A week into HRT and kinda bummed

[Melody Maia]

Well, today marks a week into my HRT and really haven't noticed much, either mental or physical. Maybe just slightly more tranquil. Not any more emotional than before. I guess I shouldn't be surprised since it is such a short period of time, but I suspect my E dose is not nearly enough to do much especially since I am not on any T suppressors. Sigh. I guess I will have to ride out the month until my new blood work shows the endo that things aren't really moving.

[V M]

It takes time to get things goin' and the Dr. has to do a bit of trial and error to get your dosages right

I only noticed slight changes after the first month and noticed more significant changes every three months and my dosages were adjusted a few times over the past year

[Janet_Girl]

I did not really see a lot of changes till about 6 month mark.  And as Virginia said the doctor will adjust things as needed.  He might put you on an Anti-androgen at the next appointment.  Also don't be afraid to mention your concerns and wants.  It is your transition, not the doctors.

[Melody Maia]

Thank you ladies. I know it is unrealistic to expect any changes after a week, but it is good to hear about your experiences. I will keep my wants in mind next time I see him Janet. Thanks.

[BunnyBee]

Be patient .  Change takes time.  Focus on that feeling of tranquility.  Isn't it amazing?  That sense of peace was the first thing I noticed too and it came right away, within a couple days, for me also.

And the great news is, through all the good and bad I've been through since, that feeling has not left and it really has helped keep me grounded through it all.

[Melody Maia]

Be patient .  Change takes time.  Focus on that feeling of tranquility.  Isn't it amazing?  That sense of peace was the first thing I noticed too and it came right away, within a couple days, for me also.

And the great news is, through all the good and bad I've been through since, that feeling has not left and it really has helped keep me grounded through it all.

It was funny, the first day I actually felt pretty loopy. Like I was a little high on something. Things did smooth out the next day though. I do like it though. Compared to my volatile past, it is calming.

[Asfsd4214]

I didn't notice any of the supposed mental changes HRT brings. I didn't feel much calmer. I'm perhaps less prone to anger than before, but it's hard to say.

I most definitely am on a correct course of HRT (blood work all in normal female range), and the only changes I have ever noticed from HRT are appearance changes over time.

To be honest, I question how much of the immediate psychological effects people report are real and how many are placebo effect. Placebo effect is extremely powerful

[jennajane]

Hi Melody, I am on day 14 of HRT so I can relate.  I haven't noticed much either, some small things, but it is hard to know if that is just normal variation or a result of the HRT.  I do feel good, and that is what I am trying to focus on.  One thing I have noticed is that I don't sweat as much in hot yoga class, but no big cries or anything.  But at least we are on the right path!!!!
A+
Jenna

[pebbles]

without T suppressors you won't get much effect as T counters E absorbsion. You have to take a huge dose of E to get any effects... It's why the FTMs don't take E blockers normally T dose it for them.

[Rosemary]

Be patient melody because these things will take time.
I only realized by looking back how much I changed. it is kind of like growing: you don't feel it but you will see it later on.

[Melody Maia]

without T suppressors you won't get much effect as T counters E absorbsion. You have to take a huge dose of E to get any effects... It's why the FTMs don't take E blockers normally T dose it for them.

I think what my Endo is initially trying to do is fool my pituitary into shutting down T production with my E dose. After 30 days I am to double my dose of E. Does that make sense?

[pheonix]

without T suppressors you won't get much effect as T counters E absorbsion. You have to take a huge dose of E to get any effects... It's why the FTMs don't take E blockers normally T dose it for them.

Honestly that's a YMMV thing.  If your testosterone levels are low to begin with T-blockers are far less essential.

[Melody Maia]

Honestly that's a YMMV thing.  If your testosterone levels are low to begin with T-blockers are far less essential.

My T level as tested a couple of weeks ago was 269. I understand that normal for a male is 200-900 or something like that. At first blush, 269 seems like low normal for a male, but without a good idea of the distribution along the 200-900 for males, I have no idea what my number means except to say that it isn't below normal. I will say that I have pretty androgynous features with a high pitched voice, gynecomastia, not much of an adam's apple and somewhat softer features than you normally see in a male. I am also only 5'6" tall. Maybe my endo took all of this into account too? Don't know, but I guess my blood test in three weeks will reveal all.

[pheonix]

If you're starting out at 269, you likely won't need a full dose of Spiro.   If the t your body produces hasn't really masculinized you, then the Estrogen won't need to work that hard to overcome it. 

It also kind of explains why you haven't felt big emotional changes -- you probably weren't very t-driven to begin with.

I know you are anxious for results, but it sounds like your endo probably did take your physical condition into account (and potentially rightfully so).  While your T-levels could be low for many reasons, one potential issue is your body may be out of balance hormonally.  If so a slow gradual approach is essential to avoid a spike which could unexpectedly bring your e to an unsafe level.

[Melody Maia]

If you're starting out at 269, you likely won't need a full dose of Spiro.   If the t your body produces hasn't really masculinized you, then the Estrogen won't need to work that hard to overcome it. 

