Interesting... technically diane discussion in
susans.org is prohibited, I know because when I politely objected to the rule because my doctor was prescribing it and thus it seems like a good idea to let people mention it, I was outright ignored and my only indication that I was not to bring up that unfortunate fact of reality was that my post in the thread simply 'disappeared'. Alas,
susans.org is of the abstinence only model, believing denial of access to information and secrecy are more effective than harm reduction by open access to information.
Excuse my bitter and sarcastic minirant, I plan to make up for it with somewhat useful opinion now.
I'm going to break with the crowd here and repeat some of my own doctors information and what I have gathered. (and I assure you that despite susans assertions, she most certainly is sane and competent).
On the subject of you not getting any initial blood work, yes that's perhaps ill advised. If only because it would provide a base line of your hormone levels.
But, keep in mind, doctors don't go to the length of testing your liver function before they prescribe MOST drugs. And for all we worry about it, none of the HRT drugs (except perhaps cyprotone, which is present albeit in extremely low amounts in most birth control pills) are unusually liver toxic.
Apart from that, all they can test for is full blood counts and other measurements of very general health that again, they wouldn't worry about with most any other drugs apart from ones specifically indicated for it.
As for being prescribed the birth control pill. It is not in and of itself the worst decision made by medicine since the ECT. It most certainly does have effective feminisation, however it needs to be combined with an antiandrogen, the tiny amount of cyprotone in it isn't enough by itself. But with a correct dosage of antiandrogen, here's the only reasons you shouldn't take the birth control pill.
1. It can have more noticeable side effects like headaches, mood swings, etc. But the same is true of anybody taking birth control.
2. It is 'more' liver toxic than bioidentical HRT, and if you are over about 40, a serious smoker, then yes you really should avoid it. However if you are young and healthy, there's no more danger in taking it than any other female on birth control.
3. I'm not sure if ethylestradiol shows up on an estradiol blood test, I'm fairly sure it doesn't. But that's not a serious problem because it the estradiol levels, after a certain point, don't make a tremendous amount of difference to your results apart from speed of the results, PROVIDED you are on an effective antiandrogen like spironolactone.
My doctor offers the pill to any younger patient because in her opinion, and my observation, far from being ineffective, ethylestradiol has faster acting feminisation effects.
So yeah, in conclusion, I don't think there's a huge problem with using birth control pill in HRT, provided it's combined with an effective antiandrogen. Provided there's no reason to be concerned for your liver health.
I do think there's a problem with you being told to take ONLY the birth control pill and come back in 6 months, don't mistake anything in my post to be supporting that. You're right to look elsewhere.
