Has anyone else had depression issues after blocking T?

[Jody]

Hello.  I have had depression issues my whole adult life, actually dysthymia to be exact and have taken medication for over 20 years which doesn't always do a great job but it keeps me alive as I always say.  I am older, now almost 59, and when I first started to seriously try transitioning 10 years ago I found that within a month or two of starting HRT I would sink into a much deeper depression while taking both Estradiol and Spironolactone.  It would effectively stop my transition because I didn't want to do much of anything anymore.  After trying the meds again a few times and experiencing the same results and even trying a different anti-androgen, I somehow ended up taking just the Estradiol by itself and had no depressive side effects so obviously it had to do with blocking testosterone.  I went to see a very experienced gender therapist who told me that it was the medication and not the lack of T that was the issue.  My plan then was to get an orchiectomy but I heard that things had changed some from when I was younger and that if the therapy letters were worded correctly I could just go ahead and have a vaginoplasty done right away which was my goal in the end anyway.  So I had the surgery 9/10/2015 and I was very happy with things but then about a month and a half later I fell into the same depression which once again virtually stopped any plan of transition. 

Sorry this is so long but I wanted to cover my story.  Anyway, increasing my Estradiol level seemed to help some but I'm wondering if I need to add some testosterone to mix to actually feel great again?  I don't know if it's my age or just the hormone levels themselves but I kind of feel like I'm the only one having this issue.  I wanted to post something here to hopefully find a kindred spirit.

Thank you.

[Tessa James]

Welcome to Susan's Place Jody,

My you have been busy!  I cannot offer personal insights as my moods lifted considerably after HRT but I have heard from sisters in this realm who have had on going issues with depression.  Some have needed medication or support including antidepressants and yes sometimes a little T around the edges;)  I am scheduled for an orchi soon and will watch my levels and moods closely.  There are so many factors that can impact our overall sense of happiness.

Congratulations for negotiating the old gatekeeper world and finding your way through the fog.

[cindianna_jones]

Look sweetie, a LOT of us are constantly depressed. It's part of our make up. It happens. Some of us experience more than others. And some of us are fortunate to leave it behind. I will admit that I get seriously depressed from time to time. I have taken meds before but they turned me into a lazy vegetable. I'd rather be down from time to time but actively engaged with life. I hate being a lazy frump. So I quit taking them years ago.

You should keep investigating the meds that work for you. Perhaps you might learn to recognize the triggers that create the most anxiety for you. Just knowing what they are can help. You don't need to do anything else but know them.

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I hope you can find the way to feeling better.

Chin up.
Cindi

[DiamondBladee]

I mean, cismen get depressed as their T goes down later in life.  That's why a lot of them actually do something to bring their T up, some as early as 30.  It's just part of it; above advice is spot on.

    ~ Winter

[KayXo]

Perhaps you aren't taking enough E. Some need higher levels to feel good without having to resort to T which could, even in low doses, have detrimental effects on one's figure and breast growth. Some report feeling better on progesterone due to the effects of its metabolite, allopregnanolone which has anxiolytic and antidepressant effects. BUT, it can also oppose E so if E is already low, not in your best interest, perhaps. You should discuss these with a doctor who is experienced in the matter, flexible (not rigid in their thinking) and open-minded.

It could also have nothing to do with hormones and be purely psychological in which case a competent therapist is needed.

Best of luck.

[Dena]

Gender dysphoria can coexist with other conditions and the treatment for it may not clear the other conditions you have. It's very possible your dysthymia is the source of your depression and you doctors may need to take another look at your medications for this. My expertise on this consist of a few minutes reading a web page so you need to talk to your doctor about this. I am not sure that hormone balance is the only source of the problem at this point.

[Jody]

I mean, cismen get depressed as their T goes down later in life.  That's why a lot of them actually do something to bring their T up, some as early as 30.  It's just part of it; above advice is spot on.

    ~ Winter

I do think my issues are due to low T, just like cis men experience with aging, I guess I was just trying to find out if there were others having similar experiences because I don't seem to find that anywhere in the trans community. 

I wish I could do without antidepressants because I'm really not a fan of medication in general but I wouldn't be alive without them unfortunately.  I guess I'm better off being a live vegetable than a suicide statistic. 

I don't think anyone who has taken a T-blocker without issues will have any problem after an orchiectomy. 

Thank you for your thoughts.

[KayXo]

Low T shouldn't be an issue if you are replacing the lost hormone with enough E which has anti-depressant (i.e. serotonin) and energizing effects.

