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My six months on low-dose hrt

Started by Jamie D, March 23, 2012, 04:07:39 AM

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Jamie D

About a year ago I seriously began to consider doing something about my gender dysphoria.  I have coped with it for since I was a young teen, or even a tween. Part of it had to do with pubertal gynecomastia.  Another part of it had to do  my bisexual orientation.

Perhaps diminishing testosterone levels that coincide with entering ones 40s and 50s had something to do with it.  So almost exactly one year ago, I began talking with a therapist about gender issues.  She wasn't a gender therapist, but she had experience in gay and lesbian issues, and was generally supportive.  Actually, I had to explain to her what the term "gender dysphoria" meant.

I was getting a lot of good information off of Susans and other sites, so I felt I was perhaps more knowledgeable than she was on trans issues.  It was hard explaining that I felt that there was a male and a female inside of me, and the female (Jamie) really wanted out.  After about 6 or 7 sessions, she asked, "Do you think you want to be a woman?"  There was no easy answer for that.  What Jamie wanted were hormones and T-blockers to finish off her male alter-ego.

So I said, "Yes" with all the conviction I could muster.  She set me up with a GLBT-friendly GP nearby, who I went to see for a general check-up, in hopes of scoring a 'script.  He looked over my medical history, which included triple by-pass surgery and said, "You're going to have to take this slowly."  I was already on a couple of meds to prevent clots from forming (Plavix, aspirin), so the risk of DVT was minimal.  I was also already on Aldactone (spironolactone) as a diuretic.  So far so good.

I started off with a low-dose 17 beta estradiol transdermal patch. (In keeping with the site policy, I'll not mention dosages).  The plan was to increase the dose after one month, and then increase again after three months.  The Rx was written for 3 months worth of patches.  The nice thing about a patch is you can cut a larger patch down for a smaller dose. It saves a little money.

When it came around time for another appointment and to consider increasing the dosage (to two patches simultaneously) a couple of changes had taken place.  I was off Aldactone.  Also,  I was a little alarmed at the "developments" taking place!  Anyway, I got renewed at the former level and also got another AA.

So, what changes have taken place in six months?

The very first week, on the lowest dose estrogen, my boobs responded.  I already had 38 A cups, ever since I was a young teen. I had glandular tissue beneath the nipples, about the size and shape of a half walnut or pecan.  They weren't just fat boy boobs.  The estrogen was like jump-starting a dead battery in a car.  My girls roared to life.  All the memories of developing breast buds flooded the carburetor in my brain.  At times I had to hold ice cubes on them, just to stanch the ache.

The next thing I noticed was a calm like I had not before experienced.  The dysphoria greatly diminished.  And I was better able to accept, and understand, my bigendered self.

I have for some time really disliked body hair.  I was never very furry, and thank god, I never had back hair. But I decided it had to go.  I used a depilatory on my legs and torso (before hrt, maybe to prove to the therapist my intentions).  I have noticed that the legs hairs have greatly diminished and grow back at a much slower rate. The hairs on the torso have become finer and also slowed. The face - no effect at all.

I let my hair grow out for several months, before getting it trimmed prior to the holidays.  As a teen in high school, I had long wavy hair that for some reason the girls liked.  My parents would only make me get it cut at the end of the summer, for school pictures.  Now I'm letting it grow again.  I just have somewhat fewer hairs than I did 40 years ago!

I've noticed a slight amount of fat redistribution.  I never had a butt to speak of.  Now my "boy jeans" are a little tight in the rear.  I have also noticed a little pooch in the pubic mons area.

The biggest development were in the breasts.  The glandular tissue has quadrupled in size. My areolas protrude.  I have seen a change in their shape and size.  When working out, I really have to wear a sports bra.  I fit a 40 B or 38 C pretty well.  The areolas were almost the size of a US quarter; now they are not covered by a dollar coin. The nipples are also visibly larger too.  And very sensitive at times.  I really like playing with them!

