Community Conversation => Transsexual talk => Male to female transsexual talk (MTF) => Topic started by: Riley Skye on December 22, 2012, 12:09:38 PM Return to Full Version
Title: Starting out
Post by: Riley Skye on December 22, 2012, 12:09:38 PM
Post by: Riley Skye on December 22, 2012, 12:09:38 PM
So pretty soon as people may or may not know I'm going to be starting HRT come january3rd :D. When i first went to my doctor he kind of confused me in saying that he wants to start me on just estrogens rather than supplementing them with an anti androgen. Whats the point in just starting out with just estrogens, to me it would make more sense in starting me out with both, which I'm going to clearly tell him when I go and visit him.
Title: Re: Starting out
Post by: crazy at the coast on December 22, 2012, 12:15:57 PM
Post by: crazy at the coast on December 22, 2012, 12:15:57 PM
He may want to see if just estrogen alone will be enough to suppress your T. Or he could just want to introduce one thing at a time and let you adjust while they do blood work. But definitely ask what his plans are for it all.
Title: Re: Starting out
Post by: A on December 22, 2012, 12:28:55 PM
Post by: A on December 22, 2012, 12:28:55 PM
To me it does not make much sense indeed. Actually, I'd think it's much better to even start with just anti-androgens, and then start E when your T is dead. Then hormonally, your development is just like a girl's, and that sounds better to me.
But it's not like your doctor is a mad scientist either. His approach does make sense in a way. Basically, in some people, just putting in E is enough to bring the testosterone down enough to make E effective. And as a general principle in medicine, you should give the smallest amount of medications required to achieve the desired results. Plus, it is true (especially in older patients) that anti-androgens are a pretty violent thing. Spiro empties you of your water and sodium, while cyproterone literally poisons testicles and is hard on the liver/kidneys/whatever.
But I disagree with that, to a point, when it comes to HRT. After all, the desired results are the maximum results, and how do you know whether you're having the maximum results if you don't ever try anything higher?
Besides, to both suppress T and get results, the dose of E required is generally higher. So there we're in a debate: What's worse? A ton of E or E and anti-androgens?
I think you should insist a little for getting anti-androgens if you believe they're right for you. After all, if testosterone is well under control, after a while, out of safety, your doctor and you can always try to slowly bring the dose down and see how your levels fare.
But it's not like your doctor is a mad scientist either. His approach does make sense in a way. Basically, in some people, just putting in E is enough to bring the testosterone down enough to make E effective. And as a general principle in medicine, you should give the smallest amount of medications required to achieve the desired results. Plus, it is true (especially in older patients) that anti-androgens are a pretty violent thing. Spiro empties you of your water and sodium, while cyproterone literally poisons testicles and is hard on the liver/kidneys/whatever.
But I disagree with that, to a point, when it comes to HRT. After all, the desired results are the maximum results, and how do you know whether you're having the maximum results if you don't ever try anything higher?
Besides, to both suppress T and get results, the dose of E required is generally higher. So there we're in a debate: What's worse? A ton of E or E and anti-androgens?
I think you should insist a little for getting anti-androgens if you believe they're right for you. After all, if testosterone is well under control, after a while, out of safety, your doctor and you can always try to slowly bring the dose down and see how your levels fare.
Title: Re: Starting out
Post by: Riley Skye on December 22, 2012, 04:05:48 PM
Post by: Riley Skye on December 22, 2012, 04:05:48 PM
thanks, ive been leaning to take both estrodial and spiro because to me it makes most sense to start off that way. I dont feel E alone will completely have the desired effects.
Title: Re: Starting out
Post by: natastic on December 22, 2012, 04:47:59 PM
Post by: natastic on December 22, 2012, 04:47:59 PM
Quote from: A on December 22, 2012, 12:28:55 PM
I think you should insist a little for getting anti-androgens if you believe they're right for you.
Seconded.
Title: Re: Starting out
Post by: JennX on December 22, 2012, 06:53:22 PM
Post by: JennX on December 22, 2012, 06:53:22 PM
The main problem with just going on Estradiol alone without any anti-androgen (ie Spiro) is that much higher dose of Estradiol will be required to achieve similar results, as compared to a lower dose of Estradiol combined with Spiro. Higher doses of Estradiol have more serious side effects and possible serious negative effects as compared to a lower dose of Estradiol combined with Spiro. HRT w/o any anti-androgen is a much riskier proposition. Why some docs continue to follow this protocol is a bewilderment to me?
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