Kickstart my hrt

[Jennygirl]

I do agree that implants do a better job, but I have never read any research to believe they work any faster! More effective, Yes ...Faster IDK  Do you know of any research that shows this to be true??

All I have is the word of my endo. Sorry, I know I shouldn't speak in absolutes when I can't back it up with sources other than words I heard. I gotta watch that. I do trust him, though, and I am very pleased with my results to say the least.

I remember one of his main points being that it's a slow steady release and that's what makes it so effective. I chose to go full speed ahead, but the results would probably still be very good with less. I can't tell you from experience though, I started out with 7 and worked my way up to 12.

I was really happy after four months (at 7 pellets) with how much my body had already changed. It's amazing what a few of those teensy little things can do

I highly recommend them at whatever level you can afford. 5 pellets every 4 months would come out at less than $100 / month. 3 would be less than $60 / month.

[Ltl89]

All I have is the word of my endo. Sorry, I know I shouldn't speak in absolutes when I can't back it up with sources other than words I heard. I gotta watch that. I do trust him, though, and I am very pleased with my results to say the least.

I remember one of his main points being that it's a slow steady release and that's what makes it so effective. I chose to go full speed ahead, but the results would probably still be very good with less. I can't tell you from experience though, I started out with 7 and worked my way up to 12.

I was really happy after four months (at 7 pellets) with how much my body had already changed. It's amazing what a few of those teensy little things can do

I highly recommend them at whatever level you can afford. 5 pellets every 4 months would come out at less than $100 / month. 3 would be less than $60 / month.

Sorry, bit of a stupid question, but do you mean 5 pellets would be 100 every four months or every month?  And that would be $100 for all 5 pellets?  That might be possible for me.  It depends on a few things.  I wonder if the lower amount of the pellets would be better than taking oral Estradiol and Spiro everyday?  While it is more cost effective and possible for me, I don't want to sacrifice anything for lesser results as I am finally starting to see some changes.

[Just Shelly]

All I have is the word of my endo. Sorry, I know I shouldn't speak in absolutes when I can't back it up with sources other than words I heard. I gotta watch that. I do trust him, though, and I am very pleased with my results to say the least.

I remember one of his main points being that it's a slow steady release and that's what makes it so effective. I chose to go full speed ahead, but the results would probably still be very good with less. I can't tell you from experience though, I started out with 7 and worked my way up to 12.

I was really happy after four months (at 7 pellets) with how much my body had already changed. It's amazing what a few of those teensy little things can do

I highly recommend them at whatever level you can afford. 5 pellets every 4 months would come out at less than $100 / month. 3 would be less than $60 / month.

It sounds as if you are getting a higher dose...I do know that higher doses don't necessarily work better...but do come with higher risks.

My HRT doctor is ok with my E level of 762...it is on the high side but not too high still. Then theirs my regular doctor that was concerned the level was too high....but she is not comfortable prescribing HRT for trans...hence the less knowledge.

Just be safe....less is more sometimes I think the biggest factor is suppressing T..especially on a consistent basis....one reason I would like to get an Orchi!!

Oh my T is almost nill at a 2

[Jennygirl]

Sorry, bit of a stupid question, but do you mean 5 pellets would be 100 every four months or every month?  And that would be $100 for all 5 pellets?  That might be possible for me.  It depends on a few things.  I wonder if the lower amount of the pellets would be better than taking oral Estradiol and Spiro everyday?  While it is more cost effective and possible for me, I don't want to sacrifice anything for lesser results as I am finally starting to see some changes.

Pellets would be around 100 per month for five. Or close to 400 every 4 months.

Dr. O'Dea told me on the first visit that even a small number of pellets is much better than hormone pills and anti-androgens. How fast would the feminization be compared? I don't know. I could ask though? Or you could email him and I'm sure he'd do a better job of answering these questions. If you do, I'm curious to know as well!

http://www.odeamedical.com/

[Jennygirl]

It sounds as if you are getting a higher dose...I do know that higher doses don't necessarily work better...but do come with higher risks.

