Low dose estrogen...what does that mean?

[Katrinka]

My husband is going to a therapy appointment tomorrow, and wants to get started on "low does estrogen". From all the reading I've done, doesn't he have to wait like three months before he starts that? He hasn't even been to a professional about his transgender feelings; all of his education and therapy has come from online resources/FB groups/etc. Also, the information I've read discusses all the physical changes that begin to happen right away; he says he want to take a low dose just to clear his mind...won't he immediately start having more of a puberty? I'm sorry, this is all happening so very, very quickly. I am not sure what I am ready for; I don't know that he has really fully considered the implications of making physical changes (he hasn't come out to anyone except me, our best friends, and one other friend). He hasn't told his family, he hasn't really researched what will happen with his job, etc. I guess I'm afraid for him, and I'm also afraid that I'm not going to be able to handle this. I'm still not sure if I will want to stay with him when he is fully transitioned (if he fully transitions)...I might be making a much, much bigger deal about a stupid pill or patch or injection. I just am wondering what happens with "low dose".

[LordKAT]

Anyone can go to an 'informed consent' clinic and get it fairly quickly. There is no real waiting period, just a suggestion of 3 months with a therapist. If either of you has one, I agree with going with to an appointment and expressing your feelings there.

The changes on a low dose are expected to happen to a slower timetable and sometimes a lesser extent. It would give you time to adjust and let your partner get a little quieting of the dysphoria.

[Renee]

Hi Katrinka,

I really feel for your situation. Any gender therapist worth their salt will require multiple therapy sessions (12 hours according to the old Standard of Care), but now days things have gotten a lot easier. In my opinion, going on even a low dose of 'e' before a investing some serious time with a qualified gender therapist is reckless and shortsighted.  Although I understand the strong desire to experience the effects of "e", it's far from a magic pill. Transition is difficult and should not be rushed into.  I've see so many people rush into it before being ready and destroying their lives.  I hope that your partner considers all the implications before going down that road. 

[helen2010]

Katrinka

While there are slight variations my experience has been fairly typical

Immediate and profound emotional improvement.  I felt 'real' , authentic and 'present' for the first time in my life.  My dysphoria significantly abated.   I felt more connected and empathetic.  My sense of touch, and smell improved.  I expressed emotion more easily.  In short I felt alive and no longer felt that I was acting a part.

Physically - my skin softened, my hair looked better and my body hair thinned over 12 months.

Slightly puffy nipples with lumps hardening over several months.  If things change too quickly (and everyone responds differently and have differing, sometimes changing objectives) you can dial back the AA or E.  Many of us have done this successfully for many years.  Those who stay on low dose hrt include those who would like to eventually transition but wish to go slowly and in pace with their other changes; those who cannot fully transition; those who wish to address their dysphoria and wish to be more androgynous and present as less masculine etc; those who wish minimal physical but significant emotional change; those who are non binary and wish to suit or better express their identity eg gender fluid, gender queer, androgynous etc.  others may take it as part of their search for truth, authenticity and escape from rigid definitions of who they are, how they should behave, how they appear etc.  so many, many different folk, with many differing objectives and situations.

Low dose hrt changed my life. After a number of years I did have a breast reduction but this could have been avoided if I had wished

In short I don't think there is a lot to worry about except that you communicate honestly and fully with each other, that he sees a good endo as hormones are not to be taken lightly and that you engage good therapists (both gender and if necessary relationship therapists) as  your partner,  your relationship and you will change through this journey and support is important. I have become a better person and I have much better relationships including that with my wife.

Hope this helps.  PM me any time and I hope that the many other low dose community members chime in and share their experiences.

Safe travels

Aisla

[Eva Marie]

I was on low dose HRT for almost 5 years. In my case the physical changes were very subtle and I could still "function". Mentally it relieved the majority of the dysphoric feelings I was having and let me live a guys life. Low dose HRT has been recognized as a treatment for dysphoria in the DSM-5.

I turned out to be a transsexual and my dysphoria came back after 5 years, pushing me into transitioning. Your SO may or may not be TS so that might not happen in your case. Therapy is definitely recommended for your SO in any event so that they are under the guidance of a professional.

I hope that this helps.

[Jill F]

Hi Katrinka,

I really feel for your situation. Any gender therapist worth their salt will require multiple therapy sessions (12 hours according to the old Standard of Care), but now days things have gotten a lot easier. In my opinion, going on even a low dose of 'e' before a investing some serious time with a qualified gender therapist is reckless and shortsighted.  Although I understand the strong desire to experience the effects of "e", it's far from a magic pill. Transition is difficult and should not be rushed into.  I've see so many people rush into it before being ready and destroying their lives.  I hope that your partner considers all the implications before going down that road.

