HRT and T-Blockers when dealing with Dysphoria and Anxiety

[clairetg]

I have a quick question for whoever can answer.  I'm not currently on any HRT or T-Blockers and I have severe dysphoria and anxiety.  I working right now to find a gender therapist that can help me to be able to get this under control.  My question is do the T-Blockers help eliminate the dysphoria and anxiety or does it require taking hormones as well. 

I know I have to do something because my body and mind can't take this punishment much longer or I'm going to snap and have a mental breakdown.  I'm just trying to understand and prepare myself for what's to come.

Thanks,

Claire

[Dena]

The T blocker help to reduce the mental noise that we feel and they can act in as little as a week or two. Short term, hormones are not needed but there are possible health issues over the long term. Depending on the nature of you dysphoria, a full transition may still be required but the blockers will make it easer for you to deal with life.

[KayXo]

The T blocker help to reduce the mental noise that we feel and they can act in as little as a week or two. Short term, hormones are not needed.

I partly disagree with you Dena. Some may do ok on just anti-androgens short-term but for some, the lack of E (and T) produces symptoms such as fatigue, depression, anxiety, insomnia, hot flashes, night sweats...in other words menopausal symptoms.

One should also realize that E is anti-androgenic in that it reduces T levels, especially when taken intramuscularly or by pellets.

[Paige]

Hi Claire,

I started dutasteride about a year ago and spironolactone about 4 months ago to ease my dysphoria.  My wife really doesn't want me on E (that's for another thread )   It seems to have worked to some extent.  I haven't had the symptoms KayXo mentioned yet, actually I think it's been a bit of the opposite for me so far.  In the last 4 months, I've been able to concentrate so much better than before.   I seem to have quite a bit more energy too.  I do find that I get more foot cramps doing yoga and I don't get spontaneous erections anymore.  My fingers also seem to be cracking much worse this winter.

KayXo could I have higher E levels than normal males?  I wonder this because I seem to be getting some early HRT body changes smooth skin, some breast growth, butt growth, hair growth on top and eyelashes, hair thinning everywhere else.  The areola area seems to harden often and puff out.   People are also starting to comment on my clean shave and face softness.

I do worry about the long term on just spiro and dutasteride.   I wonder if I could get away with low dose E, micronized progesterone and dutasteride without the spiro.   I include the micronized progesterone because I understand it's very good for helping the skin but I could get more breast growth than I bargained for.

Anyway, good luck Claire with whatever route you choose.
Take care,
Paige

[KayXo]

I do find that I get more foot cramps doing yoga

Cramps may be helped by increasing salt intake, on spiro. This is because sodium loss increases on this drug while potassium retention increases. The resulting imbalance between both can lead to cramps. Avoid salt substitutes, eat real salt.

My fingers also seem to be cracking much worse this winter.

If you mean fingernails, this is because of the drop in T resulting in a drop in skin sebum (oil) production.

KayXo could I have higher E levels than normal males?  I wonder this because I seem to be getting some early HRT body changes smooth skin, some breast growth, butt growth, hair growth on top and eyelashes, hair thinning everywhere else.  The areola area seems to harden often and puff out.   People are also starting to comment on my clean shave and face softness.

It may just be due to the change in A (androgens)/E (estrogens) ratio where A is much lower relative to E, hence E having an increased effect BUT Spiro is known to slightly increase E levels through increased metabolization of T to E and dutasteride, by reducing T to DHT conversion, may slightly increase T amount, hence allowing even more T to metabolize to E. T and DHT are partially blocked by Spiro. So, with much less androgens and perhaps a little more E, it is not surprising you are experiencing those changes.

I do worry about the long term on just spiro and dutasteride.   I wonder if I could get away with low dose E, micronized progesterone and dutasteride without the spiro.   I include the micronized progesterone because I understand it's very good for helping the skin but I could get more breast growth than I bargained for.

If you switch to low dose E and progesterone with only dutasteride, androgens will surely have a much greater effect on your body than now and the changes you are currently seeing will become less marked. Micronized progesterone can improve skin tone but as far as breast growth, it depends because, on one hand, it stimulates structures of the breast but on the other hand, it is somewhat anti-estrogenic so it can lead to less overall breast development.

It may well be that enough estrogen is produced in your body from peripheral conversion of T to E and that with the residual T still remaining, you are maintaining enough sex hormones to prevent osteoporosis, and other long-term problems. I say this because you don't seem to experience hot flashes, night sweats or any negative side-effects from too little sex hormones.

[Paige]

Cramps may be helped by increasing salt intake, on spiro. This is because sodium loss increases on this drug while potassium retention increases. The resulting imbalance between both can lead to cramps. Avoid salt substitutes, eat real salt.

If you mean fingernails, this is because of the drop in T resulting in a drop in skin sebum (oil) production.

It may just be due to the change in A (androgens)/E (estrogens) ratio where A is much lower relative to E, hence E having an increased effect BUT Spiro is known to slightly increase E levels through increased metabolization of T to E and dutasteride, by reducing T to DHT conversion, may slightly increase T amount, hence allowing even more T to metabolize to E. T and DHT are partially blocked by Spiro. So, with much less androgens and perhaps a little more E, it is not surprising you are experiencing those changes.


If you switch to low dose E and progesterone with only dutasteride, androgens will surely have a much greater effect on your body than now and the changes you are currently seeing will become less marked. Micronized progesterone can improve skin tone but as far as breast growth, it depends because, on one hand, it stimulates structures of the breast but on the other hand, it is somewhat anti-estrogenic so it can lead to less overall breast development.

It may well be that enough estrogen is produced in your body from peripheral conversion of T to E and that with the residual T still remaining, you are maintaining enough sex hormones to prevent osteoporosis, and other long-term problems. I say this because you don't seem to experience hot flashes, night sweats or any negative side-effects from too little sex hormones.

I don't tend to eat a lot of processed food so my sodium intake is probably low.   I'll try increasing the salt and see if that helps.

Actually it's the skin on my fingers that crack.  Very painful.  Sometime I resort to crazy glue to fix it. 

As for my hormone balance I think you're probably right considering I'm not really having any side effects.

Thanks so much Kay,  you are always a big help. 
Paige

[KayXo]

The skin cracking may be a side-effect of skin dryness caused by, as I mentioned above, lower T and also Spiro which is dehydrating due to water/sodium loss. Progesterone increases sebum (oil) production, increasing water/salt consumption can help too.