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Progesterone Is Important for Transgender Women’s Therapy

Started by Jessica, March 09, 2019, 06:44:42 PM

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0 Members and 1 Guest are viewing this topic.

Laurie

  I have been taking bio-identical micronized progesterone daily for about a year now. I believe my breasts have become a little fuller by taking it. But what is a better reason for me to take it is those listed in the article. These are summarized in the conclusion.

QuoteConclusion

Oral micronized progesterone, a fundamental ovarian steroid, molecularly identical to the natural hormone, should be added to E2 for transgender women based on physiology and emerging evidence of the importance of progesterone with E2 for ciswomen's bone and likely cardiovascular health. Progesterone will probably prevent at least some of the negative cardiovascular system and bone health effects reported in transgender women on current long-term, E/E2-only, or E/E2 antiandrogen CHT. Progesterone will also aid antiandrogen effects through different pathways than spironolactone or cyproterone acetate and may promote feminine physiological breast maturation, while also aiding disturbed sleep and perhaps decreasing anxiety. It may also facilitate transgender women's acceptance of physiological (rather than high) E2 doses ideally delivered transdermally. Evidence is mounting that ciswomen's lifelong health is enhanced by sufficient P4 (normally ovulatory) within regular estradiol-sufficient monthly menstrual cycles. I believe it is time that we now follow current guidelines and provide transgender women with these P4 or progesterone benefits in their CHT.
April 13, 2019 switched to estradiol valerate
December 20, 2018    Referral sent to OHSU Dr Dugi  for vaginoplasty consult
December 10, 2018    Second Letter VA Psychiatric Practical nurse
November 15, 2018    First letter from VA therapist
May 11, 2018 I am Laurie Jeanette Wickwire
May   3, 2018 Submitted name change forms
Aug 26, 2017 another increase in estradiol
Jun  26, 2017 Last day in male attire That's full time I guess
May 20, 2017 doubled estradiol
May 18, 2017 started electrolysis
Dec   4, 2016 Started estradiol and spironolactone



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Linde

My question is, who of you took/takes progesterone, and has no testicles anymore?  What effects will progesterone have for people like I?
It would be great if I could get some anecdotal information on this, to be able to talk with my Endo about it.
02/22/2019 bi-lateral orchiectomy






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TonyaW

Quote from: Jessica on March 09, 2019, 08:45:38 PM
My big sisters says....

The side effects of the synthetic version are not observed with the bio-identical
Didn't go that route to start due to cost and usually tolerating drugs pretty well.  Cost of micronized is more reasonable now so asked about trying it at my December appointment.

Sent from my SM-G930T using Tapatalk

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KayXo

Doctors, media and many other entities tend to sometimes confuse progesterone with other progestogens, namely medroxyprogesterone acetate.

PROGESTERONE is the hormone that is naturally produced in the human body, in greater quantities in women during the second part of their menstrual cycle and in very high quantities during pregnancy. It is available as oral Prometrium or Utrogestan, in suppositories as Cyclogest and as IM injection and it can also be compounded. During pregnancy, it is sometimes prescribed to women to prevent miscarriage or preterm delivery. It is also prescribed to women going through in-vitro fertility. The vast majority of studies have shown it DOES NOT increase breast cancer risk. Pregnancy, a time when progesterone levels are VERY high, has also been associated with a decreased risk of breast cancer.

MEDROXYPROGESTERONE ACETATE, on the other hand, was associated in a very large randomized trial from 2003 (Women's Health Initiative), with an increase in breast cancer incidence relative to women who weren't taking it. The bad press comes from this progestogen and also other progestogens that have been linked in other numerous studies to an increased risk of breast cancer and cardiovascular morbidity. This progestogen is NEVER prescribed to pregnant women as it can be mildly androgenic and can be harmful for the female fetus. It is not produced in the human body. It has also been associated with an increased risk of clots, been reported to adversely affect the cardiovascular system and sometimes dysregulate mood.

The issue with medroxyprogesterone acetate has mostly to do with its adverse effects on the cardiovascular system, breast tissue and coagulation whereas progesterone appears to have none of those adverse effects. MPA reduces estrogen's beneficial effects on lipids and vasodilating effects in arteries. Medroxyprogesterone is also slightly androgenic (activates androgen receptors) in contrast to progesterone which does not.

Progesterone production does not usually start in ciswomen until about Tanner 4 stage breast development. The passage to Tanner 5 stage breast development, significant (in terms of size/shape) according to Tanner scale/diagram, may be mediated by progesterone.
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
  •  

Jessica

@KayXo

Quote from: KayXo on March 10, 2019, 09:03:20 AM
Doctors, media and many other entities tend to sometimes confuse progesterone with other progestogens, namely medroxyprogesterone acetate.

