Anyone else experience menopause?

[Nina]

About three months ago, I had an appointment with my endo. She suggested that being 52 years old, estrace would have no more impact on me. I had been on hormones for 10 years.
About six weeks later, I started getting sweats, followed by hot flashes. These sweats and flashes would happen 4-5x a day...sometimes at night. I had chalked it up to the hot humid weather.
Met with my endo a month ago, told her what was going on, and she told me it was likely menopause. She put me back a low dose of estrace.
Since then, zero hot flashes and no sweats.

Anyone else experience menopause?

[warlockmaker]

I thought all TGs were like menopause wimen and like menopause women we are on HRT. I have been on HRT for 5 years. When I was off my estrogen before srs and for 2 weeks after, I had the symptoms you described. They disappeared after resuming HRT. I was told we have to be on HRT for the rest of our lives. My E intake is slightly lower and monitored by my endo every six months.

[Nina]

I haven't read or heard that we need to be on HRT for life. My endo feels that there is no benefit of it when you're over a certain age. Pretty sure there are varying opinions by endo's...I'm not really one to question it as I put my faith in my endo to do what she thinks is right.

[Gertrude]

I haven't read or heard that we need to be on HRT for life. My endo feels that there is no benefit of it when you're over a certain age. Pretty sure there are varying opinions by endo's...I'm not really one to question it as I put my faith in my endo to do what she thinks is right.

Doctors are human and if you put complete faith in them, you're rolling the dice. Do your own research and get second opinions if necessary. Doctors are basically highly trained mechanics of the human body and their competency varies just like the ones that work on cars. Unfortunately, many suffer from hubris through apotheosis.


Sent from my iPhone using Tapatalk

[Dena]

I made that mistake and was a big one. I was off HRT for 10 years. The first couple of years it was hot flashes and sweats which I could live with. Over time I lost my facial fat and my body lost some of it's feminine shape. Returning to HRT is reversing the changes that took place however the reduced dosage I am on means  the changes are taking place slowly. The problem is once we stop HRT, our estrogen drops off the scale unlike a CIS woman who continues to produce estradiol elsewhere in their body. You should have your blood tested as part of your treatment and aim for levels around 40-50 pg/ml. This is a mid range feminine menopause range and is sufficient to maintain a feminine appearance without flooding the body with higher levels of estradiol.

On the other hand higher dosages for around 30 years would be equivalent to a CIS woman's exposure from puberty to menopause. My high level exposure was around 4 years and then I was cut back to very low menopause levels. My levels were never measured but I suspect I was maintained below 25 pg/ml which meant I never completed puberty. On my somewhat higher dosage now, I am experiencing puberty again at 65 years old.

[Janes Groove]

I haven't read or heard that we need to be on HRT for life.

Doesn't lack of sex hormone lead to osteoporosis(a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal change)?  That sounds like a pretty negative health outcome, especially for an older person. 

[Megan.]

Doesn't lack of sex hormone lead to osteoporosis(a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal change)?  That sounds like a pretty negative health outcome, especially for an older person.

That's my understanding,  that a long-term lack of at least one of the two sex hormones can possibly lead to osteoporosis. If this weren't the case,  I would have almost certainly tried using just AAs and no E.

Sent from my MI 5s using Tapatalk

[KayXo]

About three months ago, I had an appointment with my endo. She suggested that being 52 years old, estrace would have no more impact on me. I had been on hormones for 10 years.
About six weeks later, I started getting sweats, followed by hot flashes. These sweats and flashes would happen 4-5x a day...sometimes at night. I had chalked it up to the hot humid weather.
Met with my endo a month ago, told her what was going on, and she told me it was likely menopause. She put me back a low dose of estrace.
Since then, zero hot flashes and no sweats.

I guess your doctor was wrong because estrace stopped the sweats and hot flashes. Why would hormones suddenly stop working at 52 yrs old??? Some transwomen transition later in life and have significant psychological and physical effects from taking estradiol.

I intend to stay on hormones for THE REST OF MY LIFE. The benefits (younger-looking, improved quality of life like better mood, avoidance/slowing down of degenerative diseases, maintenance of feminization including fat disposition and firmer breasts, reduced cardiovascular risks and possibly cancer risks like colon and even breast, slimmer waistline/healthier fat distribution) FAR outweigh the risks which are negligible on bio-estradiol estradiol.

