Powerful, Provocative and Controversial Subject

[Stephanie]

If I told you that there was an above average chance that HRT would give you dementia in 10-30 years time, would you still take hrt and take the chance?

[cynthialee]

yes

[Janet_Girl]

Damn straight.  At least I would have 10-30 years as a woman.  After that I won't know my own name, would I? 

[Nicky]

What's that lady, you want some plants??

[placeholdername]

If I told you that there was an above average chance that HRT would give you dementia in 10-30 years time, would you still take hrt and take the chance?

Not really a fair question when some of are 20-something while others are 50-something (and other in between).

[Asfsd4214]

Well, given that the alternative would most definitely involve my suicide 8-28 years sooner, I think I'd take the risk.

[Stephanie]

I have been reading Lierre Keith's amazing book The Vegetarian Myth, Keith devotes a chapter to soy and the phytoestrogens contain in soya and other plants.   Soya affects the human body in many ways but it has a particularly harmful effect on the brain.   This got me thinking about the effect of synthetic oestrogen/testosterone on our brains.
   There are studies that show a strong correlation between hrt and dementia in later life.   Of course these studies used genetic females as their participants, but it is probably safe to assume that the findings of these studies are relevant to transsexuals.
   There are no long term studies into the effects of oestrogen and testosterone in transsexuals.   We have absolutely no idea what harm we could be doing ourselves neurologically in the coming years.  We are at once both researcher and participant in an unorthodox and unofficial long-term study where it will lead us nobody knows.   You would be amazed at just how little is actually known and understood about the human brain.   It stands to reason that long-term hrt use must rewire the brain, just as much as it remodels the body.  However, many of us seem to assume that this 'rewiring' will be in a positive direction.  Isn't this belief based far more on wishful thinking, that scientific evidence? 
   Personally I would love to have a more feminine figure, softer smoother skin, and breasts.   I am just not sure I want to go where medical science fears to tread because the final results could be devastating.   Do not think that your doctor will step in an intervene if anything appears to be wrong, by the time negative symptoms show it might well be too late to do anything.
  To end on a more positive note I really do hope that taking hrt long-term is safe, and it was not my intention to scare you.  I just think that I will wait a few years before deciding about going on hrt long-term.


Post Merge: February 25, 2010, 07:20:34 PM
Perhaps I have just been reading too much and managed to scare myself.  I am 22 so even the smallest chance that I might be demented in 20 years terrifies me.
Science proves one thing one week and another week proves the exact opposite. 

[placeholdername]

A) plenty of people on here have been taking hormones for decades and don't seem demented

B) almost none of the wonder drugs doctors prescribe for physical and/or mental health problems have been tested for long-term effects either

I can't live my life around how it may or may not be 30 years from now, I haven't got there yet.  All I have is today, and I'd rather not waste it (even though I tend to waste it a fair amount anyway).

"Of course these studies used genetic females as their participants, but it is probably safe to assume that the findings of these studies are relevant to transsexuals."

From a scientific standpoint, that's actually not a safe assumption to make.

[Alyssa M.]

"Above average"? What does that mean? How much is average? And how much more than average are we talking about?

Millions of people still smoke, so we see how intelligent that makes us. And if it's not smoking, it's eating junk food, watching TV for hours each day, having sedentary desk jobs without a chance for exercise, not wearing enough sunblock, occasionally not buckling the seatbelt before getting on the highway, and so on. We humans are crappy at balancing risk.

Even more so with hypothetical risk -- risk that could exist in some universe, but doesn't in ours.
Post Merge: February 25, 2010, 07:35:59 PM
Also -- I'm kind of over these questions. I got what I wanted out of medicine, or at least it's a start, and it's a little silly to wonder about it. Kind of morbid and creepy too. From now on, let's ask them of cis people instead:

"YOUNG SIR: if you knew that you had a 50% chance of early-onset Alzheimer's disease and death by age 55, but could eliminate the risk by having an orchie by age 30 and going on E for the rest of you life -- would you do it?"

