What happens if I Run out of estrogen?

[DefectiveTurret]

Hello. I'm quite early in my transition and have just started to grow breasts, but I'm worried that I will run out of estrogen and not be able to buy more before experiencing a lapse. I'm only taking estradiol, but I get it from overseas, and it takes awhile to get here. My funding is limited, and I may have to go without for a month or so. Will I lose my progress?

[kelly_aus]

This is a question for your prescribing doctor, but, as it seems like you are self-medicating, I'll comment that it's a Very Bad Idea.

[Dee Marshall]

Assuming you are actually seeing a doctor for this and just order out of country to save money on the prescription (I've considered it) then I will tell you that I personally turn into the Incredible Hulk (without the size, strength, or green skin) if I'm too late with my dose. I've never let it go more than a few hours and I try to sit on at least a three month supply at all times. This may come back to haunt me as I next see my endo on Dec 2 and he may well adjust my dosages. I've never let it go longer than a few hours so I have no idea what would happen long term and that hasn't happened in some time, so my levels probably maintain longer now.

[ImagineKate]

You definitely sound like you're self medicating. If so, you should try to get to an LGBT or trans care clinic where you can start getting monitored by an endo or just a regular doctor. Not for nothing, hormones can damage your organs, especially your liver if you take them orally. Monitoring by a medical professional helps catch that early so that action can be taken. Not to mention that getting hormones from a US pharmacy would be much cheaper and often covered by insurance, if you have. A lot of these clinics are non-profit and will help you financially with sliding scale billing based on income.

Anyway, if you're quite early in transition and you stop, the effects may not be too bad. You might experience anything from nothing at all to migraines and maybe some nausea and anxiety and of course a return of your dysphoria and maybe even your male sex drive (if that stopped). But it probably won't lead to death or serious illness or anything of the sort. If you have significant breast growth you may end up lactating because during a pregnancy estrogen levels are high but when the baby is born they suddenly drop and this triggers your breasts to start lactating. Development wise you may lose some such as breasts and fat distribution. It may or may not be drastic because everyone is different.

[Brenda E]

Happened to me earlier this week (not self-medicating - just lost the patch and didn't bring a spare with me.)

Within 24 hours:

- Couldn't sleep
- Extremely restless and easily agitated
- Tinnitus that worsened to the point of interfering with normal activities
- Felt like I was getting the flu or something

Put a replacement patch on this morning, and two hours later all of the above had disappeared.  Feeling absolutely normal again now.

And yes, please don't self medicate.  Hormones are powerful things, and the best way to avoid health problems (and to ensure the quickest, most effective results) is to go through an endocrinologist or family doctor with experience treating transgender patients.  Plus buying meds from overseas is a complete rip off - the money spent on the doctor in the US is recouped by the fact that generic hormones from a US pharmacy are cheap as dirt.

[DefectiveTurret]

Okay, so to be clear, I am self medicating. I had recently discovered that the same hormones with a prescription are 10% of the price, but having trouble getting started with seeing someone, and don't want to have any setbacks in my transition in the meantime. I've found one therapist in my area who does referrals to endocrinologists for trans women. Problem is that I'm very broke right now, and have no way to pay for the therapist and doctor visit. I've thought about telling a doctor that I'm already self medicating and will continue to do so unless I have a prescription, because I can't pay for the doctor visit and the therapist. That way I figured they know that it's healthier for me to have a prescription and be seeing a doctor than to do it on my own. I have medicaid and live in Jamestown North Carolina. Been looking into therapists and doctors, but not getting many results back.doutkd

*mod edit for dosage

[Jill F]

Hi DefectiveTurret,

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~Jill

[ImagineKate]

Okay, so to be clear, I am self medicating. I had recently discovered that the same hormones with a prescription are 10% of the price, but having trouble getting started with seeing someone, and don't want to have any setbacks in my transition in the meantime. I've found one therapist in my area who does referrals to endocrinologists for trans women. Problem is that I'm very broke right now, and have no way to pay for the therapist and doctor visit. I've thought about telling a doctor that I'm already self medicating and will continue to do so unless I have a prescription, because I can't pay for the doctor visit and the therapist. That way I figured they know that it's healthier for me to have a prescription and be seeing a doctor than to do it on my own. I have medicaid and live in Jamestown North Carolina. Been looking into therapists and doctors, but not getting many results back.doutkd

*mod edit for dosage

OK that makes sense then.

I'm not 100% sure about medicaid but I wonder if they cover trans care or at least HRT.

You're in the triad? I think there are a few LGBT resources in the area that might help you find a low cost clinic.

You might also want to research "informed consent providers" that will get you hormones without a lot of gatekeeping and needing a therapist. I see a few but they are in Raleigh-Durham (near UNC) and Charlotte. Not sure if that is within your reach.

Good luck on your transition.

[AnonyMs]

Okay, so to be clear, I am self medicating. I had recently discovered that the same hormones with a prescription are 10% of the price, but having trouble getting started with seeing someone, and don't want to have any setbacks in my transition in the meantime. I've found one therapist in my area who does referrals to endocrinologists for trans women. Problem is that I'm very broke right now, and have no way to pay for the therapist and doctor visit. I've thought about telling a doctor that I'm already self medicating and will continue to do so unless I have a prescription, because I can't pay for the doctor visit and the therapist. That way I figured they know that it's healthier for me to have a prescription and be seeing a doctor than to do it on my own. I have medicaid and live in Jamestown North Carolina. Been looking into therapists and doctors, but not getting many results back.doutkd

*mod edit for dosage

I did the same thing for different reasons. Possibly not the best of ideas in retrospect.

The WPATH Standards of Care version 7 might help you with persuading doctors, although they don't have to follow it. You're supposed to see a psych, but on page 34 under Criteria for Hormone Therapy it says "In selected circumstances, it can be acceptable practice to provide hormones to patients who have not fulfilled these criteria. Examples include facilitating the provision of monitored therapy using hormones of known quality as an alternative to illicit or unsupervised hormone use or to patients who have already established themselves in their affirmed gender and who have a history of prior hormone use."

Having said that, I would recommend you see one when you can. Its going to make things a lot easier on the long term, and perhaps might even help.

I stopped a few times. It doesn't seem to set you back much, just delay things. The mental issues are more the problem. The good part is that you'll presumably know you don't want to stop, and it may help clarify your path forward.

[bxcellent2eo]

As a former self-medicater, and sometimes having to deal with Medi-Cal not wanting to pay for my prescriptions, there have been times that I've been without one or more of my meds at a time.

Also, since I'm wishing to remain fertile, I'm cycling on and off the Estradiol, but remaining on my Anti-Androgens.

When I'm on the Anti-Androgens, but off of the E, I generally stay at an androgynous level. My skin will get a bit oily, and my complexion gets a bit bad, but nothing a little makeup can't help. I also generally get depressed for a few days to a week. It's sort of like a post-partum depression.

When I'm off of the Anti-Androgens, it doesn't seem to matter if I'm on E or not, I start reverting back to a masculine body. My facial hair grows faster, my body hair thickens, my skin is oily, and my face looks gross. I also seem more irritable, (I've described this as a perpetual roid-rage).

It had been about 3 months from when I ran out of my self-medication supply, before I was able to obtain the doctor-prescribed meds. It took about 2 months to revert to that above-stated masculine point. Unfortunately, it seems that reverting is a lot faster than actually transitioning, as it took about 4 months to get back to where I was before I went off.

But when starting back up, your mood will change almost instantly (think of a marijuana induced euphoria). It will gradually taper off to a constant pleasant mood.