It also kind of explains why you haven't felt big emotional changes -- you probably weren't very t-driven to begin with.

I know you are anxious for results, but it sounds like your endo probably did take your physical condition into account (and potentially rightfully so).  While your T-levels could be low for many reasons, one potential issue is your body may be out of balance hormonally.  If so a slow gradual approach is essential to avoid a spike which could unexpectedly bring your e to an unsafe level.

Thank you so much Phoenix. It makes me feel better and answers some lingering questions for me. Not very t-driven is probably right. I have always thought I might be somewhat more emotional than the average guy and not as aggressive. My desire for orgasm/sex has always been much more about relieving my dysphoria, not a drive for the experience itself. I am anxious to see what happens when my equipment and brain match up one day!

My E level was 45, also male normal range. I am under instructions by my endo to continue on my current dose for 30 days, get blood work, then double my dose for the next thirty and then come see him. It does sound like a gradual ramping up.

[JennX]

Well, today marks a week into my HRT and really haven't noticed much, either mental or physical. Maybe just slightly more tranquil. Not any more emotional than before. I guess I shouldn't be surprised since it is such a short period of time, but I suspect my E dose is not nearly enough to do much especially since I am not on any T suppressors. Sigh. I guess I will have to ride out the month until my new blood work shows the endo that things aren't really moving.

I'm just at about 60 days on both E + Spiro and have noticed no to little changes. No dramatic bursting into tears moments or anything like that. Nipple soreness and that's about it. Maybe slightly calmer, more mellow and laid back perhaps.

without T suppressors you won't get much effect as T counters E absorbsion. You have to take a huge dose of E to get any effects... It's why the FTMs don't take E blockers normally T dose it for them.

Exactly. I'm not sure why some docs prescribe MTF patients E w/o any sort of andro-blocker.

I think what my Endo is initially trying to do is fool my pituitary into shutting down T production with my E dose. After 30 days I am to double my dose of E. Does that make sense?

I'm not so sure this is the reason. The pituitary gland doesn't produce testosterone. Testosterone is mostly produced by the testes and a small amount by the adrenal glands above the kidneys. The pituitary sends signals to other glands to start, stop, increase, decrease hormone production. This is why it's often called the master gland. It does produce hormones, just not testosterone.

Did you ask him specifically why he didn't prescribe Spiro or another andro blocker?

My T level as tested a couple of weeks ago was 269. I understand that normal for a male is 200-900 or something like that. At first blush, 269 seems like low normal for a male, but without a good idea of the distribution along the 200-900 for males, I have no idea what my number means except to say that it isn't below normal. I will say that I have pretty androgynous features with a high pitched voice, gynecomastia, not much of an adam's apple and somewhat softer features than you normally see in a male. I am also only 5'6" tall. Maybe my endo took all of this into account too? Don't know, but I guess my blood test in three weeks will reveal all.

I have a very similar history. My T level was lower than yours pre-HRT. Low 200s (based on an average of 3 different tests over 60 days). My voice is also naturally on the high side and my voice is definitely the thing that helps me pass the most. No Adams Apple here either, and I had little body and facial hair to begin with. I'm 5'11", but my hands and feet are closer to a normal female size than a male size.

Here's a good chart showing the "normal range" of male testosterone levels:
http://www.mens-hormonal-health.com/normal-testosterone-levels.html
As you can see by looking at the last chart, anything below 500-600 ng/dl would be in the "below normal" range.

When I was looking for a doc/endo, some told me they like to start patients on E only (low dose) to see how they'll react. Like 25% of the usual max dosage. Others like to jump in somewhere in the middle with a higher dosage of E and Spiro, and some point later add Finasteride. At some point soon, your doc should prescribe Spiro to block the action of Testosterone. That's pretty much the usual course of treatment I found after speaking to several different endos and a SRS surgeon, all of which specialize in MTF patients.

[Stephanie]

I have been on HRT almost 14 days and I have noticed quite a few changes.  These changes are almost entirely psychological.  My gender dysphoria has been greatly reduced in intensity and frequency.  I have also had much more energy these last two weeks and I feel so much calmer, centred and optimistic about the future.

[V M]

I was low T to start with for my age so I was taken off of spiro after just a few months... My E was increased and then later decreased then progesterone was added

I'll find out tomorrow or next week if any more changes will be made  (one year check up thingy)

[pheonix]

I have been on HRT almost 14 days and I have noticed quite a few changes.  These changes are almost entirely psychological.  My gender dysphoria has been greatly reduced in intensity and frequency.  I have also had much more energy these last two weeks and I feel so much calmer, centred and optimistic about the future.

But how much of those "changes" are simply a placebo effect because you've taken a major, concrete step towards resolving your GID?  It is even possible to separate which is which?

[Melody Maia]

JennX,
Yes, sorry I wasn't more specific. He meant E levels could fool the pituitary to tell the testes to shut down T production. At least, that is how I understood it. He seemed to believe I might not need spiro, but I think that will depend on my next test results.