I got a new therapist - another lady who has other trans clients.  I feel more comfortable with her, especially discussing issues of androgeny.  She is not convinced that I have GID, by the book, but she is willing to listen, discuss, and make suggestions.  She wants me to consider a more androgenous presentation.  I picked myself up some black girls jeans - size 14.  I'm hoping to lower that in the coming months.  And really work on getting rid of the gut.

I had a big setback recently, though.  I recognized I was having symptoms of a transient ischemic attack (TIA).  My endo was out of town, and the symptoms could have been attributed to my metabolic syndrome.  I decided to play it safe a go to the local ER.  A CAT scan revealed a minor brain bleed that was treated with platelets.  But now I'm off Plavix and aspirin.  I can probably go back on aspirin in about two months.  The problem is that my DVT risk has gone up.  I'm off the patch for the time being - and I'm getting really grumpy!

I liked the direction my body was headed.  I have to lose about 50 pounds (what would that be my British friends - about 4 stones?) and lower my blood pressure.  Perhaps then I can resume E.  Just in the couple of weeks since my TIA incident, the dysphoria is creeping back, and I've got an Rx for Lexapro.  A sad trade off, as far as I am concerned.

The best part of the last six months, however, are the people I have met here.  After lurking since last spring and summer, I signed up in November.  I can not express in words how much you all have taught me and how much you mean to me.  I feel confident about the future.

With love and gratitude,
Jamie D

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Joelene9

Jaime,
  I'm glad that you are responding well to the HRT despite the other health problems you have.  The threat on my side still is cancer.  My boobs has not grown as well as yours, but having nothing there to begin with, these sub-Bs are welcome as well as my butt filling out my loose fit boy jeans as well.  Soft, younger looking skin with disappearing age spots on this 59 year old with the gorilla hair down to a few strands are the most vivid physical changes here.  I haven't had a depressive episode in over a year!  A record!
  Joelene
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Jamie D

Quote from: Joelene9 on March 23, 2012, 04:31:31 AM
Jaime,
  I'm glad that you are responding well to the HRT despite the other health problems you have.  The threat on my side still is cancer.  My boobs has not grown as well as yours, but having nothing there to begin with, these sub-Bs are welcome as well as my butt filling out my loose fit boy jeans as well.  Soft, younger looking skin with disappearing age spots on this 59 year old with the gorilla hair down to a few strands are the most vivid physical changes here.  I haven't had a depressive episode in over a year!  A record!
  Joelene

Oh yeah, soft, but sometimes itchy skin.  I should have mentioned that.

I had not read much about the effects of hrt on depression, but there are an awful lots of testimonials here about that.
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Cindy

Great post Jamie,

Get that weight off.  It sounds as if you BP is still high, are you on cholesterol blockers and have you had a positive diet modification? Have you had a very serious thought of going vegetarian? The reason I ask/nag( :laugh:) is that my weight is low, but I have familial HBP and high cholesterol. I'm thinking of going to a veg diet as nothing seems to reduce my cholesterol or blood pressure.  To put in perspective I'm quite tiny. I'm 5'9'' and weigh 63kilos. This is a totally normal weight for a woman of my size. So it is very frustrating that other stuff happens.

You may not want to post on the thread but what was there a cause of of the 3BP op? And is that now under control?

As for your reponse to E with increased growth of the girls I think there can only be one legitimate comment. Bitch.  :laugh: :laugh: :laugh: :laugh: :laugh: :laugh: If that sounds like jealousy it is :laugh: :laugh: :laugh: :laugh: :laugh:

Hugs
Cindy
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luna nyan

Hi Jamie,

Thank you for sharing, as there are many of us here on the same path.  I hope that you get your blood workups sorted out soon and get everything back in balance.
Drifting down the river of life...
My 4+ years non-transitioning HRT experience
Ask me anything!  I promise you I know absolutely everything about nothing! :D
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Jamie D

Quote from: Cindy James on March 23, 2012, 04:50:42 AM
Great post Jamie,

Get that weight off.  It sounds as if your BP is still high, are you on cholesterol blockers and have you had a positive diet modification? Have you had a very serious thought of going vegetarian? The reason I ask/nag( :laugh:) is that my weight is low, but I have familial HBP and high cholesterol. I'm thinking of going to a veg diet as nothing seems to reduce my cholesterol or blood pressure.  To put in perspective I'm quite tiny. I'm 5'9'' and weigh 63kilos. This is a totally normal weight for a woman of my size. So it is very frustrating that other stuff happens.

