How to tell whether hormones are "right"

[Brenda E]

I've been told over and over that once I settle into HRT, I'll be able to tell whether hormones are "right" for me or not, as if the hormones will be some kind of definite answer as to whether transitioning is the "right" path for me to take.  (I'm still unsure how far I want to go, but this is the next step that I want to take; therapist and endocrinologist agree.)  Trouble is, I'm not sure what I'm supposed to be looking for.  Is it just a miraculous "this is right!" kind of feeling or are there some concrete indicators (less dysphoria, less depression, liking the feeling of having a different face, softer skin etc.)?

And perhaps the more important question is: how can I tell whether the hormones are "wrong"?  Has anyone gotten on HRT for a while and quit because they felt worse than before or known that it was just a step too far?

I see a slippery slope in my immediate future...(yay?)

[Rachel]

slippery slope, for me yes. I am so glad I started HRT and I was afraid for so long. Now I can not remember why I was afraid. I wanted just spiro then spiro and low does E. Well I asked for (moment of truth) full hrt. I asked my therapist at the time if she thought I would come off hrt after I started. She said give it 4 months and she did not think I would come off hrt. 6 weeks in and I knew there was no going back.

You will know if it is right for you. Your brain will be receiving the correct hormones and it is wonderful. It takes a few days to start and then slowly you will notice things start to change. There is a long list of things that are improved such as:

Dysphoria
colors
no odor
can smell much better, especially guys
mental focus
confidence
physical things like joints
skin
hair
boobs
happy
being able to sleep

I was told progesterone would not do anything but increase my bust. Well that too had some great effects such  mood and happiness and reduced depression.

If it is not right for you then, I was told, negative effects increase.

[suzifrommd]

I found all effects of HRT very subtle.

For me, the most gendered effect was a gradual emotional shift into being comfortable with a nurturing and accepting stance. I no longer felt like I had to "react" to everything. I found myself judging things and people less and wanting to support them more.

This felt very much like I wanted myself to feel. If I'd been an alpha male, I doubt I would have tolerated this, for example.

I'm not sure I quite believe the stories of the person who declares "this is awful" in response to hormones. The effects are really muted.

[mrs izzy]

I found all effects of HRT very subtle.

For me, the most gendered effect was a gradual emotional shift into being comfortable with a nurturing and accepting stance. I no longer felt like I had to "react" to everything. I found myself judging things and people less and wanting to support them more.

This felt very much like I wanted myself to feel. If I'd been an alpha male, I doubt I would have tolerated this, for example.

I'm not sure I quite believe the stories of the person who declares "this is awful" in response to hormones. The effects are really muted.

I agree with Suzi. It is the emotional shift that was most noticed by me and what i was expecting with HRT.

Each will feel there own. Whats are the expectations?

Izzy

[Lady_Oracle]

slippery slope, for me yes. I am so glad I started HRT and I was afraid for so long. Now I can not remember why I was afraid. I wanted just spiro then spiro and low does E. Well I asked for (moment of truth) full hrt. I asked my therapist at the time if she thought I would come off hrt after I started. She said give it 4 months and she did not think I would come off hrt. 6 weeks in and I knew there was no going back.

You will know if it is right for you. Your brain will be receiving the correct hormones and it is wonderful. It takes a few days to start and then slowly you will notice things start to change. There is a long list of things that are improved such as:

Dysphoria
colors
no odor
can smell much better, especially guys
mental focus
confidence
physical things like joints
skin
hair
boobs
happy
being able to sleep

I was told progesterone would not do anything but increase my bust. Well that too had some great effects such  mood and happiness and reduced depression.

If it is not right for you then, I was told, negative effects increase.

YEP!! that all rings true for me as well. The biggest change other than the mental stuff was how my physical pains that I had for so many years went away almost instantly the week I started hrt.

[Misato]

My first hit of spiro was marvelous.

Though I didn't really notice the E at first.

You'll know if they're compatible with you. Just be open and honest with yourself about how you feel as you experience it. HRT is a big deal step, but given how much I was like, "OH YEAH!" with the spiro, if you're not meant for it I'm confident you'll have an equal, and opposite, "OH NO!"

[luna nyan]

My personal thoughts:
The "immediate" effect after the first dose can be the placebo effect.  You're finally on your way and doing something.  Yay!

After a few weeks, the subtle changes start occurring.  You might feel more emotional, less turmoil, etc etc.  Some of the physical changes may start happening - softer skin, nipple soreness, libido may change, and sexual function as well.

At this point, you'll get an idea whether things are right.  You'll either hate it, are happy enough to want no more changes, or you want to go all the way.

[xponentialshift]

My therapist told me that if HRT was right for me I would have a positive reaction to HRT within 48 hours. When I actually started this was definitely true.
I then stopped after 4 days and had a terrible bout of depression... And felt slightly worse than usual until I restarted HRT after I finished with the sperm bank.