Maturitas. 1996 May;24(1-2):37-41.

"Serotonin, known for its beneficial action on mood and well-being, is also involved in cardiovascular functions. Thus the current work was undertaken to study the effect of hormone replacement therapy on serotonin turnover in postmenopausal women. Eighteen women received estradiol transdermally and 17 women estradiol valerate orally for 4 weeks. The serotonin metabolite 5-hydroxyindole acetic acid (5-HIAA) was determined in the urine before, and after 2 and 4 weeks' estradiol treatment. With both administration routes estradiol produced a significant increase in urinary 5-HIAA excretion, greatest with transdermal estradiol after 28 days of treatment. The enhancement of serotonin turnover may contribute not only to an improvement of mood and well-being but also to a cardioprotective effect of estradiol observed after hormone substitution in postmenopausal women."

Pharmakopsychiatr Neuropsychopharmakol. 1978 Jul;11(4):164-76.

"estrogens have psychotropic properties comparable to those of well-known psychotropic compounds. These are: improvement of psychological test results and increase in extraversion and decrease in neuroticism according to the Eysenck Personality Model (1964). Such effects are usually associated with the psychostimulants."

"High dosages of estrogens have antidepressant properties clinically."

Post-partum depression can be cured by taking estrogen in women after pregnancy.

J Clin Psychiatry. 2001 May;62(5):332-6.
Estrogen deficiency in severe postpartum depression: successful treatment with sublingual physiologic 17beta-estradiol: a preliminary study

"Most women recovered and did not have any depressive symptoms following treatment. There was rapid improvement in symptoms within first week and recovery thereafter. Neither psychotherapy or anti-depressants worked."

[Dena]

I suspect it's something other than low T for the following reason. I think you are transgender and the transgender feeling is the results of the high levels of T. That also results in heavy depression. Many of us have the depression and the TG feeling leave when our T levels are reduced. I have gone for years without T or E and the depression hasn't returned.

I think when men have issues with low T, it may be tied to their inability to preform sexually making them feel less of a man. For the most part, the last thing we want to be is more of a man.

I think something else is in play but I don't have a clue what it is. One thread that happened a while back was about a person who reported major body hair growth after starting the blockers. I posted I suspect in their body the blockers may be behaving like T. It is possible the blockers could be doing the same for you.

[KayXo]

I suspect it's something other than low T for the following reason. I think you are transgender and the transgender feeling is the results of the high levels of T. That also results in heavy depression. Many of us have the depression and the TG feeling leave when our T levels are reduced. I have gone for years without T or E and the depression hasn't returned.

Lower T may not always lead to fading of depression in transwomen. In some, post-op girls, taking a small amount of T or more E resolved the depression.

I think when men have issues with low T, it may be tied to their inability to preform sexually making them feel less of a man. For the most part, the last thing we want to be is more of a man.

In my opinion, this is a simplistic view of what T does in the body. T has a big impact on mood, well-being and energy as well. This also plays a big part in why many men don't feel good on low T, for the same reason many ciswomen don't feel good on low E.

One thread that happened a while back was about a person who reported major body hair growth after starting the blockers. I posted I suspect in their body the blockers may be behaving like T. It is possible the blockers could be doing the same for you.

As mentioned before by me, some anti-androgens like cyproterone acetate and spironolactone bind to androgen receptors but have partial agonist activity which means they slightly trigger receptors, thus being slightly androgenic. When your androgen levels are high, taking either shouldn't cause problems because the reduction in androgen that results with the blockage compensates greatly for their partial agonist activity BUT, when levels are naturally very low, introducing either in one's body can possibly have detrimental effects. There is also the issue of bodies responding differently from one individual to another, hence in some, the "androgenic" effects being more an issue. I don't know.

In general, however, anti-androgens, in this context, are more beneficial than harmful. By the way, bicalutamide is a pure anti-androgen and does not have agonist activity at receptors. LhRh agonists also, apart from the first 2-3 weeks, behave like true anti-androgens, reducing T to castrate levels.

[Jody]

I really appreciate all the input.  I wanted to make sure that everyone saw that I've had GRS done so I don't take anti-androgens anymore but I had the same depressive reaction about a month and a half after the surgery as I did after the same time frame when taking the T-blocker.

I think maybe some use the word depression the same as being sad which is most definitely not the case.  For me it's a genetic thing that my mother and her mother also had.  It can be very crippling at times and can last for days, weeks, or months.  I've read about many women being able to go off medication after starting HRT but for me it's not the case.