You may not want to post on the thread but what was there a cause of of the 3BP op? And is that now under control?

As for your response to E with increased growth of the girls I think there can only be one legitimate comment. Bitch.  :laugh: :laugh: :laugh: :laugh: :laugh: :laugh: If that sounds like jealousy it is :laugh: :laugh: :laugh: :laugh: :laugh:

Hugs
Cindy

I have "labile hypertension."  Just today my BP varied from 178/95 to 144/71, with no rhyme or reason or change in medications.

The HDC/LDC number have been good over the past year.  Especially in lowering triglycerides.  I take 2000 mg of Omega 3 and Omega 6 fish oil capsules each day, and I am on gemfibrozil.

My bypass happened after two failed stents in the branch of the descending artery of the heart.  My first symptom of any problem was when I had a ventricular tachycardia while refereeing a soccer game in 2004.  I was a linesman in that match and I dropped right on the pitch.  It was, thankfully, self-correcting.

The weight problems, as I have discussed with my therapist, may have been in reaction to mask the pubertal gynecomastia.  But my paternal grandfather probably had metabolic syndrome, and had a prodigious pot belly until he died at age 64.

To be forewarned is to be forearmed.
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Jamie D

Quote from: luna nyan on March 23, 2012, 05:02:46 AM
Hi Jamie,

Thank you for sharing, as there are many of us here on the same path.  I hope that you get your blood workups sorted out soon and get everything back in balance.

Thanks luna.  As I mentioned in my "I got lucky thread" on this board, my blood work looked really good in September and December.  I haven't done March bloodwork yet, but had quite a few tests while hospitalized for four days.
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Jamie D

#7
Another thing I forgot to mention.  I smell better.

I know you're saying, "Fragrance is in the nose of the beholder."  But it's true.

A couple of weeks ago I was doing a load of laundry and I had this shirt, i was pretty sure I had worn, on a chair.  I sniffed it to see if I could pick up that musky male BO in the pits.  Nothing.  Well, I thought the short was clean, until I found a couple of cooking splatters on it.
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Eva Marie

Whoa.... a TIA? Brings back some scary memories for me. I had TIAs for a long time before my stroke and didn't know what they were. Now i do.

Hopefully the docs can stabilize your situation and get you back on the HRT again soon  :)

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Jamie D

Thanks Riven.

Met with my cardio today, and with will meet with my endo on Thursday.

Looks like I am off hrt (estradiol) for at least 6-8 weeks (early to late April). My blood work done two weeks after my initial hospitalization (and cessation of hrt) showed my free testosterone had crept back up to 47 pg/mL (normal male range 35-155) and my estradiol was at 35 pg/mL (normal male range < or = 39).

I guess I'm just going to have to show patience.
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Cindy

Better than having to show as a patient.  :laugh:

My therapist is suggesting going for boob surgery and coming off HRT, since there are significant risks for 60 yr olds on HRT no matter if they have male or female metabolism. Has anyone else heard of this?
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Jamie D

Quote from: Cindy James on April 04, 2012, 03:20:04 AM
Better than having to show as a patient.  :laugh:  Nyuk nyuk

My therapist is suggesting going for boob surgery and coming off HRT, since there are significant risks for 60 yr olds on HRT no matter if they have male or female metabolism. Has anyone else heard of this?

Yes I have.