"MA'AM: If you knew you would die in your sleep one year from today if you didn't have a mastectomy and go an T -- would you do it? What about five years? 15? What's the magic number?"

Be careful: Answer wrong, and you'll be admitting you're not a REAL MAN or a REAL WOMAN! 

[Kay]

10 years of an at least tolerable life...perhaps even a good life....
vs. 0 years otherwise? 

I don't even have to think about that one.

[FairyGirl]

"Above average"? What does that mean? How much is average? And how much more than average are we talking about?

Millions of people still smoke, so we see how intelligent that makes us. And if it's not smoking, it's eating junk food, watching TV for hours each day, having sedentary desk jobs without a chance for exercise, not wearing enough sunblock, occasionally not buckling the seatbelt before getting on the highway, and so on. We humans are crappy at balancing risk.

Even more so with hypothetical risk -- risk that could exist in some universe, but doesn't in ours.

Also -- I'm kind of over these questions. I got what I wanted out of medicine, or at least it's a start, and it's a little silly to wonder about it. Kind of morbid and creepy too. From now on, let's ask them of cis people instead:

"YOUNG SIR: if you knew that you had a 50% chance of early-onset Alzheimer's disease and death by age 55, but could eliminate the risk by having an orchie by age 30 and going on E for the rest of you life -- would you do it?"

"MA'AM: If you knew you would die in your sleep one year from today if you didn't have a mastectomy and go an T -- would you do it? What about five years? 15? What's the magic number?"

Be careful: Answer wrong, and you'll be admitting you're not a REAL MAN or a REAL WOMAN! 

omg that's such a good answer!

[Asfsd4214]

I'm still waiting for anybody, anywhere, to explain to me how an MTF and someone with CAIS differ as far as the effects of HRT outside of the fact that the MTF was exposed to androgens for a period of time first.

We put all this stock in the idea that our bodies "weren't meant" to have whatever hormones we administer, but that's really just a perception. Unless you believe in god, there's not much "meant", there just "is". And what "is" is that both males and females are humans and respond in much the same way to exposure to whichever hormones are administered, depending of course on the time they are administered.

Now, yes, synthetic estrogenic chemicals like ethyilestradiol or the various unusual estrogens in premarin, certain dosages, and frequency of administration could all have effects in your long term health prospects. But taking into account that I doubt any of us are doctors, what reason would there be that makes XY's so different to XX's, or vice versa, when in the presence of the same hormonal influences?

And anyway, speaking only for myself, and frankly if you interpret any of this as a "more trans than thou" comment, I'm sorry but that's in your head not my intention. I for one DO NOT CARE if it increases my risks of various things. I DO NOT want to live as a male, not now, not ever, so if only for me, whatever risks I'm taking, whatever I might end up having happen as a result of HRT, is still better than the alternative. And I actually faced a situation not that unlike this when I was about to start. I have multiple sclerosis and hormonal influences are absolutely linked to differentiated disease activity in MS, and studies have shown that "males" with low testosterone fare worse and have more CNS damage. But I knew at the time that even if this causes a severe reaction with MS, anything is better than living as a male to me at this point.

And really, if we step back into reality for a moment, there's NO evidence and as far as I know no reason to believe that bioidentical HRT at correct dosages poses THAT much of a risk. The birth control pill absolutely does, but it's ethyl estradiol administered to people who already have a normal hormonal cycle.

So yeah, that's my thoughts on this.

[Nicky]

I think the title of this topic was much more provocative than the subject.

[Asfsd4214]

Something else to keep in mind, is that most of the studies involving HRT, involve its use in women past menopause, when their body was "meant to" have lower levels of estradiol.

Truth is we really don't know much about what it would do in simply creating a similar age appropriate hormonal profile with the same chemicals. But we already do it in the treatment of various life long hormonal deficiencies in women.

