When starting HRT

[Asniceasme]

I have a curious question, as if I haven't had a few others previously. Anyway, I was wondering about when people on here actually started hrt. Did the doctor prescribe everything you needed right at the start, then upped or lowered the dose as needed, or did he start you off on one particular hormone first, then waited, then started you on another, until you were taking what was required? I am only asking because the doctor wants to start me off on an anti androgen, then progress through to estrogen at some point, but he hasn't stated how long I would need to wait. I have read that some people start estrogen first, and others start with two hormones. I am not interested in doses, more the actual timetable I suppose you could say of what you took when you first started HRT, and when other stuff was added.

[KayCeeDee]

Do what your doctor says. What your doc is doing is normal. See how you react to AAs and take things slowly.

[Ms Grace]

Everyone is different and endos will prescribe accordingly. A lot of it is dependent on your general health, fitness, and how much testosterone your body is producing. Mine started me on low doses and increased the medication over a six month period.

[Catherine Sarah]

My Endo started with a blood test. Prescribed a low dose everything, checked 6 weeks later with another blood test, adjusted as necessary. In fact he requires blood tests before any visits, just to see how things are going.
Pretty thorough, I've no complaints, only bouquets for him. (And a hug - he's a sweetie  )

Huggs
Catherine

[Jenna Marie]

I started on estrogen only, very low dose. When my 3-month checkup showed that was enough to control T into the female range, I never got put on an AA at all.

[JohannaJohn]

I started on estrogen only, very low dose. When my 3-month checkup showed that was enough to control T into the female range, I never got put on an AA at all.

Jenna Marie, YOUR great journey has been truly fast and remarkable.  Few of us can have the luck that YOU have had, without much in the way of hormones.

Remarkable!

I haven't used AA's at all so far, and I am having great success although I cannot match the rate of YOUR success, wow.  But I have needed P and E, in pure forms.

Johanna.

[KimSails]

I am amazed that there is such a wide variety of approaches! 

I just started a week ago. My endo prescribed what I would guess is a high level of Spiro (AA) and a low level of Estradiol.  He said that these levels, over two months, would approximate what a ten year old cis girl goes through in her first year of puberty.

He had my blood work results to review before I met with him.  As far as I could tell, he only used used that to verify that am healthy.  I didn't get the sense that he determined this initial dosage based upon my pre-HRT hormone levels. 

I told him I wanted to transition as quickly as I safely could.  I think that, plus my general good health, guided him to the prescribed dosage, which I would guess is a "standard" initial transition dosage.  If I had said I wanted to go slow then maybe he would have prescribed a different "standard" dose.  The "standards" being whatever his experience has settled on over the year.  He has worked with trans folks for many years.

Kim

[antonia]

I think it's pretty normal to start with low dosage, and only change one variable at a time, then let enough time pass for the levels to adjust, do bloodwork and adjust again.

Not only is it safer in case you don't tolerate some of the meds but it also gradually changes your hormone levels which simulates real puberty and also gives you time to adjust mentally, switching from T to E or E to T is a pretty drastic change with very real emotional effects that you will need time to process.

That being said of course we are all impatient and want to get things going as fast as possible, but perhaps it's better to have someone with a more objective view advice us on things that can affect our general health and emotional state, after all we have to be able to go about our lives.

[JohannaJohn]

I think it's pretty normal to start with low dosage, and only change one variable at a time, then let enough time pass for the levels to adjust, do bloodwork and adjust again.

Not only is it safer in case you don't tolerate some of the meds but it also gradually changes your hormone levels which simulates real puberty and also gives you time to adjust mentally, switching from T to E or E to T is a pretty drastic change with very real emotional effects that you will need time to process.

That being said of course we are all impatient and want to get things going as fast as possible, but perhaps it's better to have someone with a more objective view advice us on things that can affect our general health and emotional state, after all we have to be able to go about our lives.

Nice thoughts, Antonia.

"Switching from T to E is a pretty drastic ahgne with very real emotional effects that you will need time to process..."

Yes, ALL of my work and personal relationships are better because I now intuitively understand how to FEEL others and solve things intuitively and more feminine, I don't fight verbally anymore, I cry uncontrollably at unpredictable times, and I feel euphoric happiness such a high % of the time.  Yeah, these hornones are STRONG -- this is an understatement.

Johanna.

[judithlynn]

Hi Asniceasme

I  restarted HRT last year as a second attempt at transitioning. I first transitioned  in my thirties and lived full time as a women in the UK for just a little under 2 years, but financial circumstances forced me to de-transition.
Finally last year a work crisis brought my dysphoria thundering back and I approached a Gender Clinic back in Melbourne where I now live. They diagnosed me as a typical Transgender woman.
My Doctor did my blood tests and 2 months later told me that I had T levels of 5.7 (apparently Natal females have T levels of 0 - 2.5 and Males from 6 to 60. I was then started on a low dose of Oestrogen only (partly because of my Age) and put on a strict diet ands exercise program to lose weight. Over the next 9 months my Doctor doubled and then doubled again my dose only of Oestrogen, but I was never put on T Blockers. Although I had a little Heart scare,  causing a blood pressure problem this settled down as the body switched over from a low T level to a more normal Oestrogen level. I am now happy to say that my T levels are  just a little over 1.0 well within the CIS Female levels. Although I cannot discuss actually dosages, another Sydney Transgender woman and I agree that at a certain level of Oestrogen only, the dysphoria barely lifts, then later as the dosage increases, one starts to get the positive benefits and very importantly ones libido drops and with it any chance of unwanted erections, then at the next level  at least I found that I went into a bit of a fog. That is I was getting all the positive benefits (soft skin, more emotional, less drive, less aggression, etc) but in the same level finding my mind wandering a lot and for instance becoming a bit of a ditzy female (leaving my handbrake on, reversing the car now almost impossible, then the dosage was increased again and a lot of that went and that was the stage that I really started to get the curves, real breasts - I am a B Cup headed for a C-Cup, Very obviously erect nipples, rounded bottom (I have split three pairs of male trousers)  and a very female aura about me with other women noticing that I am somehow radiating femineity (Its hard to put a finger on it). One US TS friend reckons that at just a little over 1.0 of T, basically hormonally I am now female and thus giving off a lot of female pheromones which subconsciously other women and especially men are reacting to. I am starting to be quite submissive too. In fact I think I have reached the right level of Oestrogen and don't need any more increases. My only regret is that because of my age, my Doctor will not re-prescribe Progesterone (Micronized) as from my previous transition that really helped to fill out my breast tissue.
I hope this helps
JudithLynn

