what hormone regimen is best for post-op woman?

[Laura_7]

Interesting, thanks for posting this.  I quit all meds quite a few years ago.  Less is more.  Moderation is best.  I don't ever get sick so going to the Dr. seemed pointless other than to enter into the "payment for prescriptions" scheme of gatekeeping, science experiments, and extortion.  We moved a few times and I just haven't bothered even trying.  It's a bit like taking your perfectly working car to a shady repair shop and asking them to see if there's anything they can find wrong with it - isn't it?   I'll pass, for now.

People are different.
Some people may have enough t produced by glands for a good well being.

Estro might help with libido, and the neovgina reacts to estrogen like a vagina, so there may be less dryness and atrophy, and there might be an overall better well being. Transgender women are not menopausal women, estrogen levels well in the female range might help.


hugs

[galaxy]

what hormone regimen is best for post-op woman?

Actually i take no hormones. Very simple.

[Joi]

Lyndsey:  Your post op levels rival mine.  I'm 13 weeks post op now.  My 1st labs after surgery were at approx. 9 weeks. My Estradiol was high like yours around 525.  My injectable dosage was decreased by 1/2 and the next labs showed that it dropped all the way to an 80.  Labs were run again & it jumped back to 530.  My Endo doesn't have an answer.  Last week, I started noticing a return of male BO which really surprised me. So I added a patch to my regimen.  I'm only doing injections 2 x mon. will have more labs in about 10 days.  Who knows where they will be then! 

I have been on 'mones since March '15 & my endo was never able to attain the level that he want of approx. 200.  I'm receiving treatment at a govt. run facility The scary thing is that he is the Director of the Dept.  He's only tested my Progesterone levels once and that was last year.  Guess I'll have to prod him to check the progesterone levels again now that I'm post op.  I been on Progesterone for over a yr.

What a ride!

[KayXo]

E levels fluctuate quite a bit on injections so there is really no use in measuring them, they will be over the place. Ask your doctor why he aims for 200 pg/ml and what this decision is based on. Higher levels in men with prostate cancer of a certain age and in pregnant women have not shown to significantly increase health risks, I can provide these studies and statistics to you, if you so wish. I'm post-op since 2005, my E levels are around 1,000-4,000 pg/ml. My health is fine and I'm supervised by three doctors. Injecting every 2 weeks can cause too wide fluctuations in levels leading to menopausal symptoms in some in the last few days but if you feel fine, then alright. I inject every 5 days.

Lastly, shouldn't feminization and well-being be more important than levels? Obviously the return of BO is not a good sign and this goes to show you that reliance on levels alone is not in your best interest. If instead the focus was your health, psychological well-being and overall feminization, I think things like this would not happen. Just my 2 cents, I'm not a doctor but worth discussing these matters with your doctor, I think.

[Zumbagirl]

I have been taking the same dosage of estrogen for at least 15 years now and I still take the same dosage as what I took as a pre-op. Truthfully I feel fine. I actually feel like a chemically balanced normal person if that makes any sense. I wouldn't want to change my dosage because I do well on what I take now. My endo seems to agree as well when I pay my annual visit.

[Sharon Anne McC]

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This addendum is in case any future user seeks this thread for reference.

I had my periodic gynecology exam today.  This is my first gyn exam with this gynecologist.  She and I discussed estrogen levels typically approved for M-F post-op at my age (60 years old).  My gyn is experienced with multiple post-op M-F patients; I am my endo's first and only trans patient.

     -  My endocrinologist has maintained my estrogen dose at 'X' mg per day; my gynecologist told me that she considers the correct dose at least twice that amount and will recommend it in her medical notes.

     -  My endocrinologist's dosing has kept my estrogen levels at 20s to 40s.  My gyn told me that post-op M-F estrogen levels at my age should be at upper-100s to lower-200s and that a gradual increased dose should achieve those correct levels.

Work with your physician to be certain that you receive the correct dose to sustain your correct blood levels.  I have few risks; I am a non-smoker, in good health, no risk of embolism.

Of course, the well-worn phrase is applicable:  YMMV.