My HRT doctor is ok with my E level of 762...it is on the high side but not too high still. Then theirs my regular doctor that was concerned the level was too high....but she is not comfortable prescribing HRT for trans...hence the less knowledge.

Just be safe....less is more sometimes I think the biggest factor is suppressing T..especially on a consistent basis....one reason I would like to get an Orchi!!

Oh my T is almost nill at a 2

I keep asking my dr if I should have my levels checked, and he keeps telling me what a waste of time and money it would be for me at this point. He definitely has an interesting way of treating people, but the results do not lie and I appreciate his boldness.

And yeah i want to get an orchi, too. But at the same time, I think I will most likely go to Suporn for SRS- so it's not really in the cards.

[Ltl89]

Pellets would be around 100 per month for five. Or close to 400 every 4 months.

Dr. O'Dea told me on the first visit that even a small number of pellets is much better than hormone pills and anti-androgens. How fast would the feminization be compared? I don't know. I could ask though? Or you could email him and I'm sure he'd do a better job of answering these questions. If you do, I'm curious to know as well!

http://www.odeamedical.com/

Thanks for the info Jenny.  Unfortunately, that isn't really in my budget.  Even without insurance, I was able to get my estradiol for $55 for a 3 month supply.  I'll just have to hope these pills will work their magic.

[Kristina77]

Dang girl, where are you getting your Estriadol from?  When I started orals w/o insurance I got a 3 month supply from Target for $24.

[Ltl89]

Dang girl, where are you getting your Estriadol from?  When I started orals w/o insurance I got a 3 month supply from Target for $24.

CVS. 

Now that I have insurance again, all of my prescriptions are without copay.  Thank god for that! Free hormones!  I'm lucky that my mom is in medical and gets great benefits. 

[Kristina77]

Glad you got it worked out Don't think O'Dea takes insurance.  I'm not in a position where I can get insurance (not even with Obama-care) for an affordable price, so it made more sense for me to just to go O'Dea.  The spiro was what killed my wallet -_-; $80/month yikes.  Plus I didn't want to go to counseling so I saved money there.

[Ltl89]

Wow, lot has changed since I posted this thread many months ago.  I remember writing this but it's like a different person wrote all this. Weird how time flys, lol.  Oddly enough, however, I'm still feeling the need to kick start my hrt and am very likely going to switch to injections (I've decided pellets weren't right for my personal budget in the end).

Glad you got it worked out Don't think O'Dea takes insurance.  I'm not in a position where I can get insurance (not even with Obama-care) for an affordable price, so it made more sense for me to just to go O'Dea.  The spiro was what killed my wallet -_-; $80/month yikes.  Plus I didn't want to go to counseling so I saved money there.

I remember spiro being quite expensive too.  However, I was able to get a discount at my local cvs when I was paying out of pocket.  They gave me prescription cards to lessen the cost.  It's worth a shot.  I can't even remember what it's like to pay for these things as it feels like such a long time ago since I was in that position, so sorry if that doesn't help.  Are you doing the pellets?  How's that working for you?  I would imagine spiro would be cheaper than the pellets, but maybe I'm wrong.

[Kristina77]

Wow, lot has changed since I posted this thread many months ago.  I remember writing this but it's like a different person wrote all this. Weird how time flys, lol.  Oddly enough, however, I'm still feeling the need to kick start my hrt and am very likely going to switch to injections

I remember spiro being quite expensive too.  However, I was able to get a discount at my local cvs when I was paying out of pocket.  They gave me prescription cards to lessen the cost.  It's worth a shot.  I can't even remember what it's like to pay for these things as it feels like such a long time ago since I was in that position, so sorry if that doesn't help.  Are you doing the pellets?  How's that working for you?  I would imagine spiro would be cheaper than the pellets, but maybe I'm wrong.