[Asniceasme]

Thank you for the replies everyone. I am happy to leave my fate in the hands of my doctor, as to the course of action for my hormones. I did find it a little weird that I am being prescribed the anti androgen by itself, before anything else, but the doctor has seen my blood work, and has worked with other trans people (from both sides) in the past, do he should know what he is doing. One interesting comment he did make, was that when he was looking at my blood results, (and I don't know the exact levels, mainly because I didn't ask), he did ask me whether I was already on estrogen. When I see him next week, I need to remember to ask him about that...maybe I have unusually high levels of estrogen to begin with, and he wants to see what the anti androgen does first.

[luna nyan]

Low dose E. For 6 weeks then low dose spiro.

Each endo has their own preference depending on circumstance

[JohannaJohn]

Thank you for the replies everyone. I am happy to leave my fate in the hands of my doctor, as to the course of action for my hormones. I did find it a little weird that I am being prescribed the anti androgen by itself, before anything else, but the doctor has seen my blood work, and has worked with other trans people (from both sides) in the past, do he should know what he is doing. One interesting comment he did make, was that when he was looking at my blood results, (and I don't know the exact levels, mainly because I didn't ask), he did ask me whether I was already on estrogen. When I see him next week, I need to remember to ask him about that...maybe I have unusually high levels of estrogen to begin with, and he wants to see what the anti androgen does first.

Many girls here have reported that their doctor started them on ONLY an AA such as spiro or other one, for like 6 months or something, before adding anything like E or P.

Sometimes it is only E, on very low dose to start with, and nothing else.

For me, it has been E and P, no AA.

But the bottom line is...if the RESULTS physically and emotionally make you happy -- this is really what it is all about.

Johanna.

[Christine Eryn]

My current doctor started me on E a few years ago, then added Spiro, then kept "leveling up" a little every visit. Last year, I was prescribed gel in addition to E & Spiro, but I felt physically to overwhelmed, and HRT does take its toll. My doctor is well known for HRT and I trust every prescription.

[Jenniferinutah]

My Doctor asked me what i wanted. I told her my intentions and she prescribed accordingly. I had brought recent bloodwork with me so i didnt have to worry about that aspect. I wasin and out with a prescription in 15 minutes. A Very happy day

[JohannaJohn]

Hi Asniceasme

I  restarted HRT last year as a second attempt at transitioning. I first transitioned  in my thirties and lived full time as a women in the UK for just a little under 2 years, but financial circumstances forced me to de-transition.
Finally last year a work crisis brought my dysphoria thundering back and I approached a Gender Clinic back in Melbourne where I now live. They diagnosed me as a typical Transgender woman.
My Doctor did my blood tests and 2 months later told me that I had T levels of 5.7 (apparently Natal females have T levels of 0 - 2.5 and Males from 6 to 60. I was then started on a low dose of Oestrogen only (partly because of my Age) and put on a strict diet ands exercise program to lose weight. Over the next 9 months my Doctor doubled and then doubled again my dose only of Oestrogen, but I was never put on T Blockers. Although I had a little Heart scare,  causing a blood pressure problem this settled down as the body switched over from a low T level to a more normal Oestrogen level. I am now happy to say that my T levels are  just a little over 1.0 well within the CIS Female levels. Although I cannot discuss actually dosages, another Sydney Transgender woman and I agree that at a certain level of Oestrogen only, the dysphoria barely lifts, then later as the dosage increases, one starts to get the positive benefits and very importantly ones libido drops and with it any chance of unwanted erections, then at the next level  at least I found that I went into a bit of a fog. That is I was getting all the positive benefits (soft skin, more emotional, less drive, less aggression, etc) but in the same level finding my mind wandering a lot and for instance becoming a bit of a ditzy female (leaving my handbrake on, reversing the car now almost impossible, then the dosage was increased again and a lot of that went and that was the stage that I really started to get the curves, real breasts - I am a B Cup headed for a C-Cup, Very obviously erect nipples, rounded bottom (I have split three pairs of male trousers)  and a very female aura about me with other women noticing that I am somehow radiating femineity (Its hard to put a finger on it). One US TS friend reckons that at just a little over 1.0 of T, basically hormonally I am now female and thus giving off a lot of female pheromones which subconsciously other women and especially men are reacting to. I am starting to be quite submissive too. In fact I think I have reached the right level of Oestrogen and don't need any more increases. My only regret is that because of my age, my Doctor will not re-prescribe Progesterone (Micronized) as from my previous transition that really helped to fill out my breast tissue.
I hope this helps
JudithLynn

JudithLynn, what an inspiration post about YOUR story.

I use micronized progesterone at age 56, and my boobs are small but real, and growing fast.  I am 10 weeks into full dose HRT, but no AA's!  Just pure bio-identical E (estradiol valerate) and pure bio-identical P (micronized progesterone).

Hugs to you girl, great story...

Johanna.