If HRT is wrong for you, my therapist said that panic attacks and other dysphoric feelings will clearly manifest within 48 hours. She talked  about trials where cis-males were given estrogen to try and reduce some type of cancer, but it made them so psychologically unstable that it wasn't worth it.

Edit:

Just because horomes are right physiologically doesn't mean that transition is 100% right for someone.
Some people just aren't ready mentally or socially for the changes despite being physiologically trans*.
On of my therapists MTF patients just couldn't handle the fact that he was growing breasts so he stopped transitioning even though it was physiologically right. Another patient stopped because of family/social situation.

[Eva Marie]

I was on low dose HRT for about 4 years and noticed a calming effect and a lessening of dysphoria. After 4 years the dysphoria came back so I started therapy and eventually accepted that I am a transsexual. I started taking a much higher dose of HRT.

It took about a month for me to feel anything and then suddenly WOW!! It was like someone flipped a switch in my head from morose, depressed,  and sad to happy. That's when I knew that HRT was right for me.

[Carrie Liz]

Starting estrogen seriously kicked off a reaction in my brain of "Oh my God, what have I been missing my whole life?" (I started anti-androgens 3 days earlier, but they didn't really do much but make me feel a bit calmer.)

But seriously, estrogen was like a shot of dynamite to my brain. I don't know if anyone else gets this kind of reaction, but that first day, it was as significant as a switch being turned from "off" to "on" in my mind. After an entire adult life of feeling like my brain was stuck in this constant state of "dull grey drear" as I called it, suddenly I could feel pleasure again! Food tasted better, music "hit" me emotionally, I actually started having real emotions again, true happiness and true sadness and elation and depression instead of just a constant state of "meh" where I felt emotionally brain-dead. That might or might not have been the placebo effect, but whatever.

Over time, my sex-drive dropped, I started feeling calmer (but also more emotional, so I had both elation and freakouts,) and most importantly, I stopped feeling angry and tense and defensive all the time. It felt like my brain was taking one giant sigh and going "ahhhhh....." I just knew that it was right, that this was how I'd always wanted my mind to work.

The real test is when the physical changes start happening, though. When my skin first started softening a bit 2 weeks in, I was rubbing the back of my hand across my face all day because it just felt so good. The day that I finally saw a girl looking back at me in the mirror was seriously one of the happiest days of my life. Every single one of the changes, every single bit of feminization, just made me smile so much, and love myself for having that body feature so much.

Again... you'll be able to tell. If the physical changes and emotional changes make you feel more like your mind and body are "working" right, then yeah.

I still have some troubles with the public side of transition. Dealing with the perceived judgments of other people and dealing with clocking paranoia is a real pain in the rear end. But I knew pretty much within the first week of being on HRT that I was never going to be able to go back. Because even though I was able to tolerate testosterone for many years, my brain just never felt "right" on it. Where E made it finally feel like I was myself again. Everything just "clicked."

[Ms Grace]

see, I find this hard to answer because HRT has been right for me so I wouldn't know what the effects would be like if it was not right. All I can say is that having been subject to testosterone most of my adult life, that always felt like it was wrong for me. So I guess you will know one way or the other. If it is wrong it'll become evident within a short while.

[Brenda E]

Thank you all so much for sharing your experiences.  Very helpful!

What are the expectations?

My expectations from low dose HRT are that I can finally put the thoughts about gender to the back of my mind and that the physical feeling of anxiety and unease diminishes.  At this point, I really just want to feel normal; physical changes are not too important to me right now.  Once the mental side is cleared up and I have a bit of breathing room, I'll reassess what the next stage might be.

So far, no dynamite or lights switching on.  It's early days though.  If anything, the effects have been more negative than positive (feeling depressed, not happy, but this could just be an unrelated mood swing), and with any new drug, especially as one as powerful as estrogen, I'm a little cautious about trying to recognize the warning signs that something is going wrong.  Going into this process rather fragile to begin with, I am a touch concerned that things could go from bad to worse faster than I can recognize.  Hopefully that won't happen, but I want to tread carefully.

[Joan]

I'm not that far in, but for what my experience is worth...

I got the immediate emotional calm that people have mentioned.  I also started being more in touch with my emotions, and I've become much more open with people and communicate so much more freely.  I don't know whether this is the effects of HRT or a treating willingness to be my natural self, but all of these changes are coincident with starting hormones.

I think the physical changes could come as quite a shock too, though.  When your undercarriage starts shrinking and stocks 'putting out' the stuff it used to, and when you start growing breasts, and think these things would freak out anyone who isn't transgender.  Still being part time these changes are making my work life increasingly 'difficult', but I absolutely love how my body is slowly beginning to fit to my mental image of myself.

