How HRT affects the mind

[KatrinaLynne]

I think I am at the point where I have to make the decision to start hrt. I could have started in the beginning of this year but my anxiety's and the thought of losing my wife have  prevented me from doing so. I am pretty sure it is at the point of hrt or death. So... I know it is different for everyone. But I would like to ask what the possibilities of low dose hrt can do to my mind. I can't function any more. I almost can not even leave the house. Being trans along with my ocd and super shyness is stopping me from living my life. I have a great therapist but the last 2 sessions have not made me feel better anymore.

So what I am asking is how might hrt change my brain. I need an explanation that I can give my wife. She won't read or research anything. So I need some examples to share with her.

Thank you in advance.

[KatrinaLynne]

I also plan to stay in stealth mode as long as possible so some insight on that would help too. Please and thank you

[Jessica Merriman]

At this point it would not hurt to try low dose. For some that takes care of things. Once I got a taste though it was up me now doctor! 

[Randi]

A low dose of estradiol can sometimes lessen dysphoria to the extent that you think you are "cured".

Of course if you stop the estradiol, the dysphoria comes roaring back.  That leaves you with a difficult choice.  If you continue the estradiol, even at a low dose, your body will begin to feminize.  If you stop the estradiol the dysphoria comes back. 

My wife is so pleased with the improvement in my mental state that she accepts my womanly figure.  I was a very angry unhappy fellow when I ran on testosterone.   I'm a really nice woman now. 

Many folks that took estrogen primarily for the physical effects were somewhat surprised at the mental effects.  Psychologist Anne Vitale has written extensively on this subject:  http://www.avitale.com/

[helen2010]

Katrina

Speaking  as someone who has successfully used low dose hrt for more than 3 years my dysphoria is shut down, my emotions richer and I am in a much better place and am told that I am a much nicer person.  The low dose hrt fires up the E receptors in the brain and essentially re maps and enables your brain to think as it has been structured/gendered. 

Depending upon your age and family history ymmv but physical changes are minor and easily disguised.  You need a good endo to ensure that your health is protected and you know when your fertility is being impacted and other changes likely to become irreversible.

Of course E is like many other therapies or chemicals in that it can become addictive ie you want increasing dosages, and if you stop hrt the dysphoria returns and most physical changes diminish or reverse.

For many of us low dose hrt is truly transformative but as with every step on our journey, work with a good gender therapist and endo, then select and carefully follow the path you have chosen.  There is no time table other than your own. Every person is unique so find your answer rather than follow what appears to be the most common practice.  They may be one and the same, but they may not be.

Safe travels

Aisla

[MelissaAnn]

I have been on E sense October 1st and I have to say I am feeling a big difference, I'm starting to show more emotions, I feel freer and it has had a calming effect on me. I'm not sure if its because at a molecular level things are starting to line up with how I had been feeling all my life, just like Katrina was saying. Good luck with your decision.

Hugs,

Melissa Ann

[Jill F]

Let's see...

My brain fog lifted, my depression and anxiety all but went away, my color vision got better, my sense of taste and smell are greatly enhanced, my verbal skills have improved and I found out what happiness actually is.

Oh, and I fart rainbows and pixie dust now.  You will pry my HRT from my cold, dead hand!

[Tori]

It is really hard to say for sure.

HRT has lifted the dysphoria and that gives me the chance to feel things like joy and happiness much more frequently.

Hormones do enhance emotional responses to things. I find things to cry about. Cute things. Even things that make me angry. I am more able to express these emotions which means they pass through me quickly. HRT is quite a trip.

I do not think hormones have given me a new personality, they just allow me to express the personality I always had with much more freedom.

Also, I fart rainbows and pixie dust now.

[eliza2014]

I too noticed a huge difference. My emotions are more free and I have way more happy days than off days. I started out a low dose and still felt horrible. My PCP allowed me to find a good medium and I quickly ramped up to a level I am a little more comfortable at and the dysphoria better controlled. I have an appointment next week to discuss labs and such, and I am nervous he will take me down on the HRT. I certainly hope not. It was such a difference emotionally that I have expressed to my wife that I do not ever want to stop taking it. I will accept the changes that come, but mentally I could not bear going back to the way I was. It was that awful!