Your doctor may have said this due to their own unjustified fears of keeping you on estrogen at this age as a result of some earlier studies in post-menopausal women on non bio-identical estrogens. Since, other studies have been published, showing that if bio-identical hormones are given, the risks are reduced significantly while the benefits are several.

There was even a study showing in 100 women, median age 64.5 yrs old, that quality of life not only improved significantly due to hormones (pellets comprising of estradiol and testosterone) but that no side-effects occurred after a mean duration of HRT of 17.65 yrs! The vast majority wanted to continue on HRT and did. There are more studies of this kind showing that estrogen does have a significant impact on women after 50 yrs old and can reduce cardiovascular risk, osteoporosis, colon cancer, improve insulin sensitivity and lipid profile, even reduce breast cancer risk and augment libido/mood.

From everything I've come across, it actually seems more harmful to not be on HRT.

The problem is once we stop HRT, our estrogen drops off the scale unlike a CIS woman who continues to produce estradiol elsewhere in their body.

At menopause, a woman's natural production of estrogen is quite similar to ours, as post-op women. Very little if any is produced by ovaries. Their only source, as ours, is the adrenal gland where hormone precursors such as DHEA convert peripherally to testosterone and estradiol in tissues. Both them and us benefit greatly from HRT.

You should have your blood tested as part of your treatment and aim for levels around 40-50 pg/ml. This is a mid range feminine menopause range and is sufficient to maintain a feminine appearance without flooding the body with higher levels of estradiol.

I humbly disagree. These are very low levels, in my opinion. Enough perhaps to maintain bone density and keep away hot flashes/night sweats in some (not all) women but unlikely to maintain one's feminine appearance or have a significant positive effect on mood, energy levels, skin, body weight, etc. Dena, I believe you take your estradiol buccally and that your levels are, at least temporarily, quite high.

Higher levels in older women have shown to be quite safe in several studies, contrary to popular belief.

My levels were never measured but I suspect I was maintained below 25 pg/ml which meant I never completed puberty. On my somewhat higher dosage now, I am experiencing puberty again at 65 years old.

You were initially prescribed Premarin so even if levels of estradiol were low, you had significant amounts of potent equine (horse) estrogens circulating in your blood affecting your tissues and not measured by blood tests. You forget to mention this.

[Nina]

Lot of arm chair doctors here.

[KayXo]

I am not a doctor but I have read several studies and spent countless hours researching this issue because I quickly realized doctors treating transwomen don't have the time to do this sort of thing, instead relying on often outdated/older studies or inaccurate, incomplete and poorly evidence-based guidelines. Simply put, they are not as up-to-date on the research as they should be. For this reason, I need to be proactive, I need to question their assertions; otherwise, I may be putting my own life and health in jeopardy. Transsexual HRT is not something that is taught at medical school but rather learnt on the field. It takes time, dedication and interest to truly develop an expertise in this area.

I am a fellow Canadian and under the supervision of four doctors, two of whom I continually share studies with as they admit to not being to up to date with the research. They are grateful to my contribution as I am grateful to their openness which they say is a prerequisite for any good/competent doctor.

Doctors are human beings, fallible and need to be questioned, to be asked what their assertions are based on, especially when it comes to trans HRT. Looking in the right places, we can begin getting a better picture of the benefits and risks involved with HRT in ciswomen, cismen and transpeople. Then, we are in a better position to decide if the doctor treating us is in fact telling us things that are in line with scientific findings so far.

Remain skeptical, use your own judgment, no matter who the person on the other end is and do your own research. That is my best advice to you. I've been at this for 14 yrs and read enough, seen enough to know that being involved in one's own treatment is absolutely imperative when it comes to trans HRT.

Best of luck. With love,
Kay

[KathyLauren]

Your doctor is wrong that E has no effect after age 52, because there are lots of us who didn't even start until we were in our 60s, and it works just fine.  At age 62, my boobs are growing slowly but steadily.  My face and lips have changed significantly, as have my skin and body hair.  The shape of my hips has changed.  E works just fine at our age.

They shouldn't be trying to match the hormone levels of a cis woman your age.  They should be trying to match the levels of a woman who is 10 years past the onset of puberty, because that's what you are.

[Janes Groove]

Lot of arm chair doctors here.

LOL. I've had doctors ask ME questions.

Over 10 years ago I had a doctor thank me for going outside his practice and getting a diagnosis for a life-threatening disease that he missed that he was then able to treat and saved my life. This after 3 other doctors missed it too.

