Starting HRT soon!! Are meds okay? And other anxiety provoking questions

[Jazzcat]

MTF here! So I just got my letter sayin I can get on HRT on thursday!! Yay! I have an appt to get blood drawn etc in 2 weeks and i am sooooo stoked! If all goes well with my blood tests then get a call back to come in exactly a week later for my first dose/script! I just had a few questions and a buttload of anxiety (cuz i wanna be on them already!!)

1) What exactly do they look for when taking blood? Are there any disqualifying factors? i'm 21 and weigh around 150ish lbs and am pretty muscular/in good shape still...
2) I am on 2 medications trazodone (an SSRI for sleep/depression) and vyvanse for adhd, does anyone have any experience with taking meds before getting on hormones and could they be a roadblock?? I don't necessarily SEE any interactions online but i'm still freaking out and just want this to go smoothly!
3)  How does i get rid of "v-shape back" and muscles? Will HRT take care of/fix this
4) Is 21 a good age to transition and pass without surgery?
5)I know genetics play a huge factor both my sisters and mom have size D breasts, does this mean i can potentially has big bewbs?
6) How long did it take till you started to get hips? I FREAKING WANT HIPS to match my already massive booty

I'm sure i have about a million and a half more but any reaponse is much appreciated!! Just so i can some semblance of peace in my head.

[LordKAT]

Hi Jazzcat, Welcome to Susan's. The excitement you feel is certainly coming through. I will answer your questions as best I can. Feel free to post more or read others posts for more answers.

1) What exactly do they look for when takkng blood? Are there any disqualifying factors? i'm 21 and weigh around 150ish lbs and am pretty muscular/in good shape still...

They look for baseline hormone levels and kidney and liver function along with your normal things like blood counts. Your age and other characteristics are just fine.

2) I am on 2 medications trazodone (an SSRI for sleep/depression) and vyvanse for adhd, does anyone have any experience with taking meds before getting on hormones and could they be a roadblock?? I don't necessarily SEE any interactions online but i'm still freaking out and just want this to go smoothly!

It is likely no problem. Your pharmacist can better supply you with facts about interactions. Your doctor would not likely write a script that would have a bad interaction unless they don't know about it.

3)  How does i get rid of "v-shape back" and muscles? Will HRT take care of/fix this

HRT can have an effect but it does take time. You will tend to lose muscle strength and even mass.

4) Is 21 a good age to transition and not become a wretched hun/pass without surgery?

You are younger than many of us who have had no problems. It is more a matter of genetics than age.

5)I know genetics play a huge factor both my sisters and mom have size D breasts, does this mean i can potentially has big bewbs?

Potentially, yes. Likely, no. The more likely is a B or maybe C cup. It has happened however.


6) How long did it take till you started to get hips? I FREAKING WANT HIPS to match my already massive booty

This has more to do with fat redistribution. Some have had good results with patience and playing with weight loss/gain. If you go this route, wait until you have been on HRT for a few months.


I'm sure i have about a million and a half more but any reaponse is much appreciated!! Just so i can some semblance of peace in my head.

[Ms Grace]

Lordcat has covered most of it nicely.

Unless you have some major circulatory, liver or kidney dysfunction you should be fine.

HRT isn't a magical panacea, it can make a significant difference - with time. Puberty doesn't happen overnight and by the same token, depending on your current levels of T and degree of androgenisation it may take some months for significant changes to become obvious. Some changes will be quick, you'll notice your skin and hair becoming softer, body odour will become less acrid, libido will drop, beard and body hair will grow slower, nipples will become very tender, even painful at times as they start to bud. Other things such as weigh redistribution, muscle tone loss and breast growth will take many months, between six and twenty as an approximate guide. It depends on a number of factors, including genetics. All the best!

[Jazzcat]

LordKAT and MsGrace -- thank you sooo much for your replies! I really appreciate it! Ugh as much as i hate waiting With transitioning patience seems to be the key.

In terms of my medication have you ever heard of someone on an SSRI and/or a stimulant?

