try.  I know that in a sense that makes you a guinea pig but it may mean you'll eventually find the HRT medications that don't cause adverse reactions.

Sorry if I'm out of line but you sounded really down and I'm just offering my own experience.  Maybe it will help?

Julie

[SusanK]

Susan, please forgive my ignorance but I was unclear about parts of your post.  You said the estradiol physically crashes the body.  Is that in specific reference to you or a general statement? 

Something else that I'm confused about is the onset of depression while on HRT.  Usually depression lessens or vanishes once one begins HRT.  In my ignorance, I would have thought whatever physical reaction HRT is causing to increase the depression, just the relief of being on HRT would offset that. 

But if it's the spiro that causes depression, is there another androgen blocker you can use?  Or maybe you can go without one altogether?

Sorry if I'm out of line but you sounded really down and I'm just offering my own experience.  Maybe it will help?

Julie

Julie, your questions and ideas are good. I work with a good physician who has overseen many transistions, so she's very experienced with problems that may or do occur, and she's emphasizes one's health than risking a transistion.

To answer your questions, I started on patches, but I physically crashed within 2 monhts, got excessively tired and slept 10-12 hrs/day, so we switched to lower dosage pills and it's working at the edge of being normal, meaning I can be active and do things with 8-9 hrs sleep and naps on some days. I was on spiro for 4+ months when we increased it, and I fell into a deep depression which quickly went away when I went back to the lower dosage.

In short, the lower dosage works to bring some physical, emotional and mental effects. I'm calmer, quieter and feel better about myself and the changes, but I have genetic Dysthymia which is easily triggered into double depression. My physician thinks it's related to the mind-body's longstanding adjustment to my old self and has problems adjusting to the new self. I discovered that short illness and anti-biotics offsets the hrt, so it's the conundrum where I'm at a plateau where adjustments are small and senstive, and progress slow.

The key to the reaction of your body is also your metabolism and your mind-body connections. We're all individual so hrt can individual effects within the generally known effects but it doesn't mean everyone falls in the frame, some react outside the normal, and this is where I find myself. I have to keep active and watch my diet to keep my metabolism normal, otherwise it falls through the floor. It's where the male hormones kept it up naturally and losing that, it has little to sustain it.

Is this clear? My physician says there's little real studies in the short and longterm health of transpeople, but she makes sure all her transpatients live healthy lives in and after their transistion. While she uses blood tests to monitor things, she goes by the patients physical and mental/emotional health more to ensure they're having the life they want. Being relatively physically fit, she wants to make sure that while I will lose strength, I won't lose my fitness and health.

Thanks for the words. It helps. Thanks for the ear.

--Susan--