PROGESTERONE is the hormone that is naturally produced in the human body, in greater quantities in women during the second part of their menstrual cycle and in very high quantities during pregnancy. It is available as oral Prometrium or Utrogestan, in suppositories as Cyclogest and as IM injection and it can also be compounded. During pregnancy, it is sometimes prescribed to women to prevent miscarriage or preterm delivery. It is also prescribed to women going through in-vitro fertility. The vast majority of studies have shown it DOES NOT increase breast cancer risk. Pregnancy, a time when progesterone levels are VERY high, has also been associated with a decreased risk of breast cancer.

MEDROXYPROGESTERONE ACETATE, on the other hand, was associated in a very large randomized trial from 2003 (Women's Health Initiative), with an increase in breast cancer incidence relative to women who weren't taking it. The bad press comes from this progestogen and also other progestogens that have been linked in other numerous studies to an increased risk of breast cancer and cardiovascular morbidity. This progestogen is NEVER prescribed to pregnant women as it can be mildly androgenic and can be harmful for the female fetus. It is not produced in the human body. It has also been associated with an increased risk of clots, been reported to adversely affect the cardiovascular system and sometimes dysregulate mood.

The issue with medroxyprogesterone acetate has mostly to do with its adverse effects on the cardiovascular system, breast tissue and coagulation whereas progesterone appears to have none of those adverse effects. MPA reduces estrogen's beneficial effects on lipids and vasodilating effects in arteries. Medroxyprogesterone is also slightly androgenic (activates androgen receptors) in contrast to progesterone which does not.

Progesterone production does not usually start in ciswomen until about Tanner 4 stage breast development. The passage to Tanner 5 stage breast development, significant (in terms of size/shape) according to Tanner scale/diagram, may be mediated by progesterone.

This is certainly one of the stumbling blocks for many to get.  Thank you for putting this in such a good fashion, so others will understand.  Hopefully endocrinologists will read the article and "get it".

"If you go out looking for friends, you are going to find they are very scarce.  If you go out to be a friend, you'll find them everywhere."


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Paige

Thanks Jessica for starting this thread on this very interesting article.
Paige :)
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Linde

Quote from: Jessica on March 10, 2019, 10:49:31 AM
@KayXo

This is certainly one of the stumbling blocks for many to get.  Thank you for putting this in such a good fashion, so others will understand.  Hopefully endocrinologists will read the article and "get it".
I am pretty sure, mine will not!  He is to full of himself to accept anything others did!  I will change him out, as soon as I find another one who seems to be competent
02/22/2019 bi-lateral orchiectomy






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CindyLouFromCO

My experience of taking Micronized Progesterone has been nothing but positive.  Mostly because I no longer need to take a AA and fat redistribution increased amazingly!  I love my body now.  I can't be more happier other than I have to get most of my clothes tailored to hug my hourglass shape.  Size 4 to 8 fits ok, but not skinny enough around the waist.  I'm very happy taking Progesterone.  I totally agree with this topic!
I've taken what others have offered, so now I'm giving back.
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pamelatransuk

Thank you Jessica for this extremely informative and recent (January2019) article.

Purely by coincidence I decided in February to raise the possibility of starting Progesterone with my Endo mainly for the reason of having no areolae increase but also because I have previously had poor bone density (osteoporosis).

My Endo has been considering taking my medical history and recent Blood tests into account, and I shall be starting on Progesterone (Utrogestan) in the next few days.

I hope this latest detailed and thorough analysis reaches many other specialists in transgender care in US, in UK, indeed worldwide.

Hugs to all

Pamela  xx


  •  

Jessica

Quote from: pamelatransuk on March 12, 2019, 08:04:05 AM
Thank you Jessica for this extremely informative and recent (January2019) article.

Purely by coincidence I decided in February to raise the possibility of starting Progesterone with my Endo mainly for the reason of having no areolae increase but also because I have previously had poor bone density (osteoporosis).

My Endo has been considering taking my medical history and recent Blood tests into account, and I shall be starting on Progesterone (Utrogestan) in the next few days.

I hope this latest detailed and thorough analysis reaches many other specialists in transgender care in US, in UK, indeed worldwide.

Hugs to all

Pamela  xx

Congratulations Pamela, maybe start a thread like I did in Jess's progesterone experiences to document your experiences or add them here on this thread. 
I'm certain it will be helpful.