And as for the reply to my question about breasts -- a C cup is actually my IDEAL freaking size and B is juuust fine as well D would probably look dilly on my anyway i actually do have pretty large chest muscles but its almost like ...soft muscle..it looks as if fat has kind of collected there already (i hvent done chest exercises in a few months but even then its always been like that) do you think the loss of that muscle could possibly redistribute to fat thus creating larger breasts?

How exactly does the "muscle shrinkage" ive read about work? Is there often a noticeable difference or is it subtle at best?

Finally i read somewhere that if one does take hormones early enough that they can actually potentially have outward growth in the hip bones or it like shifts or something to that nature.. Is that just nonsense?

And thank you for your kind welcome to the board! It seems like a very friendly atmosphere here! Glad to be a part of the forums!

[Tori]

Oh honey, trans folk own the SSRI market.

Also stimulants should be no problem.

If anything, you may discover you will eventually be able to scale back on your meds, since HRT tends to work most of its magic on a transitioner's state of mind.

As for the cosmetic stuff, you are just going to have to take what genetics bring you, like any other woman... and you will learn the joy of finding microscopic faults in your looks, like any other woman.

SO much of being a woman is presentation rather than genetics. Looking your best takes a lot of work, just like, say it with me, any other woman.

[Flan]

In terms of my medication have you ever heard of someone on an SSRI and/or a stimulant?

How exactly does the "muscle shrinkage" ive read about work? Is there often a noticeable difference or is it subtle at best?

hii

There are millions of people on ssri based psych meds; they might interact with hormone therapy but psychologically. A good therapist will (should) know how to help their client cope with the unlocked emotions.

And muscle mass loss is mostly the result of  the loss of tone and the increased difficulty to maintain (muscle) in absence of a testosterone rich umm blood stream.

[Jazzcat]

Oh honey, trans folk own the SSRI market.

Also stimulants should be no problem.

If anything, you may discover you will eventually be able to scale back on your meds, since HRT tends to work most of its magic on a transitioner's state of mind.

As for the cosmetic stuff, you are just going to have to take what genetics bring you, like any other woman... and you will learn the joy of finding microscopic faults in your looks, like any other woman.

SO much of being a woman is presentation rather than genetics. Looking your best takes a lot of work, just like, say it with me, any other woman.

Hehe very wise and well put! Oh the joy of being a transwoman and being born with a freaking "laser guided flaw detector" <3 thanks you for your words of encouragement girl!

[Jazzcat]

hii

There are millions of people on ssri based psych meds; they might interact with hormone therapy but psychologically. A good therapist will (should) know how to help their client cope with the unlocked emotions.

And muscle mass loss is mostly the result of  the loss of tone and the increased difficulty to maintain (muscle) in absence of a testosterone rich umm blood stream.

Lol yeahh i honestly should have assumed as much in terms of the ssri judging from how "swell" being trans is for everybody hehe. I actually take trazodone (the SSRI) for sleep, the antidepressant effect seem minimal at best which i'm sure everyone here can understand being that i havent technically begun transitioning (hrt-wise) yet. It's silly, both the medications i take are because of comorbid disorders of my tourettes syndrome. I know, i know, gotta love genetics right?

[Tori]

My pleasure.

Oh, and let me repeat the point Ms Grace made.

Hormones work slowly. Compared to testosterone, estrogen is quite subtle.

You will not notice much from one day to the next, but rather from week to week, month to month and year to year. On the plus side, nipples tend to be one of the first physical things E works on... and having perky nipples and budding breasts is a constant reminder of good things to come. If it weren't for nipples, the first few months would be much less exciting for many of us.

Be prepared for more anxiety before you start, even the "OMG, should I really do this?" kind of anxiety. It is natural and has nothing to do with the reasons you are currently on your meds.

Oh, and be prepared to feel REALLY happy for extended periods of time. If HRT is right for you, your brain will let you know rather quickly after you start.

[Jennygirl]

Seconding Tori on the brain part. HRT can sometimes fix the issue requiring antianxiety meds at the root source. However, as anyone will tell you, transition can obviously be extremely stressful. You may find however that the anxiety meds are no longer necessary once you have adapted to life with estrogen in the brain

[Jazzcat]

My pleasure.

