How long on full dose HRT?

[Charlie Nicki]

So I've been on a full dose for about 5 months now, and I'm almost one year on HRT overall. My goal is to remain on a full dose for at least another year to see what other changes I get...The problem is that I feel I'm way too sensitive now, I cry a lot, overthink everything, and I'm super insecure. I know all of this is part of the process but I really believe HRT is enhancing this, mostly the sensitivity part; I get my feelings hurt quiet easily, I don't let it show but it does hurt me inside. I feel awkward and ugly sometimes, just like a teenager.

How long were you on a full dose before lowering it?

[HappyMoni]

I am on 3 years HRT, 2 1/2 full dose and only lowered after GCS. I am currently off of it about a month for two surgeries and hot flashes are killing me. As for the emotions, I think there is something to the second puberty thing. Over time, you do get used to the emotions and it levels out. It just becomes normal you. You don't cry all the time but if the right trigger happens, you are able to cry for example. Why reduce? Health concerns?

[Jessica]

I have been full dose as long as you girlfriend, and I feel the same, sensitive, easily hurt feelings and overthinking things is common now.  As long as we hold on to each other's hand and feel our support, we can get through this.

Hugs and smiles, Jess

[AnonyMs]

I'm around 4 or 5 years, but I've none of these issues and I'm never going to lower it. I wonder why the difference.

I'm using implants so my blood levels are very stable, and high.

[Charlie Nicki]

I am on 3 years HRT, 2 1/2 full dose and only lowered after GCS. I am currently off of it about a month for two surgeries and hot flashes are killing me. As for the emotions, I think there is something to the second puberty thing. Over time, you do get used to the emotions and it levels out. It just becomes normal you. You don't cry all the time but if the right trigger happens, you are able to cry for example.Why reduce? Health concerns?

No, I just don't like being oversensitive.

[Harley Quinn]

I have been on full dose since day 1, and going on 3 years now.  It took me about 6 months to adjust to my "moods".  Its a bit different for everyone, but for me it wasn't too difficult to adjust to being on estrogen and progesterone.  You'll learn what will "set you off" at stages in your cycles, it just takes time.  I learned to embrace it, and I don't really notice it anymore.  It has just become part of me.

[Charlie Nicki]

I have been on full dose since day 1, and going on 3 years now.  It took me about 6 months to adjust to my "moods".  Its a bit different for everyone, but for me it wasn't too difficult to adjust to being on estrogen and progesterone.  You'll learn what will "set you off" at stages in your cycles, it just takes time.  I learned to embrace it, and I don't really notice it anymore.  It has just become part of me.

I seem to be stable for a couple of months and then something happens that gets me depressed and I start once again getting all these doubts and negative thoughts even on antidepressants. I hope it smooths out soon.

[Devlyn]

I asked the same question in regards to aging transgender women. It turns out "Granny in puberty" is a perfectly valid choice that many people make.

I'm 56, I personally like to be in control of my emotions. My doctor has said she likes my levels but would bump my dosage up if I want to. I turned it down, I feel good, look great, and don't like the idea of taking medicine I don't have to.

Hugs, Devlyn

[EllenJ2003]

HRT dosage depends upon the person. I was never on more than 1/2 of a full dose, and still had mega breast development (I remember my doctor back in 2002 making the mistake of asking me when I had had breast augmentation surgery - when I informed him I had not had BA, he informed me that I had major breast development).  Physical feminization from HRT is dependent upon how many estrogen receptors your body has.  In some ways that is just as important as doseage.  Remember, any estrogen that doesn't latch onto receptors, ends up just getting metabolized by your liver.  Testosterone suppression also helps things (things really really took off after my orchie [you know, as of this week, that happened 17 years ago, I'd almost forgotten that!]). 

A few years after SRS, there is no need IMO for a full dose of HRT daily (I'm only on 1/3 of a full dose).  Why?  To help minimize breast cancer concerns.  That may not be a concern for you, but it definitely is for me.  My sister ended up having a double mastectomy 10 years ago due to breast cancer, and when I informed the mammogram technician of this during my annual mammogram (you're asked about any family history breast cancer, when you go for a mammogram [a mammogram is something which any MTF on HRT long term SHOULD be having done yearly of you're 40 years old or older]), this became a part of my medical file as a potential medical concern for me.  Since many breast cancers are estrogen linked (my sister's was), the more estrogen you have, the higher the risk of estrogen linked breast cancers.

[Devlyn]

It depends upon the person. I was never on more than 1/2 of a full dose, and still had mega breast development.  Physical feminization from HRT is dependent upon how many estrogen receptors your body has.  In some ways that is just as important as doseage.  Remember, any estrogen that doesn't latch onto receptors, ends up just getting metabolized by your liver.  Testosterone suppression also helps things (things really really took off after my orchie [you know, as of this week, that happened 17 years ago, I'd almost forgotten that!]). 