Aaaah omg I didn't look at the dates on ur lasts posts until now! XD Injections will probably do better because it's being directly injected into your bloodstream and not having to pass through your digestive tract... that seemed to be the sticking point with oral Estrogens if I remember. 

I feel like a diffferent person too after all this time, this thread was back from when I first started HRT.  Now I've been full time for like 6 months or so O.o So much has happened since then.  Spiro is cheaper than pellets, & for awhile I was doing both... so yeah I've gotten results hella fast XD I went full time like 2.5 months into HRT as a necessity (noticed I was getting called miss or ma'am all the time so I thought sweet might as well go full time XD)

I'm doing great on the pellets but last time I went I lessened my progestrone in favor of my estrogen (was trying to budget a little more tightly) and that idn't go so hot... I realize now how invaluble progesterone is in the equation.  Too much estrogen + not enough progesterone = depression for me -_-; I sleep like 10 hours a day lol ^^; luckily though I'm 2 days away from my next appointment and getting that fixed.  Lost my job due to transistion tho so it's gonna be reaaaaalllly hard to budget for pellets, luckily I have until beginning of October to figure things out again.

I don't really have any other options though since I stopped seeing my psych and O'Dea / pellets is an informed consent thing.  So I still don't have the universal letter for HRT even though my name change is processing and I've been FT now for so long XD  I guess I figured orals + psych = $600/mo Pellets=$300/mo with better results, so it was a no brainer for me.

[teeg]

I think the slow progress many people experience in HRT is mainly due to SHBG. Androgens decrease it, estrogen increases it. The goal of MTF HRT is to lower androgens and raise estrogen, however this indirectly increases SHBG. Pellets probably don't do anything special compared to other routes of administering estrogen, they're just usually administered without antiandrogens which yield lower SHBG levels due to androgens still being present. Personally I noticed very fast progress when I was only on oral estrogen and finasteride, yet when I started taking spironolactone that progress slowed down dramatically. Your best bet is to somehow lower your SHBG levels while maintaining your estrogen levels. I don't know how to do this. GH, CBG, prolactin, insulin for example can all lower SHBG, but probably not in enough proportion as would be needed in HRT. Tamoxifen is an estrogen antagonist used to block ER+ breast cancer cells, however it also acts as an estrogen agonist in the ovaries and temporarily can aid in fertility. I'd be interested to see if there are some sort of medications that can stop the liver from producing so much SHBG, and also perhaps other safer estrogen agonists that force the receptors to take and use the estrogen.

[Hikari]

LTL in the photos you have posted, your face looks like it has taken to HRT well, what exactly are you wanting to kickstart still, breast growth? Fat redistribution? Something else?

I don't really know what to really offer for advice, as my results have been a bit quicker than I would like seeing as I am not ready for fulltime yet, and I have some small stretchmarks on my breast now. I do know that when I started Bicalutamide things really sped up, but that was probably because I hadn't been taking enough spiro to be effective. If your T is under control and your levels are good, the only thing that makes much sense is to have a more constant form of delivery and injections have to be better than the pills. I take a single E pill everyday and you can actually see the difference in my face from 3 hours after the pill and 3 hours before the pill, which means the levels have to fluctuate wildly.

[teeg]

I take a single E pill everyday and you can actually see the difference in my face from 3 hours after the pill and 3 hours before the pill, which means the levels have to fluctuate wildly.

There's no way anything attributed to hormones would show in such a short time span like that. You're likely noticing something else.

[Kristina77]

There's no way anything attributed to hormones would show in such a short time span like that. You're likely noticing something else.

Agreed. It's a psych / placebo thing absolutely.  I should know because I've gone through this (which is why I went on pellets + injections instead of oral, the fluctuating amounts in your brain chemistry).  I also go through it when I'm just about done with the pellets and can feel them 'fade off' as my Estrogen (and especially progestrone) fade towards the end. I feel far less feminine right before going to my pellets + injected at the 3 month mark, even though the outside world treats me no different.

