Post op hormones

[Monaluv]

So just came out of my Endo doctors office and he cut down my premarin intake from high dosage a day to 20% of the original a day... WTF..?? Is this normal I know Im post op and dont produce Testosterone anymore but that seems rather low And I dont want to de-feminize so what do you girls think...? Is this a normal dosage post op?
Are u guys on Premerin on Estradiol?? Is there differance between the two??







_dosages

[kinz]

hey, someone's going to pop around and tell you to pull down the dosages 'cuz it's against board policy, but i'll add my $.02 here before they're gone

the thing about it is, different amounts work for different people. personally i deal with chronic low levels so my dosage is pretty high for someone who's postop, but if your endocrinologist feels like you're good to go, you may be just fine with that smaller amount!

that said, if you feel like your sex drive or your mood is hella off after being on a different dosage for a while, yell at your doctor, he'll either change it and hopefully stuff will be fixed or he won't and you might want to consider switching if it's possible. i know endos sometimes act like trans women don't need or want sex and give them postmenopausal doses, that's what mine did to me right after surgery, but when i asked him to up it he was happy to oblige.

[Doctorwho?]

Dosages are a very individual thing - which is why their posting is discouraged. What works for one will be all wrong for another.

The important thing is to get your doctor to do Blood Serum Levels and check that your estradiol level is within the normal range... The dosage you quoted before it was removed sounded a little lower than most, but as I myself take a ridiculously low dosage, thanks to endogenous production which is much much higher than that found in a normal male, it is possible that this may be right for you...

Normally post-op you would take around double that, but as I say there is no standard level as we all react to medication differently so just get him or her to check your bloods, which is good practice anyway.

[Jenna Marie]

I stayed on the same dosage post-op, but I also started off (while pre-op) taking something well within the cis menopausal woman's range. (And still got great results, including T levels squarely in the female range.)

Honestly, my endo always says it comes down to the patient's feelings and results, assuming they're otherwise healthy; she doesn't even believe in estrogen blood level testing, since that doesn't reflect how much E is being used by the body's receptors and can be wildly variable. Basically, if you don't think it's working for you, ask for a change, but the dose amounts themselves don't mean much. It's educated guesswork to figure out how much was needed to suppress T versus contributing to feminization, and everyone is different.

[Vicky]

I don't think we do, but Jenna Marie and I could have the same Endo for how her stuff is working and the advice and rationale she has been given.  Dr. Bowere recommended twice what I was taking before surgery, and in fact UPPED my dose while I was under her direct.  My Endo called their office though and my Endo came out ahead.  No problems though since I look and feel great, and pretty much ignore the whole thing by now.

[Tristan]

Yeah I know mine dropped after my orchi and slightly after my srs. I was off due to it and they changed my dosage to help. I agree on. The sex thing. That's one of the reasons I knew my levels were off

[JennX]

My preop dosage of estradiol has remained the same today almost 1 year postop. I'm on near the max dosage for oral (sublingual) E. This course of action depends greatly on the individual, their physiology, metabolism and your blood tests... and your doc.

Adding a new hole where your testes used to be will not have much effect on your hormone receptors, if you have been on HRT for 2+ years, and have had stable E2 serum levels (no spikes up/down) over that same period.

[Monaluv]

Thanks girls, Ive been taking androgens and premarin since 19yrs old Im now 32 and 6weeks post op, so my Endo said I did not need the high dosage of estrogen because of blood clots and other risks so he redused my premarin intake and Im no longer on androgens... We'll try this low dosage for 3mnths then I will see him again in march so I can get back on a higher dosage if things are not to my likeing...

[Missy~rmdlm]

It'll depend on labs, if you have enough E in your system post-op on the low dose you are good to go. I am still hunting the ideal dose with SRS just months away. My July labs were high(female) T, okay E, a dosage adjustment was made. New labs from a day ago are low T okay E. When I say my T is low...it's below female range, it's not 0 but less than 1% of normal male range. I talk to my endo in eight hours. I'll find out if another dose adjustment is in order to get my T into normal female range.

[Jennygirl]

I stayed on the same dosage post-op, but I also started off (while pre-op) taking something well within the cis menopausal woman's range. (And still got great results, including T levels squarely in the female range.)

Honestly, my endo always says it comes down to the patient's feelings and results, assuming they're otherwise healthy; she doesn't even believe in estrogen blood level testing, since that doesn't reflect how much E is being used by the body's receptors and can be wildly variable. Basically, if you don't think it's working for you, ask for a change, but the dose amounts themselves don't mean much. It's educated guesswork to figure out how much was needed to suppress T versus contributing to feminization, and everyone is different.

This this this! Thank you again Jenna

Labs mean nadda. Free E says nothing about receptor sensitivity.

Also everyone should seek non-orals if possible. Every time I see the word premarin mentioned, I cringe.

[kinz]

This this this! Thank you again Jenna

Labs mean nadda. Free E says nothing about receptor sensitivity.

Also everyone should seek non-orals if possible. Every time I see the word premarin mentioned, I cringe.

premarin isn't the only oral out there! bioidentical 17ß-estradiol is also easily available, generally inexpensive, and can be taken sublingually to avoid the first pass effect.

and you're right that labs aren't as all-important as some people claim, but they can still sometimes tell you if something's up, like if you're suffering from chronic low levels, and feeling it. this is something that happened to me right after having srs and i got it checked out and doubled my dose.

[suzifrommd]

From my doctor: "Many doctors believe your estradiol dose should be lessened after surgery. I've never agreed with them."

[Northern Jane]

My endo believes in maintaining blood serum estrogen levels within the normal female range (both pre and post-op). What dosage is required is totally individual.

[Zumbagirl]

From my doctor: "Many doctors believe your estradiol dose should be lessened after surgery. I've never agreed with them."

My endo agreed with this as well. I have not changed my dosage for 15 years now. I seem to be on a nice even keel and am quite happy with how I turned out. I did get the proverbial development bump after surgery and continued to change a little more once the surgery was done as well. If that helps any.

[Missy~rmdlm]

I actually got my endo's post op instructions today, phase out finasteride when my scrip runs out, reduce estradiol, maintain spiro, maintain progesterone.

[calico]

I stayed on the same dosage post-op, but I also started off (while pre-op) taking something well within the cis menopausal woman's range. (And still got great results, including T levels squarely in the female range.)

Honestly, my endo always says it comes down to the patient's feelings and results, assuming they're otherwise healthy; she doesn't even believe in estrogen blood level testing, since that doesn't reflect how much E is being used by the body's receptors and can be wildly variable. Basically, if you don't think it's working for you, ask for a change, but the dose amounts themselves don't mean much. It's educated guesswork to figure out how much was needed to suppress T versus contributing to feminization, and everyone is different.

I asked for a change from my doc and she said no to the e increase as she felt I was at max which is half dosage of before srs, and I'm now injecting it, she did give me bio-ident progest but still no on the increase in e  and I don't have a lot of docs here actually just the one. I know there is some clotting risk involved with oral e but what about injected?

[Jennygirl]

I asked for a change from my doc and she said no to the e increase as she felt I was at max which is half dosage of before srs, and I'm now injecting it, she did give me bio-ident progest but still no on the increase in e  and I don't have a lot of docs here actually just the one. I know there is some clotting risk involved with oral e but what about injected?

Not nearly as much. Most of the clotting risk comes from estrone conversion during phase 1 pass through the liver (which occurs only as a result of ingesting it). Phase 2 still creates some estrone but not nearly as much.