do hormone dosages make a huge difference?

[amyallen]

Hello ladies hope  all is well! I have question about hormones and dosages. Do hormone dosages make a big difference in your transition? For instance say a girl started hrt at a low dose while the other girl started at a high dose would the girl who started at a high dosages see more prominent changes faster than the girl who started at a low dose? I feel like Ive seen a lot of changes in myself but I'm just starting to see drastic changes to my face and I'm at 6 months. They just raised my prescription to a high dose. I'm just curious thank you ladies!!!!!! 

[Beth Andrea]

"How fast" depends on how well the body can use the hormones, both the anti-androgen and the E (assuming MtF). Some people get incredible changes quickly, on a low dose...others may get very little on a higher dose.

Or vice-versa. There's no telling until time has passed. And by then...it doesn't matter. 

Just gotta have patience, face changes at 6 months is very nice! Bet you're happy for that!

[Doctorwho?]

To work well HRT has to be introduced in a way that mimics nature... It takes quite a while for a pubescent girl to reach full adult levels of estrogen and the rise in HRT should be similarly gentle. If you do it that way you actually get more bang for your buck because the body doesn't like sudden changes and if you try to introduce one it will immediately counteract to try to restore equilibrium. Thus endocrine manipulation is best done quite slowly and subtly.

You should be started on about a 1/16th of the final dosage and slowly ramp it up in small steps doubling it every 3 months or so until after a year you are on the full whack. Unfortunately to do that requires more time than most patients are willing to wait, and so in practice the endo will usually start off on a 1/4 dose and step it up in just two steps.

In reality, its not just about how much you take. There is also the question of how good your body is at responding. A hormone is merely an intercellular messenger. In order for the message to be delivered you must also have a suitable receiver. So if, like me, you have a body littered with estrogen receptors then a pretty tiny dose will make a big difference. If on the other hand you are unlucky to be one of the few that has virtually no receptors then you could take the entire output of a chemical factory and it won't make the slightest difference.

So the bottom line here is, have patience, and trust your doctors... they will calculate the right dose for YOU.

[EmmaS]

Like the others were saying it depends on your individual body, each of us has a different level of hormones and based on your genetics with your level of hormones is generally how quickly you should see typical changes. If you take a significantly higher dose than recommended, you will still get the same amount of changes in the long run, but you may see them sooner than later, if that makes sense, but there are also health risks with taking that high of a dosage. I'm sure you have heard this a million times, but just try to continue doing research of the medications that you are taking because information is key in transitioning in my opinion. Also, your doctor will be monitoring your blood levels to see what dosage to have at because you want your T to be very low but not at 0 because we all need a little bit of T to function properly. The key is to have T at a low, but safe level and to have a healthy level of E, which is determined by your doctor. Individuals with naturally lower T and a higher E should benefit from hormones quicker, but in the end it's a long process and you should expect to see changes for around 2 years is the average I hear. Just ask your doctor about it, and they should be happy to tell you all about it as well.

<3

Emma

[Jill F]

Don't forget that your body will convert "excess" estrogen into testosterone.  This level is different for everyone.  You definitely don't want more testosterone if you are MTF, so too big of a dose will work against you.  The reverse is true for FTMs.

[Jill F]

JillF,

The conversion of T to E is widely accepted as a fact.  The conversion of E to T draws a lot of dispute.

Wasn't aware of any controversy there.  I'm just going by what my endo told me.

[EmmaS]

JillF,

The conversion of T to E is widely accepted as a fact.  The conversion of E to T draws a lot of dispute.

That's why I didn't want to mention that because I don't think it's completely known if it does convert for sure or not or if it's based on other factors. The point is don't take a super high dosage because you think you will get better changes because you won't, you may get them a little sooner but it's not worth the possible health risks or potentially a T conversion if that is possible(not sure).

[Jenna Marie]

I think a lot depends on individual bodies - it really comes down to how well your body uses the estrogen. (more efficiently = less needed.) I do not think that a higher dose automatically equates with better results.

I would think that, though, since a "higher" dose almost killed me at the start. In reality, I started on estrogen-only HRT at a dose that's considered very, very conservative... and it was still too much. So clearly more was NOT better for me!

[Ltl89]

Listen to your doctors and share your concerns with them.  Tell them how you feel and ask them questions about your progress.  It really depends on the individual.  In my case, low dose hrt did nothing.  My current estrodial dose has been increased twice from my initial dose.  It's working well for me,  but I don't know whether that would be the case for everyone.   

[kathyk]

I was going to post more, but all they what is for the estrogen levels to be near, but below the higher female levels.  And the T level very low.  Each person metablizes estrogen differently so they tend to start real low doses. 

They also check to see how you handle the hormones and they monitor the critical body functions that estrogen effects. 

Don't worry, you'll get there, but it might take a couple months more.  But if you get to some point where you feel the dose is still way to low talk to another doctor (I actually had this problem).  It's your body and your transition, you want to get this right.  And you want it safe so you can enjoy being the person you truly are.   

[amyallen]

Thank you so much ladies I feel so much better now. Thank you for your insight! Now that you all have mentioned it I really need to schedule an appointment with an endocrinologist to see where my levels are, and what they look like as of now being 6 months into my transition.

[Randi]

This is incorrect.   Estrogen NEVER converts to testosterone.  It is chemically and biologically impossible.

Testosterone can and does convert to estradiol through the action of the enzyme aromatase.

This graphic shows the pathways for conversion of many sex hormones:

http://web.archive.org/web/20110810081521/http://www.ceri.com/steroid.gif

Don't forget that your body will convert "excess" estrogen into testosterone.  This level is different for everyone.  You definitely don't want more testosterone if you are MTF, so too big of a dose will work against you.  The reverse is true for FTMs.

[Christine Eryn]

It's made a GIGANTIC difference for me. I've been on HRT for 6 years. Every so often my doctor would increase my dose through the years. A few months ago, my dose was increased yet again, but this time, the changes became overpowering. My skin overall has become really really really silky, to the point of where anything I touch even feels soft. But, as I've said before, it feels like I'm melting from the inside out and it's not fun. It's almost like I can feel my muscles weaken or break down or I don't know what the hell. I do get my bloodwork twice a year though.

Also, this new dose has really hammered my face into a truely feminine shape, even my eye sockets. It's like my eyes were made for eyeshadow. 

[Lisbeth]

One time my estradiol ramped up too fast, and I got a nasty case of morning sickness.