[KayXo]

If HRT is wrong for you, my therapist said that panic attacks and other dysphoric feelings will clearly manifest within 48 hours. She talked  about trials where cis-males were given estrogen to try and reduce some type of cancer, but it made them so psychologically unstable that it wasn't worth it.

Interesting because I've come across several studies where hundreds of prostate cancer patients were given high doses of estrogen only, by injection or patch for several months to years. So, must not be every man that reacts that way, otherwise this treatment would have been discontinued a long time ago. And this sort of treatment where only estrogen is given for prostate cancer has been going on for at least since the 1960's, from what I gather where in the past estrogen was given orally and the type of estrogen was not bio-identical but instead DES (Diethylstilbestrol). Thousands of men were treated this way.

Just because horomes are right physiologically doesn't mean that transition is 100% right for someone.
Some people just aren't ready mentally or socially for the changes despite being physiologically trans*.
On of my therapists MTF patients just couldn't handle the fact that he was growing breasts so he stopped transitioning even though it was physiologically right. Another patient stopped because of family/social situation.

Indeed. VERY true. Good point.

[Brenda E]

Quick update - today was a good day.  Feeling 100% great, almost euphoric this morning, my skin kinda tingles a little, occasional waves of sheer pleasure for no reason whatsoever.

Without incriminating myself, it feels a little like the rush of an illicit chemical.  If I knew what that was, I mean, because, er, I've never done anything like that before.

[luna nyan]

Interesting because I've come across several studies where hundreds of prostate cancer patients were given high doses of estrogen only, by injection or patch for several months to years. So, must not be every man that reacts that way, otherwise this treatment would have been discontinued a long time ago. And this sort of treatment where only estrogen is given for prostate cancer has been going on for at least since the 1960's, from what I gather where in the past estrogen was given orally and the type of estrogen was not bio-identical but instead DES (Diethylstilbestrol). Thousands of men were treated this way.

This is not so often done these days.  Androgen deprivation therapy is now usually achieved by other means and is usually a last resort for prostate cancer.

And if you think about it -for a normal natal male - if it's your life on the line or growing breasts, which one would you choose?  People will tolerate a lot in many cases if it means they get to live, so the side effects of cross hormone therapy in these cases is better tolerated.

Without incriminating myself, it feels a little like the rush of an illicit chemical.  If I knew what that was, I mean, because, er, I've never done anything like that before.

Hahaha!  Someone has been taking something starting with the letter E...
Glad to hear that things are getting better.

[alena]

Quick update - today was a good day.  Feeling 100% great, almost euphoric this morning, my skin kinda tingles a little, occasional waves of sheer pleasure for no reason whatsoever.

Without incriminating myself, it feels a little like the rush of an illicit chemical.  If I knew what that was, I mean, because, er, I've never done anything like that before.

I've been on e patches for a few days and that's how I feel. If it stays this good I don't ever want to take them off

[helen2010]

Is it just a miraculous "this is right!" kind of feeling or are there some concrete indicators (less dysphoria, less depression, liking the feeling of having a different face, softer skin etc.)?

And perhaps the more important question is: how can I tell whether the hormones are "wrong"?  Has anyone gotten on HRT for a while and quit because they felt worse than before or known that it was just a step too far?

I see a slippery slope in my immediate future...(yay?)

Brenda

Yes to all of the posts above.  The only thing I would add is that my GD shut down, it completely shut down when I started HRT..

In terms of negative effects - the only one I experienced is that the physical changes moved more quickly and were more pronounced than I was ready for.   In hindsight if I was a little lighter and had stayed on lower dose hrt longer, I think that I would have felt more comfortable, but there again it could be because I am non binary and desire a more androgynous physical outcome together with the end of my GD and all of the other HRT benefits (skin, hair, emotional richness, more acute senses, peace, greater connection etc).

Safe travels

Aisla

[Brenda E]

The only thing I would add is that my GD shut down, it completely shut down when I started HRT.

That's what I'm afraid of.  It's started to happen already, and I find myself now thinking, "Oh good, the dysphoria has gone away.  Maybe that means I'm not trans after all and it was just a phase, and oh my god what on earth am I doing transitioning when I'm not even trans...I must be making the worst mistake of my life..."

[helen2010]

That's what I'm afraid of.  It's started to happen already, and I find myself now thinking, "Oh good, the dysphoria has gone away.  Maybe that means I'm not trans after all and it was just a phase, and oh my god what on earth am I doing transitioning when I'm not even trans...I must be making the worst mistake of my life..."

Brenda

Don't worry.  From experience if you stop HRT, the dysphoria comes right back, seemingly stronger than ever.  I had the same thoughts as you!

Aisla