The was another time before that I got  conflicting diagnoses from 3 different doctors on a surgical procedure I needed.  I finally got the right procedure and got the problem well resolved, but only after doing a lot of research on my own.

Doctors don't have magic powers.

[Dena]

At menopause, a woman's natural production of estrogen is quite similar to ours, as post-op women. Very little if any is produced by ovaries. Their only source, as ours, is the adrenal gland where hormone precursors such as DHEA convert peripherally to testosterone and estradiol in tissues. Both them and us benefit greatly from HRT.

I humbly disagree. These are very low levels, in my opinion. Enough perhaps to maintain bone density and keep away hot flashes/night sweats in some (not all) women but unlikely to maintain one's feminine appearance or have a significant positive effect on mood, energy levels, skin, body weight, etc. Dena, I believe you take your estradiol buccally and that your levels are, at least temporarily, quite high.

Higher levels in older women have shown to be quite safe in several studies, contrary to popular belief.

You were initially prescribed Premarin so even if levels of estradiol were low, you had significant amounts of potent equine (horse) estrogens circulating in your blood affecting your tissues and not measured by blood tests. You forget to mention this.

Prior to a year and a half ago, my estrogen levels were never measured. I have only been taking my tablet buccally a little over half a year and there is a world of difference in the way Estradiol affects my body and the way Premarin did. While the manufacture claims equine estrogens are more potent, I didn't experience that while I was taking it. I find that unit per unit estradiol has several times the effect on my body than that of Premarin.

Another question for you to pounder is why does everybody warn about calcium loss when we lose our sex hormones if our body produces sufficient hormones to maintain our health? Granted, I didn't seem to have bone problems without estrogen but the fat movement away from feminine locations was very visible. Others noticed it in as little as two years after my estrogen was lost however it took me much longer to figure it out.

[KayXo]

They shouldn't be trying to match the hormone levels of a cis woman your age.  They should be trying to match the levels of a woman who is 10 years past the onset of puberty, because that's what you are.

10 years past the onset of puberty, ciswomen have recurrent menstrual cycles with levels ranging anywhere from 20 to 762 pg/ml and some of these women also become pregnant with levels much higher. The range, being so wide, it's useless to try and match their levels. Measuring levels is also inaccurate for the simple reason that they fluctuate over time so that, what you'll be getting is a random level at a random time which means nothing. It also does not take into account the fact that sensitivity to levels varies so that some of us may need less or more than others for optimal results. Other point to consider is that SHBG binds E2 and SHBG is sometimes higher in us due to oral intake of E2 so that even if our E2 level is in the "range", our free E may be lower in comparison. Lastly, transwomen have a different history, with being exposed to high levels of androgens during and after puberty AND also in-utero, which studies suggest can make a significant difference in how we respond to sex hormones later.

Whether measuring E or T levels, the same applies.

there is a world of difference in the way Estradiol affects my body and the way Premarin did. While the manufacture claims equine estrogens are more potent, I didn't experience that while I was taking it. I find that unit per unit estradiol has several times the effect on my body than that of Premarin.

A few things of note:

- you are not the same age today as you were back then while taking Premarin so that age is a confounding variable insomuch as the dose required back then to yield optimal results could have been significantly higher than today. Your body may be more responsive today and require much less due to a host of reasons.
- you are taking estradiol buccally which means far higher levels of estradiol even despite equine estrogens in Premarin.

It's therefore impossible to accurately and objectively compare the two given the above.

[Dena]

- you are not the same age today as you were back then while taking Premarin so that age is a confounding variable insomuch as the dose required back then to yield optimal results could have been significantly higher than today. Your body may be more responsive today and require much less due to a host of reasons.
- you are taking estradiol buccally which means far higher levels of estradiol even despite equine estrogens in Premarin.

It's therefore impossible to accurately and objectively compare the two given the above.

At twice the dose of Premarin taken orally my breast never hurt and it took over 4 years to approach a AA size cup. Estradiol had my breast sensitive within a month of starting which I never expected. Oral estradiol bumped me a cup size within a few months. Premarin was better than nothing but not a whole lot.

I only went to Buccally because I can't get a full transition dose and am stuck at half a transition dosage. The suggestion was I just need to maintain and I don't need to develop any longer  It appears she wasn't listing when I explained my reasons for going back on HRT and figured like the OP's doctor that previous treatment had accomplished everything that needed to be done.

It seems like I am destine to be on the slow boat to femininity but I think at 35 years I should have reached a destination by now.