Thanks for commenting.  As you are a person in the medical field, I especially value your opinions.
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luna nyan

Quote from: Cindy James on April 04, 2012, 03:20:04 AM
My therapist is suggesting going for boob surgery and coming off HRT, since there are significant risks for 60 yr olds on HRT no matter if they have male or female metabolism. Has anyone else heard of this?
The risks of issues from HRT increase with time.  With any sort of risk, it's a probability thing - like the golfer standing at the tee all day trying to get a hole in one - if he tees off a sufficient number of times, he will eventually get that hole in one.  Same thing with HRT - the longer you're on it, the more likely you will have to factor in the risks of being on it.

A good brief technical paper on it from the NHMRC of Australia can be found here.

If it's TL;DR the relevant bits affecting CIS females aged over 50:
1.  Increased risk of DVT (deep vein thrombosis)- 6 cases per 1000 vs 4 cases per 1000 over 5 years.
2.  Increased risk of PE (pulmonary embolism) - increase from 3 to 8 per 1000 over 5 years.
3.  Increased risk of stroke - increase from 4 to 6 per 1000 over 5 years.
4.  Increased risk of breast cancer - increase from 11 to 15 per 1000 over 5 years - PLEASE NOTE THAT THIS IS ON COMBINED HRT ONLY.

Basically the statistics say, in the worst case scenario (breast cancer) - you have a 1.5% of getting it versus 1.1% over a 5 year period in your 50s if you choose to be on HRT.

On the plus side - there is a significant decrease in osteoporotic fracture, and poor evidence of possible positive effects against dementia.

Now whether this can be directly extrapolated over to MTFs is a matter of conjecture, but it would be reasonable to say that there may be a similar risk increase.  Obviously this is a poorly researched area, as the many of the pioneer mtfs are only reaching their latter years now, many in stealth, and thus getting good data may prove to be difficult.

edit: Oh... one more thing - I've kept the analysis as simple as possible, and have not factored in family history, previous episodes of DVT, etc etc.  These will need to be factored in to any decision made.
Drifting down the river of life...
My 4+ years non-transitioning HRT experience
Ask me anything!  I promise you I know absolutely everything about nothing! :D
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Jamie D

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Jamie D

The continuing saga of Jamie takes another twist.

I had re-started therapy with a young, mid-20s woman, who was quite bright, engaging, and understanding.  She had worked with transgendered clients before, and had a close friend who is FtM.

At our most recent session last week, she told me she was leaving the practice to work with a local hospital program dealing with young people who have addictions and substance abuse problems. (This is a very noble calling, IMHO.)

However, she will no longer be affiliated with my insurance provider, so now I have to find another therapist and try to establish a rapport.  She was just really beginning to understand the whole genderfluid concept too.

Damn.
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Jamie D

Well, good news and bad news.  I got the results from my myocardial perfusion scans, chemical stress tests, and echocardiogram this afternoon.

Where I had the bypasses 5 1/2 years ago, my arteries are still open.  However, on the backside of my heart, I am developing a new blockage.

This means sometime in the future I will likely need an angiogram or angioplasty. I am determined not to get my chest cracked again.

The problem remains, I can't go on any blood thinners for the time being.  Therefore, I can't really have the angiogram except under emergency circumstances.  So, in the interim, I'm going to get to carry around with me some nitro glycerin tablets.

And I can't resume HRT.

Wonderful, just frickin wonderful.
  •  

Felix

everybody's house is haunted
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Cindy

So sorry to hear that Jamie. Can you go for a boob job instead of HRT?
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Jamie D

Quote from: Cindy James on April 21, 2012, 01:52:18 AM
So sorry to hear that Jamie. Can you go for a boob job instead of HRT?

The hrt really knocked down the dysphoria.

I will grin and bear it. I coped for 40 years, I can cope for a few more weeks or months.

It's sort of like getting the rug pulled out from under you ...

at the top of the stairs and doing a Scarlett O'Hara all the way down.
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Siobhan

i hope you get better soon Jaime, i can imagine its very frustrating for you.
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