Oh, and let me repeat the point Ms Grace made.

Hormones work slowly. Compared to testosterone, estrogen is quite subtle.

You will not notice much from one day to the next, but rather from week to week, month to month and year to year. On the plus side, nipples tend to be one of the first physical things E works on... and having perky nipples and budding breasts is a constant reminder of good things to come. If it weren't for nipples, the first few months would be much less exciting for many of us.

Be prepared for more anxiety before you start, even the "OMG, should I really do this?" kind of anxiety. It is natural and has nothing to do with the reasons you are currently on your meds.

Oh, and be prepared to feel REALLY happy for extended periods of time. If HRT is right for you, your brain will let you know rather quickly after you start.

Hehe definitely! Is it totally weird that I am likee super duper freaking excited for the chest pain (and goodies that come with those swollen nipples... If u catch my drift)

Just the idea of FINALLY being on track to recognizing myself for the first time in my life is enough to make me freaking tear up as i write this. I'm more ready than i've ever been. Ughhh the days seem to be going by sooo slowly. It's hard to not count down to like the seconds until my first dose. Pretty sure it'll be the most bittersweet moment of my entire life <3 and i'm more than prepared to probably start crying tears of joy that day. I feel like itll be impossible for me to tell if i'm that intensely happy because of the 'mones or because of how freaking amazing it will be to become me!!!!

[LordKAT]

Some where around here is a post from a lady who took her first dose then posted saying something like. "It's been 10 minutes, where are the changes?."* It was hilarious but shows how much the changes are expected. I do think the first thing that happens is a feeling of relief that you now actually have started on your way, it is almost a calm after all the hype.



*She wasn't serious, just expressing impatience for the future changes.

[Jazzcat]

@jennygirl - definitely!! Are those changes (mood/anti-anxiety) felt rather quickly? Like first to first five doses fast? Was it obvious  to you ladies right away or was it more subtle like most all of hrt's effects?

[Jazzcat]

Oh and i finally remembered the one question i really wanted to ask!!

Sooo what exactly are those differences between the methods of ingestion?? I've read about it but i'd much rather get a firsthand account of what you girls have noticed! I really want to do injectables being that i have no issue with pokin' my butt with a needle is that the best means of taking hormones? Do i have a choice in which method i use or is that all the doc's decision?

[Tori]

The feeling of relief/calmness is almost immediate, and likely a result of getting past the pre HRT anxiety you are describing.

The mental stuff seems to happen rather quickly for many of us... but give it a month or so, and you will likely see the difference between a happy brain because you are doing something for yourself and a happy brain because it is on the right fuel.

And things are not always happy. Life does not work that way. They just tend to default to something more positive rather than dysphoric. You will not be immune to dysphoria, but you may find HRT provides you some strong armor. 

As for method of administration, that may have something to do with your doc and perhaps your insurance. You can always ask your doctor questions.

I am on injections.

Pills go through the liver but they work fine. Everybody's liver is different though, so it may take a bit of trial and error to find the proper dose.

Other methods bypass the liver so it is a little easier to find your proper dosage quickly for some people.

Most doctors know one HRT method better than the others so I do suggest working with the treatment they suggest, at least to start, and see how it goes. Why be a guinea pig for your doctor if they have already treated other trans patients successfully?

IME, people here tend to have their favorite form of HRT, and it tends to be the one they are currently on.

[Jamie D]

Pleased to meet you Jazzcat.

My one suggestion to you is to get your bloodwork done prior to starting HRT.  In that way you establish a "baseline" to adjust your dosages and/or medications in the future.

The best method is probably by implant.  Jennygirl and Cindy are two of our members who have gone that route.

Injections and patches are also good, because they bypass the "first pass" through the liver.

Pills are the most common form of HRT for younger folks, like you.  It would be good if you could take them sublingually (under the tongue).

The least common forms are transdermal gels and suppositories.