It could still effect your face though, because you're not full time... how can I explain before I went full time certain situations called for 'boy version' so I intentionally would narrow my eyes or do little 'male' things from adopting a 'male' persona mentally.  You mention a 3 hour cycle and this is about right.  O'Dea says Estrogen pills usually last about 4 hours in your system if dissolved under the tongue... at which point ur androgens kick in and you experience a 'swing back' effect where it seems to you mentally that your testosterone is raising (it isn't, just the estrogen lowering in your brain).

This is why I do pellets- I go through a 3 month cycle instead of a 3 hour one.

I think the slow progress many people experience in HRT is mainly due to SHBG. Androgens decrease it, estrogen increases it. The goal of MTF HRT is to lower androgens and raise estrogen, however this indirectly increases SHBG. Pellets probably don't do anything special compared to other routes of administering estrogen, they're just usually administered without antiandrogens which yield lower SHBG levels due to androgens still being present. Personally I noticed very fast progress when I was only on oral estrogen and finasteride, yet when I started taking spironolactone that progress slowed down dramatically

The pellets are I think superior to orals because they stay in your bloodstream. A constant influx of steady levels of Estrogen essential- especially when you're sleeping as that's when your testosterone is replenished.  I think you're right though about Spiro.  I took only like a quarter dose of Spiro once starting on pellets, so the effects were probably neglible... and the more I think about it I had another spurt of breast grow after quitting Spiro XD (O'Dea told me just to stop once my prescription ran out).

What you said also makes sense to something O'Dea told me- Progesterone reduces and replaces Testosterone.  Makes sense to me because Progestrone is a 5a reductase substrate in the same family as Finasteride. I noticed a faster change when I kept my progesterone levels high, and I struggled less with depression / negative emotions.

[KayXo]

Too much estrogen + not enough progesterone = depression for me

I noticed the same thing.

I think the slow progress many people experience in HRT is mainly due to SHBG. Androgens decrease it, estrogen increases it.

I don't think androgens decrease SHBG. They just do nothing whereas estrogen in the liver stimulates production of SHBG.

Your best bet is to somehow lower your SHBG levels

I think having high SHBG levels is good since it binds androgens more strongly than estrogens with the net effect of less androgen being active relative to estrogen. Taking estrogen orally vs non-orally tends to increase SHBG levels much more.

I take a single E pill everyday and you can actually see the difference in my face from 3 hours after the pill and 3 hours before the pill, which means the levels have to fluctuate wildly.

This was my feeling too on oral E (based on how I felt) and especially sublingual! On injectables, levels seem to stay high longer and things seem more stable.

Progestrone is a 5a reductase substrate in the same family as Finasteride.

In the blood, only very high levels of progesterone not found ever in the human body, even during pregnancy, can significantly inhibit 5 alpha reductase. Perhaps, super high concentrations in the skin can have an effect, I don't know. 

[Kristina77]

Interesting discussion while we don't all always agree I think we can take away that oral estrogen is probably the least effective & safe ways of getting estrogen in your bloodstream, and that progesterone is necessary on some level.  Like others have noted in the progestrone thread, I've noticed a change to my hairline on high doses of progesterone injections.  While I've never experienced any recession or thinning and my hair has always been pretty thick on the whole, it definitely did have an 'M' shape to it as long as I can remember.  That started to change on progestrone I started growing little fuzz & baby hears along the corners of that M shape.  My hair is blonde so it hasn't thickened enough in the corners to a completely female shape yet, but I'm only 8 months in and at the 5 month mark I lowered my progestrone & upped my estrogen thinking I might save money & get faster results (I was wrong XD) The change is noticeable though and people have remarked on it w/o me saying anything.

Also interesting how estrogen in the liver produces that SBHG stuff! Makes sense as to why O'Dea told me to throw out the oral estrogen and said that taken in conjunction with pellets it could actually slow the feminization process! I've always taken my oral estrogen under the tongue / dissolved (before pellets) but never fully understood why everyone said to do it that way before now.