Hugs and smiles, Jessica

"If you go out looking for friends, you are going to find they are very scarce.  If you go out to be a friend, you'll find them everywhere."


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Jessica

Has anyone experienced "night sweats" while taking progesterone?  I woke in the middle of the night drenched after taking my first dose last night.

"If you go out looking for friends, you are going to find they are very scarce.  If you go out to be a friend, you'll find them everywhere."


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judithlynn

#31
Hi Everyone;
I am a complete convert to Micronised Progesterone. I take Promethium  (one capsule) at bedtime. I have been on Progynova for  nearly 6 years now and after Promethium became available in Australia about a year ago, I persuaded my doctor to also prescribe it to me as part of my HRT. I should say that I have never been on Blockers (this time around in my "2nd" transition).  Part of the reason was when I started  my {2nd) transition 6 years ago my T was very low and my doctor indicated that it was the E ie Progynova that would work best.

Over the last year my Doctor initially put me on Promethium taken daily (contunously). I was on that regime for about 3 months, but I found that it really was too much for me, making me very moody and irritable (sometimes described as a bit crazy). Since I have gone onto a  2 weeks off and 2 weeks on cycle I have become so much better.

Effectively I am on an Estrogen only regime (take twice a day ) at 10am and 10pm for Days 1-14, then on Day15 I take initially 2 capsules of Promethium at 10pm as a combined regime until about Day 20-22, the slipping back to 1 capsule at night time and Proynova once a day until day 30. Around  the mid month period I do get moody and a girlfriend reckons I go into a pseudo PMS stage, but after 2 days on the combined regime I am literally on top of the world. I described it elsewhere saying that for the first half of the month, I feel I just want to lounge about (jeans grungy look), but once on the combined regime after my Pseudo PMS stage, I really feel ultra feminine. I love going out with girlfriends, shopping,  really focusing on looking great on my make-up (the first  part of the month I probably only bother with Lipstick and eyeliner and a little mascara, spending at most 5 minutes on my make up routine. The second half I can easily spend 60 minutes getting ready to go out, wearing some great clothing combinations and feeling on top of the world, with my makeup (Bare Minerals foundation, highlighter, glow, blusher, eye shadow, eyebrows, eyeliner,  mascara, lip pencil, lipstick, perfume etc etc).

After a year on the combined regime, I have had increased areola growth (almost Tanner stage 5,) my breasts have achieved larger upper pole development (I am now a Small C Cup and I have much more pronounced buttocks. (adding about 4" to them)  Lots of girlfriends have commented on my new curves.

So I am a big favourite of the combined regime.

I did though get some hot flashes intially when I started on the Progesterone and also when I went onto a Cycle, which by the way mimics a Cis gender female  hormone levels with Progesterone falling offer rapidly and Estrogen generally a slower curve from Days 22.

The only other thing was that when I started on it I did experience some lactation in the breasts. My doctor did pre-warn about it and has been checking my Prolactin levels. With the plan to reduce the Progesterone if I generate too much fluid. So far I haven't  had the increase in fluid leakage, with Progesterone levels adequate to Cis gender female hormonal levels.

JudithLynn

:-*
Hugs



  •  

Kirsteneklund7

Quote from: judithlynn on March 12, 2019, 11:18:51 PM
Hi Everyone;
I am a complete convert to Micronised Progesterone. I take Promethium  (one capsule) at bedtime. I have been on Progynova for  nearly 6 years now and after Promethium became available in Australia about a year ago, I persuaded my doctor to also prescribe it to me as part of my HRT. I should say that I have never been on Blockers (this tome around in my "2nd" transition).  Part of the reason was when I started  my {2nd) transition 6 years ago my T was very low and my doctor indicated that it was the E ie Progynova that would work best.

Over the last year my Doctor initially put me on Promethium taken daily (contunously). I was on that regime for about 3 months, but I found that it really was too much for me, making me very moody and irritable (sometimes described as a bit crazy). Since I have gone onto a  2 weeks off and 2 weeks on cycle I have become so much better.

Effectively I am on an Estrogen only regime (take twice a day ) at 10am and 10pm for Days 1-14, then on Day15 I take initially 2 capsules of Promethium at 10pm as a combined regime until about Day 20-22, the slipping back to 1 capsule at night time and Proynova once a day until day 30. Around  the mid month period I do get moody and a girlfriend reckons I go into a pseudo PMS stage, but after 2 days on the combined regime I am literally on top of the world. I described it elsewhere saying that for the first half of the month, I feel I just want to lounge about (jeans grungy look), but once on the combined regime after my Pseudo PMS stage, I really feel ultra feminine. I love going out with girlfriends, shopping,  really focusing on looking great on my make-up (the first  part of the month I probably only bother with Lipstick and eyeliner and a little mascara, spending at most 5 minutes on my make up routine. The second half I can easily spend 60 minutes getting ready to go out, wearing some great clothing combinations and feeling on top of the world, with my makeup (Bare Minerals foundation, highlighter, glow, blusher, eyes, eyebrows, eyeliner,  mascara, lip pencil, lipstick, perfume etc etc).