[Jennygirl]

@jennygirl - definitely!! Are those changes (mood/anti-anxiety) felt rather quickly? Like first to first five doses fast? Was it obvious  to you ladies right away or was it more subtle like most all of hrt's effects?

Yes they can happen quickly, but as others have said transition is stressful in itself so it is not a cure-all. There isn't such a thing

Oh and i finally remembered the one question i really wanted to ask!!

Sooo what exactly are those differences between the methods of ingestion?? I've read about it but i'd much rather get a firsthand account of what you girls have noticed! I really want to do injectables being that i have no issue with pokin' my butt with a needle is that the best means of taking hormones? Do i have a choice in which method i use or is that all the doc's decision?

The best ways are pellet implants and other transdermal methods like patches or creams, next best is injections, and lastly (and also what I would recommend against) oral hormone pills.

There are many people here on about every one of those types of administration. Ultimately it will be up to the doctor, but that shouldn't stop you from choosing a different doctor if you don't like their methods. Injections are a good route but like I said pellets or patches/creams are the very best in every way health and effectiveness mentally and physically.

[Cindy]

Hi Hon,

Congrats on moving forward! We can all understand your excitement.

I was on antidepressants and at my first endo consult she asked me what other meds I was on and I told her about the antiDs her reply was instant, 'of course your on antidepressants, you've been in the wrong body all your life'

Do be honest and clear with your medics as the good ones custom design your dosages etc for the best outcomes. You will probably start on pills as it is easy to adjust dosages, you will probably have more blood test a month or so after you start to make sure your liver is tolerating the drugs.

As Jamie said I'm on implants as is jennygirl, by far the easiest as you get a new implant every six months or so and you don't need to remember to take your pills. The down side is that they can be more expensive.

Changes as the others have said are gradual, but in a youngster like you they may be more rapid and dramatic, I hope so!

But get ready for the ride of your life! It's great!!

[Jazzcat]

The best ways are pellet implants and other transdermal methods like patches or creams, next best is injections, and lastly (and also what I would recommend against) oral hormone pills.

There are many people here on about every one of those types of administration. Ultimately it will be up to the doctor, but that shouldn't stop you from choosing a different doctor if you don't like their methods. Injections are a good route but like I said pellets or patches/creams are the very best in every way health and effectiveness mentally and physically.

Thanks Jenny Honestly i had no freaking idea transdermal methods are that effective, that's really interesting that you say patches and creams are the best because I like never would have guessed that. I always assumed injections were best (besides implants of course) in terms of effectiveness. Any idea s to why patches/cream works so well?
I do apologize for the "interrogation" hahaha. It seems as though the more i learn the more I want to ask! That and it's always good to just educate myself on kinda what to expect and become knowledgeable so i can make a sound choice and ask questions to my doctor. Plus honestly I get super excited when talking about it. It makes it seem all the more real!

And again seriously to everybody who responded so kindly and took the time answer all of my questions thank you so much! You ladies are seriously the bomb!

[Jazzcat]

Hi Hon,

Congrats on moving forward! We can all understand your excitement.

I was on antidepressants and at my first endo consult she asked me what other meds I was on and I told her about the antiDs her reply was instant, 'of course your on antidepressants, you've been in the wrong body all your life'

Do be honest and clear with your medics as the good ones custom design your dosages etc for the best outcomes. You will probably start on pills as it is easy to adjust dosages, you will probably have more blood test a month or so after you start to make sure your liver is tolerating the drugs.

As Jamie said I'm on implants as is jennygirl, by far the easiest as you get a new implant every six months or so and you don't need to remember to take your pills. The down side is that they can be more expensive.

Changes as the others have said are gradual, but in a youngster like you they may be more rapid and dramatic, I hope so!

But get ready for the ride of your life! It's great!!

Cindy-
awee thank you! Hehe makes me feel way better to know I'm not the only one on antidepressants before transition! Seriously though...words like cannot express how exhilarated I am right now! This thread has like made me all super giddy with excitement hahahaha. I can only HOPE that the changes will be rapid and dramatic. But eh ya'know "Expect the worst hope for the best" right?  I'm as ready for transition as I'll ever be!