[KayXo]

I've noticed a change to my hairline on high doses of progesterone injections.

Do you inject bio-identical progesterone or another progestogen? Because bio needs to be injected daily due to short half-life.

Makes sense as to why O'Dea told me to throw out the oral estrogen and said that taken in conjunction with pellets it could actually slow the feminization process!

Yes, I would think so too because of high levels of estrone orally interfering with estradiol. But maybe he has another explanation.

[teeg]

I don't think androgens decrease SHBG. They just do nothing whereas estrogen in the liver stimulates production of SHBG.

SHBG is decreased naturally by androgens (as well as other hormones), and especially by anabolic steroids. I saw a thread on a body building forum talking about ways to reduce SHBG as it binds all sex hormones, reducing available testosterone, and thusly reducing "gains". One of the reason steroids work so well is not only because of the influx of androgens, but steroids are almost always cycled with GH, which greatly lowers SHBG, allowing more free testosterone.

Progesterone reduces and replaces Testosterone.

This interested me because basically of what I mentioned before of higher androgen levels being present and more noticeable feminization progress being present. Whenever I've mentioned progesterone increasing breast growth, even on here, the consensus has always been mixed. Dutch studies have found it has no direct impact, while Boston US swears by progesterone in their patients. If progesterone does replace testosterone then perhaps this is reducing SHBG levels, allowing more active estrogen, and increasing breadth growth in that way.

I once saw a study where some British endocrinologist (she was FTM I think) discussed progesterone not being present during puberty where the majority of breast development occurs, only estrogen, so they assumed progesterone must play no role in breast development. If there were evidence of progesterone helping breast development we would've heard about it already. There is so much breast growth supplements BS out there that this would've been discovered long ago if it were true. However what this endocrinologist didn't mention is that SHBG levels drop by half when females enter puberty allowing sex hormones activity to greatly increase and mature the body.

Personally most endocrinologists I've worked with seem to think transgendered HRT is simply getting our estrogen and testosterone levels within genetic female levels and hoping by some odd luck we feminize. None of my endocrinologists have ever cared enough to think about any of this, I've had to direct my healthcare in this regard, and I doubt I'm the first. Like I suspected HRT can't be that simple. While we live as females, we still have genetic male endocrine systems, probably not designed to work well with genetic female levels. Remember that there's still little to no research on most any of the treatment we undergo. Research on breast cancer for MTF patients, progesterone effects for MTF patients, etc., there is little to none.

[Kristina77]

Dutch studies have found it has no direct impact, while Boston US swears by progesterone in their patients. If progesterone does replace testosterone then perhaps this is reducing SHBG levels, allowing more active estrogen, and increasing breadth growth in that way.

I once saw a study where some British endocrinologist (she was FTM I think) discussed progesterone not being present during puberty where the majority of breast development occurs, only estrogen, so they assumed progesterone must play no role in breast development. If there were evidence of progesterone helping breast development we would've heard about it already. There is so much breast growth supplements BS out there that this would've been discovered long ago if it were true. However what this endocrinologist didn't mention is that SHBG levels drop by half when females enter puberty allowing sex hormones activity to greatly increase and mature the body.

Well, I swear by Progestrone.  Just went in for another dose of pellets and my endo said to keep on the progestrone pellets because it's working wonders.  On breast growth alone... I'm a B cup, and I'm only 8 months in.  8 months.  I see talk around here a lot of girls struggling to fill an A cup after a year.  And I'm 29 (started at 28).  And my mom is only an A cup (sisters are C range).  My endo told me I would hit a D easily because 8 months is only about 1/3 of the way into the feminization process.  If things go really, really well I have even the potential for a DD.  I could just be one of the lucky ones of course. I don't know.  I can feel when the progestrone is off (i.e. more depression and anxiety).  So... people can cite whichever studies they want, I know it works for me XD

There's not a whole lot of research into hormones period sadly