Suddenly going off HRT, should I expect side effects?

[Miss Kitty]

Heya gurls,

So my bottom surgery is in 2 weeks time and the hospital has asked that I stop taking my hormones 2 weeks prior to the operation. I am wondering what, if any, side effects I should expect from suddenly withdrawing from them. I am on Progynova and Androcur daily (I have been on them for 13 months) and I am worried that I will have violent mood swings.

I have severe untreated type 2 Bipolar and I am deeply concerned that going off HRT will cause mood swings, depression and heightened gender dysphoria. Has any one else had a similar experience and should I be worried or just celebrating over becoming my true self in 2 weeks?

Thanks a bunch guys and my apologies if this question has been asked a million times before.


<dosages removed by moderator>

[Ryuichi13]

I'm going to be honest, I never understood why doctors make you "go off HRT" before any kind of GCS surgery.  Do they also make cis people take hormone blockers before any kind of genital surgery?  No?  I didn't think so.  I'm hoping to have top surgery this time next year, and I expect my surgeon to also instruct me as to "stop taking your HRT before surgery"

To be honest, I've always wondered if it was some kind of gatekeeping. 

Anyone and everyone is welcome to prove me wrong.  I'll gladly read any articles or scientific studies that prove there's some reason as to why transpeople have to stop taking their HRT meds prior to GCS surgery.  What is the logical reasoning behind such a move?

I don't mean to hijack your thread, but it's always something I've wondered about.

Ryuichi 

[Sarah.VanDistel]

Heya gurls,

So my bottom surgery is in 2 weeks time and the hospital has asked that I stop taking my hormones 2 weeks prior to the operation. I am wondering what, if any, side effects I should expect from suddenly withdrawing from them. I am on Progynova and Androcur daily (I have been on them for 13 months) and I am worried that I will have violent mood swings.

I have severe untreated type 2 Bipolar and I am deeply concerned that going off HRT will cause mood swings, depression and heightened gender dysphoria. Has any one else had a similar experience and should I be worried or just celebrating over becoming my true self in 2 weeks?

Thanks a bunch guys and my apologies if this question has been asked a million times before.

Hi Miss Kitty!

Gone through the same almost 2 months ago, before my GCS. I was under higher doses than you <dosage removed> since 2 years and suddenly stopped both 2wk before surgery. I was expecting much worse... I did get migraine a couple of times, feelings of warmth (perhaps what is described as "hot flashes"), but no big swings in my humor, no depression, certainly no suicidal thoughts. I guess I "compensated" by being very happy about the upcoming big day! [emoji4]

I suppose this is a YMMV thing, but in my exprerience it wasn't too bad.

BTW, I too had a diagnosis of bipolar disorder type 2 from about 6 or 7 years ago, but I've been doing fine without medication. In fact, I never had any mood swings again since I began my transition, so I tend to believe that it was just yet another manifestation of dysphoria.

After surgery... I resumed the estrogen as soon as I recovered my mobility, i.e. 8 days after surgery. No more Androcur, of course.

Hope this help!

Warm regards,
Sarah

Sent from my SM-G965F using Tapatalk

<no dosages please>

[StacyRenee]

From what I understand, estrogen and progesterone (if you're on that too) are known to cause blood clots. DVT and PE (deep vein thrombosis and pulmonary embolism) are risks associated with high levels of estrogen and are increased with smoking.

When I had my orchiectomy done in January I had to stop HRT for two weeks and quit smoking for a month before surgery. It was more difficult quitting smoking that going without HRT. I barely noticed a difference. Then again, my estrogen is administered via subdermal pellets and can't really be removed. So I didn't really have to go without estrogen. I could tell my testosterone was increasing, mostly by the oiliness of my skin (which never went away).

Sent from my SM-G930V using Tapatalk

[Miss Kitty]

thanks for the responses every one. I had FFS 2 months ago, they simply gave me anti-clotting drugs the day before the surgery and I took my med's as normal. Im not sure why it would be a big deal for other surgeons to do the same thing, especially given the small fortune we are paying them.