I got a therapeutic dose of E almost immediately, as recommended by my therapist.   I had no intention to transition at the time and almost refused it, but she told me that if I am truly transgender (she specializes in trans issues, and pegged me as trans within minutes of seeing me for the first time) that a low dose of estrogen was what I needed to keep my starving estrogen receptors happy and help alleviate my dysphoria, depression and anxiety.   If the estrogen did nothing or made my mood worse, then I would know for sure that I was not actually transgender and we could put that out of my mind.  Well, it made things SO much better in my head that I was able to get off antidepressants and antianxiety meds.  I also went full time eight weeks later and only four months after wearing women's clothes for the very first time.

If you're trans, it seems you are best off taking the hormones your brain is wired for.  IMHO, the sooner the better.  Why suffer needlessly? 

[E-Brennan]

I'm most likely going to be low-dose to begin with.  After many discussions with my therapist and endocrinologist, the best way I can describe it is that low dose is primarily aimed at relieving the mental/emotional problems of gender dysphoria, while regular dose is aimed at the physical issues.  The goal of low dose is not to change the body, but to alleviate the stress and stabilize the mood.  Kind of like a hormone-based antidepressant.

[luna nyan]

Hi Katrinka,

Sorry to hear about your situation, you must feel awful as though the rug has been pulled under your feet.  If you spend enough time reading through some of the older threads, you'll see plenty of anguish and heartbreak from both the SO and transitioning partner.  The common thread in the cases where things are genial, or even the marriage survives, is genuine heartfelt communication from all.  I hope that you and your SO find a reasonably happy ending.

To answer your question, low dose HRT is exactly what it means for MTF - a much lower dose of oestrogen and possibly anti androgen (usually anything from 1/4 to 1/2 dose for typical transition).  The intention is to reduce or eliminate the feelings of gender dysphoria without causing excessive levels of feminisation.

It can also be used as a diagnostic adjunct to therapy.  If one is genuinely TS, the changes are welcome and accepted.

Personally, I've been on low dose for over two years and have found it sufficient to keep things at bay.  My sig has a link to the thread where I've been recording my experience in relative detail.  Feel free to PM me questions after reading it.

[JoanneB]

I've been on/off low dose E several times over the past 30 something years. For me it served as a brain/emotional reset or reboot. The dysphoria lessened and my mood improved. After 3-6 months the physical effects began to hit me a bit. Since these were in direct opposition to my decision to try to be a "Normal" guy, I had to stop.

Like all things hormones your mileage may vary.

As others have mentioned your spouse should spend a few quality sessions with an experienced gender therapist. (and there is a BIG difference between a therapist and one who is experienced with gender issues) Yes, there are shortcuts. Yes there are what I call "Rubber Stampers" out there that will give the CYA letter right away. Basically the informed consent route with a twist since a lot of endocrinologists want one.

It would also be good if the two of you go together before a decision is made. Afterall, this is a decision affecting you both. My wife's feelings and needs I place above my own. We are a team, a partnership. Dealing with a spouse that is TG is not easy. Dealing with in a vacuum is far harder

[judithlynn]

Hi Katrinka;
For someone with Gender dysphoria or a belief that they are Transgender, low dosage of hormones is an excellent way of confirming the overall diagnosis. Like Luna Nyan below today I am on a low dosage regime. In fact I have been on such a regime for 14 months now. I am not allowed to discuss the levels, but my doctor started me on a very low dose, after taking my blood level test and discovering that I had a very low (for a male) level of Testosterone in my blood stream. Mine was just 5.2. A normal CIS Female has a Testosterone level of between 0.25- to 2.5, whereas a Genetic male level is between 6.0 to 40 (Young virulent men in their 20's). After 3 months my doctor took another test and my Testosterone had dropped to 5.0, so he doubled the dose (although it was still very low). Again at 6 months I had another test and my T level  had dropped to 3.75. The doctor then increased the dosage (by the way of Estrogen only) to 3 times the basic starting dosage. This is what I have been on for the last 14 months, with my latest tests showing my Testosterone levels at just 1.95 well within a genetic females.

The amazing thing at least for me is that my gender dysphoria has basically abated and almost gone. Mind you so have the spontaneous erections (thank goodness) and my libido is  very low. That is I am not always wanting to masturbate or have sex. However the good things are that everyone tells me that I am a very calm person now, although a little emotional - I cry all too often now at a sad or emotional/girly movie.  I am really into fashion and love shopping with women friends (even dressed as a male) and really notice when a women looks well dressed or with great make-up. I do find I enjoy reading women's magazines and love looking at the fashions and make-up. Yes I  do go out dressed as a woman and pass very easily as I have no Adams apple and have very small hands and feet. Since doing a Colour co-ordination course a few years ago with a girlfriend I also have a good guide on what colours suit me and my skin tones, but I do love shopping with girl friends both as Judith and even in my male self (although its not as much fun as I cant try stuff on!). Thanks to some women friends and an occasional trip to the beauty therapist, my make up skills are pretty good. I also now have regular (monthly) manicures and pedicures and I follow a daily regime of cleansing, toning and moisturising my face and legs (and my hands).  All the women in my life have commented that my skin and complexion is just amazing and its true that  I now have very soft skin all over. So now in bed with a female partner our skin together feels incredible. I also find that I am much more appreciative of a women's erogenous zones and am able to focus on bringing a woman to climax without the urgency of male testosterone  libido. 