A few years after SRS, there is no need IMO for a full dose of HRT daily (I'm only on 1/3 of a full dose).  Why?  To help minimize breast cancer concerns.  That may not be a concern for you, but it definitely is for me.  My sister ended up having a double mastectomy 10 years ago due to breast cancer, and when I informed the mammogram technician of this during my annual mammogram (you're asked about any family history breast cancer, when you go for a mammogram [a mammogram is something which any MTF on HRT long term SHOULD be having done yearly]), this became a part of my medical file as a potential medical concern for me.  Since many breast cancers are estrogen linked (my sister's was), the more estrogen you have, the higher the risk of estrogen linked breast cancers.

Mammograms are definitely required, my doctor said once I was 5 years on HRT we'd start squeezing 'em. 

[Harley Quinn]

I seem to be stable for a couple of months and then something happens that gets me depressed and I start once again getting all these doubts and negative thoughts even on antidepressants. I hope it smooths out soon.

I'm not a huge fan of antidepressants.  I turned them down several times when they were offered, so I have zero experience with them... they complicate a complicated situation.  I would suggest checking with your doctor to tweak the dose.  It sounds like you're pretty close to finding the sweet spot if you rarely have an issue.  Don't lose heart!

[Charlie Nicki]

HRT dosage depends upon the person. I was never on more than 1/2 of a full dose, and still had mega breast development (I remember my doctor back in 2002 making the mistake of asking me when I had had breast augmentation surgery - when I informed him I had not had BA, he informed me that I had major breast development).  Physical feminization from HRT is dependent upon how many estrogen receptors your body has.  In some ways that is just as important as doseage.  Remember, any estrogen that doesn't latch onto receptors, ends up just getting metabolized by your liver.  Testosterone suppression also helps things (things really really took off after my orchie [you know, as of this week, that happened 17 years ago, I'd almost forgotten that!]). 

A few years after SRS, there is no need IMO for a full dose of HRT daily (I'm only on 1/3 of a full dose).  Why?  To help minimize breast cancer concerns.  That may not be a concern for you, but it definitely is for me.  My sister ended up having a double mastectomy 10 years ago due to breast cancer, and when I informed the mammogram technician of this during my annual mammogram (you're asked about any family history breast cancer, when you go for a mammogram [a mammogram is something which any MTF on HRT long term SHOULD be having done yearly of you're 40 years old or older]), this became a part of my medical file as a potential medical concern for me.  Since many breast cancers are estrogen linked (my sister's was), the more estrogen you have, the higher the risk of estrogen linked breast cancers.

Now that you say that, I also almost forgot that I had an orchi on April 5th. Now I'm thinking my emotional state might have something to do with that...With no T in my body and A LOT of estrogen I guess this was bound to happen, but I would hope the changes would be more on the physical side and less on the emotional one.

I'm not a huge fan of antidepressants.  I turned them down several times when they were offered, so I have zero experience with them... they complicate a complicated situation.  I would suggest checking with your doctor to tweak the dose.  It sounds like you're pretty close to finding the sweet spot if you rarely have an issue.  Don't lose heart!

I really hope you're right! I don't want to deal with the emotional bumps that much longer. I also seem to get random crushes on men who treat me nicely and that makes me feel like an idiotic 12 year old.

[Charlie Nicki]

I asked the same question in regards to aging transgender women. It turns out "Granny in puberty" is a perfectly valid choice that many people make.

I'm 56, I personally like to be in control of my emotions. My doctor has said she likes my levels but would bump my dosage up if I want to. I turned it down, I feel good, look great, and don't like the idea of taking medicine I don't have to.

Hugs, Devlyn

LOL, well I guess I'm a grown ass woman in puberty (I'm 30) and that feels just as crazy.

[Janes Groove]

I never really experienced the change in emotions that other transwomen talk about.  I've always been able to cry easily and lived openly as a gay man for many years so I never really felt the need to stuff my feelings like cishet dudes do.  I gave up on the cishet life model when I was around 30.   And that was only after some pretty feeble attempts at being cishet.   The only emotional change I noticed is the vague sense that things are right. The way they should be.  I've been on a full dose for a little over 2 years and a high moderate dose for just over a year.  I'll probably dial it back down to a lower dose after 3 years to give the physical expression of HRT it's fullest flowering.

AlSo I have to say there is no real empirical evidence to support the analysis that HRT is causing the way you feel.  It could be something else.  It could be that living with the process of HRT and the changes it necessarily brings is what's causing it. Not having to struggle anymore  with the 'should I or shouldn't I transition' question redirects your energy to other issues in your life.  Or it could be something else altogether.

But then again, you could be right and it is the cause of your troubles.  The only way to find out tho is to reduce or stop and then compare the way you feel.  If it's better then go with it. If it's not then you can recommence your full HRT dose transition.  But like they say, 'you can't pick and choose only the changes you want with HRT.'

It's all a journey. The arc of your life is long.  YOu have time.  You'll eventually figure it out.  There is no one right way to do this. Best of luck with what you decide to do.