Since we are on the topic, how does the bottom surgery affect my HRT after? So I wont be taking androgen blockers ever again? And will I be on a lower does of Estrogen? (doctor's here in Australia dont give out Progesterone as far as I know).

[Sarah.VanDistel]

Well, Miss Kitty...

FFS and GCS are two entirely different "beasts" in terms of post-op.

With my FFS, 1 year ago, I just had to stay fast 12h and I did not stop my medication, but I was walking freely <24h after surgery, so no significant period of immobilization.

This is very different from GCS, where I had to stay *strictly* bed-ridden 6 days (so a quite prolonged period of immobilization) - I could not even sit on the side of the bed! I also used compressive stockings and got a daily subcutaneous injection of a low-molecular weight heparin (nadroparin). But in my mind, if that could reduce my risk of getting a potentially fatal complication (pulmonary embolism), no problem.

As for the estrogen dosis, I will have my first post-op consultation with the endo in less than 2 weeks. My endo told me to stop the Androcur entirely and to resume the Progynova at the same dosis, but he also told me that the dosis of Progynova will probably be reduced in the future. We never talked about progesterone, so I wouldn't know.

Warm regards, Sarah

Sent from my SM-G965F using Tapatalk

[F_P_M]

You might get menopause like symptoms depending on how your body reacts so that's like, headaches, hot flushes, night sweats (those suuuuck) and some really vivid dreams. (in fact if you look up menopause symptoms those are probably what you're potentially looking at as your body will react much like a natal woman having her ovaries removed would)

But 2 weeks isn't that long ultimately, so hopefully you'll be lucky and avoid the worst of it.

Good luck and i hope surgery goes well for you!

It never occured to me, I admit, that they'd make you stop taking the hrt before surgery. Euuuugh.

[TheRitz]

Going off Estradiol and Spirol wasnt a huge problem for me.  My hormones tanked, I got a head ache for a day and I didn't necessarily feel 100% since my balance was thrown off but it wasn't anything major.

Things started to ramp up a bit in the 'menopausal' side like 1-3 weeks after surgery(symptoms varied between those weeks).  Hot flushes, more breakdowns ect ect.  A mix of not being on hormones, and another mix of no longer making the same level of T takes a bigger toll on your body imo then just stopping your meds.  Since without meds your body just balances itself back, but post surgery it might have difficulty doing so since you still dont generate estrogen on your own.

But the severity and length of such affects on me were pretty minimal and mild.  Not something i'd be overly concerned with.  Some of it  was also triggered by being alone, and in a very vulnerable state.

[GordonG]

From what I understand, estrogen and progesterone (if you're on that too) are known to cause blood clots. DVT and PE (deep vein thrombosis and pulmonary embolism) are risks associated with high levels of estrogen and are increased with smoking.

When I had my orchiectomy done in January I had to stop HRT for two weeks and quit smoking for a month before surgery. It was more difficult quitting smoking that going without HRT. I barely noticed a difference. Then again, my estrogen is administered via subdermal pellets and can't really be removed. So I didn't really have to go without estrogen. I could tell my testosterone was increasing, mostly by the oiliness of my skin (which never went away).

Sent from my SM-G930V using Tapatalk

For my Orchi I was not asked to stop my E intake. However I was asked to stop taking vitamins and other supplements. Very interesting how different doctors do different things.

[Rachel]

I was on HRT for about 2.5 years then off 2 week pre and 1 week post FFS and 2 months later 2 weeks off E and anti-T 2 days then GCS then off E for 2 weeks.

I got dull, is the best way to describe it. Lack of energy. Post op the lack of energy could be from healing.

I was off the HRT post FFS due to flying home from FFS. My sister drove me to her house post GCS hospital stay. I went back on HRT as soon as allowed.

Post GCS after 2 weeks I had some heightened depression that lasted two weeks. I think going back to work at 3.5 weeks post op was too soon but really helped my depression. I had to dilate twice a day at work and 3 times at home.

[Miss Kitty]

I really appreciate the detailed answers everyone 
My anxiety has definitely been taken down a notch, hot flashes and a few headaches seem like a small price to pay for having my deepest wish granted. My mother is coming along to Thailand for emotional support so being lonely or isolated shouldn't be a problem.