Why do endo's seem to start with androgen blocker first

[Randy1980]

Just curious from what I've seen it seems that endo's typically start trans women on an androgen blocker for a few months before adding estrogen.. is this usually for people with really high t levels to get there levels down before adding the e.. is this common practice to start on an androgen blocker?

[Deborah]

Mine started with a full dose of everything and I had a really high T level.  So, not all endo's start with only a blocker.


Conform and be dull. —James Frank Dobie, The Voice of the Coyote

[tgirlamg]

Just curious from what I've seen it seems that endo's typically start trans women on an androgen blocker for a few months before adding estrogen.. is this usually for people with really high t levels to get there levels down before adding the e.. is this common practice to start on an androgen blocker?

From what I understand it is so the E doesn't have to "fight" the T... 

[Anne Blake]

I have seen it done many different ways. My doctor started me on both estrogen  and blockers at about half level and then moved me up to current levels 2 months later. At the 6 month mark she added Prometrium  and it has  been a wild ride ever since.

The logic that I have been given is that many doctors separate the starting of e and blockers to be able to identify any drug reactions easier. Others just start them together and sort out any issues if or when they show up.

[Randy1980]

Thanks for the input ladies.. I'm really hoping they start me on both I'm really wanting to get the e in me and see how it's going to effect me mentally I'm really excited to get started. I'm going to go with whatever the endo recommends I'm just hoping I don't have to wait like 3 months of anti androgen before I can get the e I know my mind and body has been wanting my whole life

[RobynD]

For myself, there was about a 3-4 month period between starting Spiro and Adding Estrogen. My doctor felt it would give my body a chance to adapt to changing hormones. I still consider my HRT as having started the day i took that first Spiro pill.

Suppressing the T alone will give you changes, your body does make its own E, so i'd not be too worried about the gap as you will be on your way!

[Devlyn]

I started spiro and estradiol at the same time, except the pharmacy didn't have the right patch, so that came 24 hours later.

Hugs, Devlyn

[Miss Clara]

I have to wonder sometimes if anyone really knows how to administer hormone therapy.

[Jayne01]

I started on E only. Everybody is different. There is no one size fits all. In my case, I wanted minimal physical changes while still getting the mental relief. I am 7 weeks into my HRT and starting to feel some mental effects now.

One of the first things my endocrinologist told me is that hormone therapy for trans patients is not an exact science. Everyone has different goals and expectations and everyone reacts slightly different to the hormones. Some people want to transition, some don't. There are too many variables to have a "standard" practice of administering HRT. There will be a little bit of trial and error at the beginning until the right disease and combination of medication is found that specifically suits you.

[Randy1980]

Well I feel like it's all pretty cut and dry basically surpress male horemone levels and add female horemone untill you reach cis female ranges.. do it slowly so it doesn't shock the system to much I don't really think there is a whole lot of science to it

[Kendra]

Yay, I get to add even more randomness to the discussion.  My endocrinologist started me on just E with no blocker, and she knows my goal is full transition (other than I'm undecided on GRS) and I do not have any social barriers.  I want my body to change.  My endo is very well regarded in Seattle.

She hinted this isn't her usual prescription, described my starting dose as double.  I think my existing natural hormone levels were a factor.  I never messed with hormones on my own.  Also she mentioned T blockers help reduce body hair and I have none - took care of that already with Mrs. Laser and her evil twin Madam Electrolysis.

[Daniellekai]

There's a lot of different takes on it, for instance the use of progestogens is debated in male to female patients, there are also some that say there is benefit to mimicking the hormonal levels at the onset of female puberty before hand.

The main problem is that there aren't many studies looking at this, so there's a lack of data. I'm of the mind that starting slow is probably beneficial long term although I don't know why, just a gut feeling. I also think I'd like to add a progestogen at some point, the argument is that it may help breast development, but not by a huge amount. I'm more interested in the supposed increase in libido though.

[Colleen_definitely]

I have to wonder sometimes if anyone really knows how to administer hormone therapy.

Plenty of doctors do.  It just happens that there are several different approaches that all work well.

[rmaddy]

Not all doctors prescribe spiro before estrogen, but the potential advantage is that if the patient has a reaction to medication, it is easier to tell which is responsible if they were started at separate times.