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[kimbee777]

Do your endos recommend progesterone? Mine said it would be pointless to take, since it's main role is to prepare the milk ducts during pregnancy. Yet I've read some girls on here swear by it.

[Karen_A]

     -  My endocrinologist's dosing has kept my estrogen levels at 20s to 40s.  My gyn told me that post-op M-F estrogen levels at my age should be at upper-100s to lower-200s and that a gradual increased dose should achieve those correct levels.

My endo said:

The Endocrine Society guidelines recommend a target estradiol between 50-150 pg/ml. 200 is the upper end of the range.

I started HRT about 20 years ago and am 18 years post op (well to be accurate it will be 18 years in 4 more days) and about your age. I was off HRT for 6-7 years and just restarted a couple of months ago. I was on injectables for many years with very high E2 levels with no issues.

For most of the time I was on HRT originally,  those guidelines did not exist and I was not aware, until recently, that they existed at all.

This new (and much younger) endo put me on patches... After a the first month my blood level 3 days after putting on the patch on (the day before i was supposed to put the new one on) was 63 pg/mL... i was horrified at how low it was ... but she said that was within the target range and that is when she told (well wrote) me about the guidelines.

Given that my blood work (lipid levels , cholesterol, triglycerides etc) was very good, particularly considering my age and the fact that I am heavy, she agreed to double my patches..

When tested again (again at 3 days after) my blood level was 111 pg/mL and she does not want it any higher. She worries about possible clotting - but given I was ay MUCH higher levels for many years, and given i'm using patches so no first pass through the liver, I am not worried and would not be if my levels were much higher.

Right now about a day after I put on the patches I sometimes have a little breast tenderness, which is gone by the next day. BTW even on the high does I never got much breast growth.

- Karen

[Sharon Anne McC]

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My endo placed me on progesterone a couple months ago after I lobbied her about it for more than a year.  I mentioned to her that others in my similar circumstance (post-op, age 60, good health, no risk factors, etc.) were on it.  I asked her what she says it is supposed to do and how will it show on my blood draws to be certain that it is not harming me.  She was not much help in any of that.  It remains to be seen with my next blood draw in October how it affects those issues.

Otherwise, I really do not know what it is doing, or not doing, or maybe it needs to be a higher dose, or a lower dose, or how it needs to be in relation to estrogen (I dissolve that pill under my tongue).  More than a few months seem to be needed to assess what progesterone is doing for me, to me.  We shall determine this early effect at that October appointment.

I lost my then-primary about 16 years ago and had to continually hunt for a physician who would work with me.  They lasted maybe one or two years; at least they continued my prescription level at more than double what my current endo prescribes - until I came to my current endo (2012).  She dropt me to bare minimum and has not raised it since then.

It seems that though there are target levels, each endo or primary wants to do their own.

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[Tanya62]

The lack of hormones post-op can cause osteoporosis, cognitive deterioration, accelerated ageing, mood problems, lack of energy and motivation, dry skin/hair/vagina, contribute to the onset of early diabetes, perhaps increase the risk of cancer and heart disease, etc.

I guess I am still catching up on all the information that is available here at Susan's Place. Kay, when I saw your comment on some of the problems caused by no HRT, I thought you were talking to me!    A few months ago I went to my MD to find out why I was so tired all the time. Sometimes pretty moody too, although in my eyes to a lesser degree.

Anyways, a follow up to MD found I am prediabetic and possibly osteopenic, along with what i mentioned already. So now, I am back on HRT, and making adjustments to it as needed. I find using some progesterone is beneficial for me, and there are others who likely don't need it or want it. I feel better about pretty much everything. I found that getting back on female hormones motivated me to take better care of myself, and this makes my life a little more bearable. But my bones are still a little sore, esp some of my joints.

I am also trying to shed a few pounds, and already people are commenting on how I look like I lost some weight. Some are aware of the HRT, others not so much.

I guess what I want to say is that hormones play a pretty big job in keeping us going, and finding the right dosages for each individual is necessary. Some more, some less.

Hugs