There are MILLIONS of small things everybody does that increases or decreases their risks for various future illnesses. Smoking, obesity, alcohol consumption just being among the largest, just small but long term things in your diet can increase your risk of various things including dementia.

[rejennyrated]

My partner and I are both already past 30 years of taking hormones.

Not only so but we have taken various hormones over that time as the science has been refined. Some of the early ones were pretty rough compared to those available now.

As far as I know neither of us is demented. Last year I successfuly studied for a university postgraduate degree which revealed no appreciable mental deterioration since I was in my twenties.

Now... errr.... what was that question again

[LordKAT]

If I can't live as myself then why live? I think some of us feel the same way. I am garbage right now but don't expect to be a precious gem in the future. I'll be happy being a ...garnet?!

[Hannah]

We have absolutely no idea what harm we could be doing ourselves neurologically in the coming years

The potential negative effects of three inch slices into the wrist are considerably more dangerous in terms of lifespan. I don't think it's more trans than thou at all to say we want out of these bodies, now, by whatever means possible.

Also, as a side note, we know exactly how the brain works. We don't know for sure how some of the medicines we use on it work and that gives rise to the misconception that brains are some mysterious thing; but the actual organ is pretty well understood. The only thing we haven't found yet is the actual origin of thought, but we are hot on the trail.

[Asfsd4214]

The potential negative effects of three inch slices into the wrist are considerably more dangerous in terms of lifespan. I don't think it's more trans than thou at all to say we want out of these bodies, now, by whatever means possible.

Also, as a side note, we know exactly how the brain works. We don't know for sure how some of the medicines we use on it work and that gives rise to the misconception that brains are some mysterious thing; but the actual organ is pretty well understood. The only thing we haven't found yet is the actual origin of thought, but we are hot on the trail.

Also, saying we have "absolutely no idea what harm we could be doing to ourselves" is not really accurate. We don't have a complete idea of what we could be doing to ourselves, but we do have some idea of the risks, studies have been done that DO relate to us, and they indicate the risks as far as neurological harm are mild to nonexistent.

[pebbles]

When I was studying spiro oddly I got this
http://en.wikipedia.org/wiki/Spironolactone#Other_potential_benefits

It has been suggested that spironolactone can reduce the risk of Alzheimer's disease. In one study, researchers observed a reduction in the risk of Alzheimer's specifically associated with potassium-sparing diuretics. Unpublished findings from other studies, including the Gothenberg Study have suggested that higher potassium levels may be associated with a lower risk of dementia.

[Arch]

It stands to reason that long-term hrt use must rewire the brain, just as much as it remodels the body.  However, many of us seem to assume that this 'rewiring' will be in a positive direction.  Isn't this belief based far more on wishful thinking, that scientific evidence?

Going in, I knew that I might not be pleased with absolutely every effect that I got from HRT--mental as well as somatic. I was assuming that every responsible person takes this approach. I also knew that there was no real information about long-term hormone use. And I have not seen any evidence either way. If you have some references, I would love it if you PMed me.

I see a lot of fuss about synthetic versus natural substances, but most of it appears to be dogmatic hoopla without real scientific basis.

But in the end, it really doesn't matter for me. I firmly believe that I would not have lived much longer if I hadn't transitioned when I did. Whatever happens happens. It took me twenty years to decide to transition. Much of that time, I was miserable. If I get another twenty years of reasonably happy and useful life, well, that's not as much as I was hoping for, but it's better than the last twenty years. I'll take it.

P.S. I was worried about the long-term effects of Wellbutrin, but I came to the conclusion that I was better off alive and on it than dead or catatonic or institutionalized off it. I was willing to take my chances. I was on it for seven years and knew full well that the long-term risk was unknown. And I was willing to live with that. We make such decisions every day with a variety of medications that haven't been extensively studied. As far as I'm concerned, HRT is no different.