I may never be able to safely take HRT

[Jennygirl]

Umm, afaik clotting risks are just related to E levels.  So a low dose would not put you at any more risk than a cis girl... and would still give you changes long-term.

It's also related to how the E is initially metabolized, such as orally or straight into the bloodstream. Orally, ALL of it passes through the liver, where it is converted into Estrone (the form of estrogen that is BAD bad bad). Going straight into the bloodstream (transdermal patches, subdermal implants, or injections) only a bit of it passes through the liver once it is already in circulation, reducing the conversion to estrone to a negligible level.

What you need in order to feminize is Estradiol. When the liver converts Estradiol to Estrone, feminization is not nearly as effective- and it comes with the heavy price of unhealthy side effects- the same as birth control pills.

While describing this to me, my endocrinologist was literally getting red in the face with anger because so many Dr's use oral methods to administer E. As far as he is concerned, oral E is just bad for the body because of the Estrone coversion. On the other hand, when administered straight into the blood, Estradiol prevails and is extremely good for you AND the feminization process. You need much less of it in order to be effective. Besides increasing the risk of breast cancer, it reduces blood pressure, makes the heart healthier, greatly reduces risk of prostate disease, promotes life longevity, and there were more reasons but I forget all of them.

I have my next implant scheduled for April 1st, I will try to ask him if he has any good literature on the differences in the biological effects of oral vs trans/subdermal. The article I posted earlier I found myself and describes it vaguely, but I am definitely interested to know the details.

[tomthom]

thanks for all of your help Jenny. I enjoy the fact you've been supportive and helping with actual research since day one with this question of mine.

[Jennygirl]

I'll definitely ask my endocrinologist about it when I go in next (April 1st or 2nd or something). I've been wondering too about the exact biological mechanism because I don't want to be spewing any kind of inaccurate information with such a serious scientific topic that I only have a surface level understanding of. He gave me kind of a layman's description of the process, and even then it was a bit overwhelming. I'll be seeking some literature I can easily share with you all.

But literally, he was red in the face if that is any indication. Hope I don't get him all RILED again! j/k

And tomthom you are so welcome, I really hope that this information can help you on your journey (as well as others', too). I'll get the details or proof or what have you and share them in this thread asap

[Jennygirl]

Well I just said heck with it and sent him an email maybe he will get back to me before our appointment.

[Rosa]

Both of my parents have had clots and I had my first at 48 and eas in hospital for a week. I expressed my concern about being able to go on E. My internist said it probably would not prevent HRT but I would need close monitoring and maybe need an anticoagulant.

[tomthom]

well, reviewing all of this information, I should be fine. I'd still love to see those tests and compile the research in a way that's easier for when others come by or if I need to reference it, but seeing as my age is 20 and all my current levels and risks are pretty much at perfectly acceptable levels, all I can do is go to the endo and see what we can do.

[Eveline]

I go to Dr. John Odea in Marina del Rey here in California. He swears by pellet implants, and now I can swear by them too

Jennygirl, are you happy with Dr. O'Dea so far? Any other girls using him who want to comment?

[Jennygirl]

Jennygirl, are you happy with Dr. O'Dea so far? Any other girls using him who want to comment?

I am extremely pleased with Dr. O'Dea. He has a quirky personality that I have come to adore and more importantly he really knows his stuff. From the beginning I got the feeling truly wants to help us girls feminize as fast or slow as we want and be healthy at the same time- both mentally and physically.

A huge plus with him is: the pellets are so safe, he lets you choose your own pace for feminization- and of course he operates on informed consent. He lets you pick anything in between slow and steady to fast tracking the feminization process. I have my second implantation on Wednesday, and I've decided to go up on the dose because things have been working out so well. I started on a medium dose but I am confident that going up will only make things better

He's a little pricey and I'm pretty sure he's not covered by insurance, that would be the only downfall I could see for someone wanting to use him and expecting insurance to cover it... But it's worth it. My results from a mid-range dose so far have been great to say the least.

So, yes.. I am very happy with him. He's a great endocrinologist

[Joanna Dark]

Most estrogen pills, like estrofem, are meant to be taken sublingually and thus are similar to injections, except for the nominal amount that is lost to the stomach. But, if you wait five minutes and don't swallow, the vast majority are absorbed by the mucuos membranes in the mouth. Correct me if I'm wrong, but very little of it gets to the liver first-pass. Ultimately, everything enters the liver. But with injections, patches, and sublingual administration, the pills enter the blood as estradiol. Doctors should not even prescribe pills that are not sublingual. Soon, all pills will be sublingual in the form of films that dissolve within seconds.

[tomthom]

films do make more sense. But I always enjoyed needles, so hey, win win.