[helen2010]

Eliza

It really is hard if not impossible to go back.  Being non binary it has been less complicated with low dose hrt working for me, but you always wonder ...

So at what point do you notice the pixie dust and rainbows?!   

Safe travels

Aisle

[Tori]

They came shortly after the sprinkles, at least for me. YMMV.

[helen2010]

They came shortly after the sprinkles, at least for me. YMMV.

Very, very funny.  This has made my day

Safe travels

Aisla

[Stochastic]

KatrinaLynne,

I hope you can find whatever it takes to get better. I too was fearful in losing my wife (and kids). The dysphoria was crippling. Tried non-HRT meds, but they did not work for me.  After a bad night and a destroyed bathroom, I had a heart to heart talk with my wife, and said I needed to try HRT. Like you it was HRT or death. I did not know how or when, but I was sure I could not live a long, happy life with the level of pressure experienced.

I have to be straight up with you about HRT. On low/med dose for about eight months and am doing very well. It was so great to finally have a full night of sleep. I am very emotional which, for me, has its ups and downs. The best message for your wife is that she will see a smile on your face that has probably been missing for quite some time.

Still presenting as male (i.e., stealth), but people have noticed the changes. Expect to like those changes....really, really like those changes. As others have said, the good feelings experienced may be difficult to contain and you may want more - Julia

[eliza2014]

Eliza

It really is hard if not impossible to go back.  Being non binary it has been less complicated with low dose hrt working for me, but you always wonder ...

So at what point do you notice the pixie dust and rainbows?!   

Safe travels

Aisle

Oh, I don't ever want to go back. I get shudders just thinking about it. I am doing what I can to do stealth mode ATM. My wife, thankfully, has been very supportive and I am trying to reciprocate that. It has been a long journey and a long-time coming. If it comes down to it, I will find people who are willing to prescribe HRT. I feel so much like a normal person with it.

Presently, I am fighting the typical up and downs you get towards the end of dosing of the oral estrogens. Right in the morning and in the evening I can basically predict when the dysphoria will be coming back. At this point, I would love to do either patches or injections, but at least something consistent.

[Violet Bloom]

  I've posted in depth prior about my experiences on HRT vs before so I don't really want to go into a lot of detail again.  I will simply say that physically I feel better now than at any prior point in my life and I feel much happier than I really have a reason to.  As a serious skeptic I was very surprised when my hunches about my hormones were proven completely right beyond even what I thought I could expect.  It was truly a shock when I realized just how much mentally/emotionally better I've gotten.  I told my Mom on the day of my one-year anniversary of starting HRT that it has proven to be the single most important thing that has ever happened to me.  It was impossible for me to know this until I felt it for myself.  I left behind someone that pre-transitioning and pre-HRT was almost unrecognizably different from how I am now (except for much of the façade I put up to hide how rotten I was feeling from the outside world).  I can be more emotional when I want to but overall my mood and my emotions are actually far more stable now than they were prior to HRT.

  Just to be clear, I am on a full transitioning dose of anti-androgen and estrogen, but the sense of being on the right path was quite immediate even at the beginning of the lowest doses being phased in.  First I felt physically better, then I felt emotionally better.  I started Spiro first and it seems to have been responsible mainly for settling down all the physical discomforts I'd been suffering from.  That of course helped me mentally somewhat on its own.  The Estrace continued this trend to the point now where it seems to be providing rather strong anti-depressant effects.

[AnonyMs]

I could have started in the beginning of this year but my anxiety's and the thought of losing my wife have  prevented me from doing so. I am pretty sure it is at the point of hrt or death.

It sounds like you're going to lose you wife if you don't start hrt, its just a matter of how and when. If you do start you may get lucky, and at least you'll keep your sanity/life. You wife won't be suffering though it either. I found it incredibly helpful to get my wife to speak to my psych - she won't research anything herself, but coming from a doctor it seems to carry weight. I just had to hope she wouldn't give up on me when faced with the reality of it all (I'm still married).