[EllenJ2003]

Mammograms are definitely required, my doctor said once I was 5 years on HRT we'd start squeezing 'em. 

Yep!  I've been having them done once a year (my health insurance through work covers them) since 2004.  Ya gotta love having your boobs squashed flat between 2 plates for multiple mammogram images (both vertical, and oblique for each breast).   

[EllenJ2003]

Now that you say that, I also almost forgot that I had an orchi on April 5th. Now I'm thinking my emotional state might have something to do with that...With no T in my body and A LOT of estrogen I guess this was bound to happen, but I would hope the changes would be more on the physical side and less on the emotional one.

It probably is to a significant extent.  I remember not only suffering hot flashes (I remember my female coworkers giggling at me, when I had a hot flash while telling them I was suffering hot flashes - I went from feeling nice comfortable, to feeling like I was in the Amazon rain forest, with the mega sweats I was having), but having mood swings where I went from calm and collected to just about foaming at the mouth (in one instance I actually got rabid with the ex-QA Manager at an informal departmental meeting, in front of my coworkers [so NOT my typical behavior]).  It was almost like going through menopause.  Luckily by a month or two after my orchie, things settled down emotionally, as I started to settle down hormonally.

[Charlie Nicki]

I never really experienced the change in emotions that other transwomen talk about.  I've always been able to cry easily and lived openly as a gay man for many years so I never really felt the need to stuff my feelings like cishet dudes do.  I gave up on the cishet life model when I was around 30.   And that was only after some pretty feeble attempts at being cishet.   The only emotional change I noticed is the vague sense that things are right. The way they should be.  I've been on a full dose for a little over 2 years and a high moderate dose for just over a year.  I'll probably dial it back down to a lower dose after 3 years to give the physical expression of HRT it's fullest flowering.

AlSo I have to say there is no real empirical evidence to support the analysis that HRT is causing the way you feel.  It could be something else.  It could be that living with the process of HRT and the changes it necessarily brings is what's causing it. Not having to struggle anymore  with the 'should I or shouldn't I transition' question redirects your energy to other issues in your life.  Or it could be something else altogether.

But then again, you could be right and it is the cause of your troubles.  The only way to find out tho is to reduce or stop and then compare the way you feel.  If it's better then go with it. If it's not then you can recommence your full HRT dose transition.  But like they say, 'you can't pick and choose only the changes you want with HRT.'

It's all a journey. The arc of your life is long.  YOu have time.  You'll eventually figure it out.  There is no one right way to do this. Best of luck with what you decide to do.

Yeah I'm not stopping. I have my next checkup in August, and if the E levels are alarmingly high then I'll know I'll have to cut the dose. If not, I'll just keep going. The past couple of months have been crazy for me when it comes to social changes, mostly after going full time so you might be right that the additional stress might be part of what's causing this instead but I definitely think I'm wayyyy more emotional and prompt to cry than I was before.

[Charlie Nicki]

It probably is to a significant extent.  I remember not only suffering hot flashes (I remember my female coworkers giggling at me, when I had a hot flash while telling them I was suffering hot flashes - I went from feeling nice comfortable, to feeling like I was in the Amazon rain forest, with the mega sweats I was having), but having mood swings where I went from calm and collected to just about foaming at the mouth (in one instance I actually got rabid with the ex-QA Manager at an informal departmental meeting, in front of my coworkers [so NOT my typical behavior]).  It was almost like going through menopause.  Luckily by a month or two after my orchie, things settled down emotionally, as I started to settle down hormonally.

Thankfully my emotional peaks have nothing to do with aggressiveness; it's mostly depression which isn't fun either but at least I'm not randomly lashing out at people.

[Kirsteneklund7]

Hi Charlie Nicki,
The exact same thing happened to me after 6 months on HRT. I felt fragile, wretched& insecure. I lacked buoyancy, my stoic self disappeared. Things people said affected me where they didn't before.
  I believe this is part of the female puberty you didn't have the first time round.
In the end I had my androgen blocker dose reduced to put my testosterone in the higher end of the female range. Estrogen was maintained in the slightly high female range.
It took until after the 12 month mark to feel adjusted to the new disposition and mindset. I think an amount of emotional development & maturing takes place in this time-consuming it's still going on by the way.
I found good diet and exercise helps. Time out doing yoga or reading is good. Also allow yourself to cry as required( you probably do anyway).
I have heard Progynova in pill form can can create adverse mood from the excess estrone it produces. Bioidentical estrogen doesn't .
In the end it's tough being a 14 year old girl but it does get better.My experience was after 12 months things settled down and the euphoria came back.
Hope this helps.
Kind regards, Kirsten.

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[Megan.]

Hi Charlie Nicki,
The exact same thing happened to me after 6 months on HRT. I felt fragile, wretched& insecure. I lacked buoyancy, my stoic self disappeared. Things people said affected me where they didn't before.

Ditto, I feel I went through this too. I'm still more emotional now than I ever was pre-hrt, but substantially more stable than I was around the 5/6 months mark. X

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