After a year on the combined regime, I have had increased areola growth (almost Tanner stage 5, my breast have achieved larger upper pole development (I am now a Small C Cup and I have much more pronounced buttocks.  Lots of girlfriends have commented on my new curves.

So I am a big favourite of the combined regime.

I did though get some hot flashes intially when I started on the Progesterone and also when I went onto a Cycle, which by the way mimics a Cis gender female  hormone levels with Progesterone falling offer rapidly and Estrogen generally a slower curve from Days 22.

The only other thing was that when I started on it I did experience some lactation in the breasts. My doctor did pre-warn about it and has been checking my Prolactin levels. With the plan to reduce the Progesterone if I generate too much fluid. So far I haven't  had the increase in fluid leakage, with Progesterone levels adequate to Cis gender female hormonal levels.

JudithLynn
Just had a good read Judithlynn. Thanks so much for putting this out there. I will read this again after work. Sounds like progesterone really does get results.

I will definately speak to my prescribing doctor about P.

Kindest regards, Kirsten.

Sent from my SM-G930F using Tapatalk

As a child prayed to be a girl- now the prayer is being answered - 40 years later !
  •  

judithlynn

Hi Kirsten;
The important thing to ask for is Micronised Progesterone - Promethium by Besins (that's the name of the manufacturer). The other option if you are Post Op is utrogestan. This is a pessary that you insert in your vagina.
Best
JudithLynn
:-*
Hugs



  •  

Ellement_of_Freedom

Promethium is an element. Prometrium is the progesterone capsule by Besins.


FFS: Dr Noorman van der Dussen, August 2018 (Belgium)
SRS: Dr Suporn, January 2019 (Thailand)
VFS: Dr Thomas, May 2019 (USA)
  •  

Jessica


"If you go out looking for friends, you are going to find they are very scarce.  If you go out to be a friend, you'll find them everywhere."


  •  

pamelatransuk

Just to confirm that Utrogestan (which is bio-identical) can also be taken orally.

Hugs

Pamela


  •  

Kirsteneklund7

Quote from: judithlynn on March 13, 2019, 09:24:17 PM
Hi Kirsten;
The important thing to ask for is Micronised Progesterone - Promethium by Besins (that's the name of the manufacturer). The other option if you are Post Op is utrogestan. This is a pessary that you insert in your vagina.
Best
JudithLynn
Judithlynn
Thank you so much again. Yes I really wish I did have a vagina- I am doing my best to cultivate that eventuality. I know you have mentioned the correct Besins product in previous posts. I cant help but think the cycling regimen is the most efficacious.

If It results in C cups instead of B and a bum that can rock a dress I dont know if I could handle that much euphoria all at once!

Yours truly, Kirsten.
Sent from my SM-G930F using Tapatalk
As a child prayed to be a girl- now the prayer is being answered - 40 years later !
  •  

Kirsteneklund7

Quote from: pamelatransuk on March 14, 2019, 05:26:12 AM
Just to confirm that Utrogestan (which is bio-identical) can also be taken orally.

Hugs

Pamela
Thank you Pamela,
It is important to ascertain what bio-identical products are available.

Please tell me are you seriously considering P as well ?

With curvaceous wishes, Kirsten.

Sent from my SM-G930F using Tapatalk

As a child prayed to be a girl- now the prayer is being answered - 40 years later !
  •  

pamelatransuk

Quote from: pamelatransuk on March 12, 2019, 08:04:05 AM
Thank you Jessica for this extremely informative and recent (January2019) article.

Purely by coincidence I decided in February to raise the possibility of starting Progesterone with my Endo mainly for the reason of having no areolae increase but also because I have previously had poor bone density (osteoporosis).

My Endo has been considering taking my medical history and recent Blood tests into account, and I shall be starting on Progesterone (Utrogestan) in the next few days.

I hope this latest detailed and thorough analysis reaches many other specialists in transgender care in US, in UK, indeed worldwide.

Hugs to all

Pamela  xx

Yes Kirsten I am indeed starting within days and will confirm so on my HRT thread next week.

Thank you for your kind compliment and curvaceous wishes to you too!

Hugs

Pamela  xx


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