MtF HRT contraindicated because of Polycythemia Vera?

[Katie S]

I have polycythemia vera. It's a bone marrow disorder that makes it produce too many red blood cells. It also greatly increases the chances of blood clots. When I search for information online all I can find is that its a relative contraindication. However I can't find any academical information specific to my condition. So far I understood that its gonna be hard for me to get HRT. Does anybody else have my condition? What happened when you wanted to start HRT? Were you able to start it? Did you have any complications?

Hi, Really sorry to pick up this thread almost a year late, but I'm transitioning and I've also been diagnosed with polycythaemia vera.  I was diagnosed about four months' ago, which has led to my endocrinologist taking me off estrogen because she is afraid of the risk of blood clotting or strokes.  I was on HRT for about 10 months up until January this year when I was told I had to come off the estrogen patches whilst the cause of my high red blood cell and platelet count was investigated.  I was eventually referred to a haematologist who diagnosed me with PV in August of this year.  My understanding is that they are prepared for me to go back on estrogen patches but only if the PV medication I am on is successful in getting my platelet count down to normal levels.  Since August, I have been on Interferon along with dispersible aspirin.  I'm a bit of a strange case at the moment, as since September, I have been allowed to have Zoladex injections as an anti-androgen resulting in me having zero point something testosterone left, meaning that I currently have virtually no hormones whatsoever.  I'm just hoping now that my blood cell/platelet count will go down enough for me to continue estrogen patches and therefore move forward again with my transition.

[Jessica]

@Katie S

Hi, Really sorry to pick up this thread almost a year late, but I'm transitioning and I've also been diagnosed with polycythaemia vera.  I was diagnosed about four months' ago, which has led to my endocrinologist taking me off estrogen because she is afraid of the risk of blood clotting or strokes.  I was on HRT for about 10 months up until January this year when I was told I had to come off the estrogen patches whilst the cause of my high red blood cell and platelet count was investigated.  I was eventually referred to a haematologist who diagnosed me with PV in August of this year.  My understanding is that they are prepared for me to go back on estrogen patches but only if the PV medication I am on is successful in getting my platelet count down to normal levels.  Since August, I have been on Interferon along with dispersible aspirin.  I'm a bit of a strange case at the moment, as since September, I have been allowed to have Zoladex injections as an anti-androgen resulting in me having zero point something testosterone left, meaning that I currently have virtually no hormones whatsoever.  I'm just hoping now that my blood cell/platelet count will go down enough for me to continue estrogen patches and therefore move forward again with my transition.

Hi Katie 🙋‍♀️ Welcome to Susan's Place!  I'm Jessica.
It's fine to enter an older thread, especially if it pertains to issues you have.
I hope you are able to sort this out with your doctors, and continue your estrogen patches.

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[Katie S]

Hi Jessica, Many thanks for your kind wishes, for the links provided in your reply and for welcoming me to the site.  I'm very sorry that my reply to you is so late.  Yes, I am hoping that this will be the year that I can get back on estrogen and resume my transition.  When I visited the haematologist last month with regard to my polycythaemia vera he said that the interferon I'm on is making my blood cell and platelet count go down so that's given me some hope, even if it's still nowhere near the healthy average level yet.  I have my next anti-androgen (zoladex) jab next Thursday and my endocrinologist said she'd contact me hopefully some time in February to see if it's safe for me to go back on estrogen.  Thank you so much for your warmth and kindness and I'd like to wish you a very happy new year and all the best for 2019. x

[PurplePelican]

I understand the first pass issue and I am working on an alternative explanation that's not ready for prime time. I discount the first pass theory some because if the liver doesn't see it on the first pass, it will on the second, third, forth and so on. Eventually all of the estrogen will visit the liver and at the rate blood flows, the time period will be fairly short. In any case whatever the reason, it sounds like pills are best avoided in cases like yours.

It's actually less to do with the liver and more to do with passing to the blood from the digestive tract - which every admin method other than swallowing the pills avoids.