Of course for me after 14 months I have had breast growth (small size B Cup) and put on 2 inches on my bottom and hips and I am getting a defined waist at long last. Male trousers don't really fit me any longer, but women's  skinny jeans look really great on me (I split 2 pairs of trousers from waist to knees on the things when bending down). My hair texture has improved dramatically, and I have hair re-growth on my bald patches and thankfully my body hair has been getting much softer and much finer (I hate it and regularly get it waxed). I am having my facial hair removed as I hate shaving.  But I am on a mad diet and exercise regime and despite having weight distribution, so far managing to keep weight steady, although I would like to lose about 20kg. I have also had an immediate and profound emotional improvements in I find myself very well connected to other women and very empathetic with them. My touch and smell has improved dramatically and I just find it quote natural to greet another woman with kissing them on the cheek (a few have commented on how soft my skin feels). I am also able to express my emotions much more and don't feel I am forever hiding. As a man I was all too often a bit aggressive butting into conversations to make a point in discussions. Now I just feel its important to sit and listen . When I am dressed as a women I feel  quite natural about being more submissive, but as a male I feel its important to be less aggressive and like  to show empathy  with others
.
After the third dosage increase (after 6 months for me) I got the start of breast development with puffy nipples with lumps hardening behind them (and then the standard itching of the nipples as the breasts developed). Now my areolae and nipples are very well developed (but that is something I wanted). For your partner if  changes such as the breast, nipple or areolae changes are happening too quickly you can just cycle down on the dosages, I have other friends that have remained on low dosages and continue to have successful female partnerships and marriages, as long as their partner is  happy for the sex to be more sensual and less focussed on penetration (although I do have one  MTF friend that lives full time as a woman with his wife and regularly has penetrative sex with her (admittedly using Viagra).

It could be that as time goes on you will be happy for your partner to transition fully as a woman, or not as the case maybe.

Personally I feel a much better place since lowering my Testosterone levels on a low dose of Estrogen to that of a CIS female and I feel so much more contented than I ever did before.
Feel free to PM me if you want or get you partner to do it . I will help if I can.
Hugs

[Katrinka]

thanks for the details. that sounds scary to me...

[Sayra]

You and me both.

[Jayne]

Hi Katrinka,

I'll start with a disclaimer that everyones body reacts differently on HRT so nothing is set in concrete.

I was on a low dose of E for about 3 months, my breast development was next to nothing & wouldn't be noticed even if I was wearing a flimsy t-shirt.
The physical changes for me at that point was better hair condition & my skin became softer. I also noticed the day after my first dose that my scent had changed, for the first time in memory I woke up with out the urge to dive in a bath to wash away the "male" smell.
None of the physical changes were noticed by anyone but very close friends, not even my own mother saw any physical change until my dosage increased.
My physical changes only really took hold after my 3rd dosage increase.

The real benifit from the low dose is the peace of mind it can give you, I was instantly calm & happy. As my dosages have increaded i've become more & more content with myself & more comfortable around others.

[Jessica Merriman]

thanks for the details. that sounds scary to me...

I totally understand your feelings. You need to prepare yourself though for the possibility she may want to go further though. Sometimes low dose is a trial of sorts and if she likes it may want to up the dose. I do feel for you and the possibilities that may occur. Be strong and realize Dysphoria is a very hard thing to live with. I do commend you for finding out more and being supportive to this point. 

[eliza2014]

Katrinka,
I am in a very similar situation with your SO. I finally revealed my gender dysphoria to my wife after suffering with it for years. Some vary their responses and as has been mentioned previously one-size-shoe does not fit all. My wife has done very well with everything so far, but isn't like it has been easy. Ever since the beginning, I expressed my wish that my goal is to maintain my relationship with my spouse and my children. As a result, I have no intention of fully transitioning. I also told her I would communicate with her my needs, but that I would approach things slowly.

I, too, have been reading about low-dose estrogen as a possible therapeutic option for my gender dysphoria without the intention of transitioning. As you have read on several threads there are varying responses depending on the dose of the estrogen including the effects on breast growth and libido, but the common underlying theme is a relief of the gender dysphoria. I personally would love to get rid of those feelings and feel human again.

I wish you the best as you figure this out. For me and my SO, I was concerned about her feelings and I didn't want to do anything she was uncomfortable with. We have been working slowly and for the most part things are working out well. I am doing better and I feel much better about my self-image and overall well being, but I am still in the discovery phase and experimenting with various ideas. Keep the lines of communication open!

[luna nyan]

Eliza,

Welcome to the forums.  There's plenty of information re: low dose in the HRT, mtf, androgyne and non binary sections of the forums.

Definitely, low dose is not one size fits all - there is a balance between it being therapeutic and for it to be too effective .  For each individual, experimentation with dose under the supervision of an endo is  needed.

I hope you can keep things on an even keek with your wife.