A therapist asked me a question I found helpful in a somewhat similar situation. I don't recall the exact words, but what kind of parent could I be when I'm living like this? Would it be better for the kids to break up over this, but be a better person for them? Its not happened fortunately, but I think the answer would be yes, because I don't think anyone (including my wife) should be exposed to years of what I was going though. Its a terribly hard thing to face though, and I think maybe I'd die before doing it.

I started relatively low dose hrt more than 5 years ago, and still successfully present male. I felt great for years, but eventually it got much, much worse. I upped my dose to a more normal level, and that resolved my depression and most dysphoria. Then I increased it again and I don't think I've ever been so happy in my life - it feels like it should be illegal. Short hair, and a light beard helps a lot. I can still just about hide my breasts, and none of the rest is noticeable.

Possibly part of the depression is caused by not moving forward, but I have noticed that both times I increased my hrt it lead to huge increase in my happiness a few days later (implants take a few days to work I guess). I've been working on moving forward also so I'm not sure how much effect that's had.

I'm planning on presenting male for as long as I can, hopefully some years, but I've kind of given up predicting the future as I seem to have very little control over it these days.

[KatrinaLynne]

I checked before the hockey game came on and there was one reply. It helped a lot. Just that helped my mood. Forgot about it cause my team won. Yay. Plus today was so exhausting it took every bit of my energy to push down all my Anxiety's and depression so I could leave the house and get my nails done. Been trying for 2 days. So just before bed I decided to check. And I want to thank you all for sharing. I love you all. I am drying the tears right now. Gives me hope. Thank you.

[JoanneB]

I've been on and off low dose HRT several times over the decades for the brain or emotional reset. It works. There is the differentiation of Low dose vs HRT since it is lower then typical feminization doses. I only did estrogen, others have reported a similar emotional relief from just an anti-androgen. Typically, my periods on low dose HRT lasted a few months. Once the dydphoria cleared then came the anxiety over WTF am I doing? I did this to be a normal guy. About the only minor physical changes were perhaps slightly more sensitive nips. An erection that did not last quite as long I can also easily attribute to the lose of dydphoria and being able to get into the feelings I was getting from down there.

Six years ago I once again started low dose but that went pretty quickly to normal. As in all things hormones YMMV. There has been some feminization, I have a good A to small B cup. I have no problems presenting male. I've always been a baggy clothes dresser in male mode. My biggest problem is sticking to baggy now that I am at a point in my life that I am happy living in my own skin. TBH, some of my far far younger support group members are envious of my results which I attribute to a touch of gynocomastia, perhaps related to my former fatty days as a kid.

You can likely go a very long time without any significant physical changes. They will very likely be gradual on low dose. Monthly testing of E levels early on can help confirm the levels. Your body will certainly let you know also.

As to what to tell your wife.... Two schools of thought here since I was in a sort of similar situation six years ago. One is the total guilt avoidance route of telling her ahead of time, which also means you can only guess at answers to her questions, which also means she may think the worse since you aren't being totally forthcoming. Then there is the route I chose. Try it first, then decide if it is right for you to stay on. Then report on known facts. I guess a deciding factor is also how you perceive her response will be and how much she already knows about your GD.

The only thing that has allowed my marriage to stay intact has been the really difficult, open, and honest discussions my wife and I have had. Talking about feelings and such things for me was a thousand times more difficult then just everyday stuff. I was not what you'd call a talker. Just the opposite of my self described pathologically honest wife.

After dropping the T-bomb on my wife 6 years ago the hardest part of our discussions for me has been avoiding TMI. She was very scared and concerned about the future, on top of all the other feelings of being lied to and betrayal. (BTW-she knew for over 30 years I had gender issues) I was an emotional mess too, since that is what drove me to all my introspection, life examination and conclusion that how I was handling being a TS was the root cause of most to all my life disasters. I sure was asking myself a lot of questions that had no solid answers, just the emotion du jour.

[ashley_thomas]

low dose had enough impact on me mentally to allow more calm reflection to decide whether or not to transition. Then when I made the decision to transition, I had the confidence to move forward.  Powerful stuff, the best meds out there are the ones with low unintended side effects and high rates of intended outcomes. E fits that description for me 100%.

[peky]

I like boys now, before I was an exclusive lesbian... other than that I am the same old alpha bitch !