Susan's Place Transgender Resources

*I hope this doesn't break any rules. If it does then please delete or edit as you see fit*

Hi everyone. I had my second appointment with the endo today. It seemed to go by so fast, and the doctor gave a lot of information and then told me what he was going to use.   Anyway I got my first estradiol depo. It's good to finally be on my way! :)

The endo said he's starting me on these depos twice a month, adding pregosterone once a month for added breast growth. Is this unusual?

He's holding back on spiro until he sees how my T levels look after six months. My T levels are at a starting point of 10 (high?), and I'm wondering if next time I should ask for an antiandrogen too.

Does anyone have any experience with this kind of regimen?

Thanks for your input :)

Quote from: Joan on January 11, 2014, 08:49:40 AM
*I hope this doesn't break any rules. If it does then please delete or edit as you see fit*

Hi everyone. I had my second appointment with the endo today. It seemed to go by so fast, and the doctor gave a lot of information and then told me what he was going to use.   Anyway I got my first estradiol depo. It's good to finally be on my way! :)

The endo said he's starting me on these depos twice a month, adding pregosterone once a month for added breast growth. Is this unusual?

He's holding back on spiro until he sees how my T levels look after six months. My T levels are at a starting point of 10 (high?), and I'm wondering if next time I should ask for an antiandrogen too.

Does anyone have any experience with this kind of regimen?

Thanks for your input :)

10 by which unit? Because AFAIK, 10 is low, males generally have 250+.

It's not unheard of to use progesterone to reduce testosterone. My understanding is that it lowers LH and FSH, hormones that stimulate the testis to produce testosterone and sperm.

If 10 is your baseline T level, then I'm inclined to think that would be in SI units - nmol/L. If that's the case then you would be on the lower end of the male reference range (according to my lab 8 - 29 nmol/L).

Using ranges from the same lab, the female range is about 1/10 th (0.5 - 3 nmol/L)

Quote from: Joan on January 11, 2014, 08:49:40 AM
*I hope this doesn't break any rules. If it does then please delete or edit as you see fit*

Hi everyone. I had my second appointment with the endo today. It seemed to go by so fast, and the doctor gave a lot of information and then told me what he was going to use.   Anyway I got my first estradiol depo. It's good to finally be on my way! :)

The endo said he's starting me on these depos twice a month, adding pregosterone once a month for added breast growth. Is this unusual?

He's holding back on spiro until he sees how my T levels look after six months. My T levels are at a starting point of 10 (high?), and I'm wondering if next time I should ask for an antiandrogen too.

Does anyone have any experience with this kind of regimen?

Thanks for your input :)

It would be more helpful if you described what the actual test was and the units measured.  "10" is just sort of nebulous.

Quote from: ErinM on January 11, 2014, 10:56:37 AM
It's not unheard of to use progesterone to reduce testosterone. My understanding is that it lowers LH and FSH, hormones that stimulate the testis to produce testosterone and sperm.

Erin makes a very good point.

I have recently requested to start Prometrium.  Doing so would mean stopping Finasteride, since both block DHT.

I was on Finasteride alone for 7 weeks before starting Estradiol & switching to Spiro.  The Finasteride alone worked very well to stop involuntary erections, even though blocking DHT doesn't necessarily stop or reduce testosterone production.  Blocking DHT does prevent whatever T is produced from affecting us (which is why Finasteride is used to combat male-pattern-baldness).

It sounds like your doc knows what they're doing.

I've never had to take spiro.  According to my endo, it's not always necessary and he's achieved GG T levels more often than not without it.  And yes, I do take a P cycle.

This seems to be the direction that my endo is leading me. Glad to hear I'm not alone.

Mine started me on E only, he said he thought he'd be able to knock out most of my T with the E, and he was right. I am in Spiro now though. He does tell me my T and E levels when I visit but it's WOOSH totally over my head.

I also never needed spiro; in fact, I was fairly quickly at cis female levels of T on a menopausal dose of E alone.  (Post-op now, so it's moot, but that was true for the four years I was on HRT pre-op.)

Quote from: TessaMarie on January 11, 2014, 11:25:49 AM
Erin makes a very good point.

I have recently requested to start Prometrium.  Doing so would mean stopping Finasteride, since both block DHT.

I was on Finasteride alone for 7 weeks before starting Estradiol & switching to Spiro.  The Finasteride alone worked very well to stop involuntary erections, even though blocking DHT doesn't necessarily stop or reduce testosterone production.  Blocking DHT does prevent whatever T is produced from affecting us (which is why Finasteride is used to combat male-pattern-baldness).

It sounds like your doc knows what they're doing.

Finasteride is derived from progesterone.

Quote from: TessaMarie on January 11, 2014, 11:25:49 AM
I was on Finasteride alone for 7 weeks before starting Estradiol & switching to Spiro.  The Finasteride alone worked very well to stop involuntary erections, even though blocking DHT doesn't necessarily stop or reduce testosterone production.  Blocking DHT does prevent whatever T is produced from affecting us (which is why Finasteride is used to combat male-pattern-baldness).

T will still cause masculinisation, it's the main active sex hormone for that.. Blocking DHT will stop DHT doing it's thing. But blocking DHT will not entirely prevent further masculinisation..

Quote from: Ms Grace on January 11, 2014, 12:21:56 PM
Mine started me on E only, he said he thought he'd be able to knock out most of my T with the E, and he was right. I am in Spiro now though. He does tell me my T and E levels when I visit but it's WOOSH totally over my head.

I struggle with that stuff too - but always have!  My GP nows just prints the blood test results off for me before we start talking and even then, I can't focus too well.

I started on E and Spiro and continued on with Fin (taking it for 2 years now)  GP doesn't care either way about Fin and happily gave me a further prescription for it.  After 3 months, we have hit the target for both E & T levels so no tinkering required. Yay! GP mentioned P at the start but we thought we would see how things go.

Thank you all.

My baseline testosterone level is 10.4 pg/ml.  Sorry for the nebulousness. 

Grace and Emma, that's is kind of what I meant.  This guy could talk! :)  And he drew pictures with lots of arrows linking the hypothalamus (?) and the testes and then started crossing arrows out.  And though I knew what he was talking about I kept having to try to remember the  English equivalents of all these medical terms to keep up.  In a whirlwind spiro was proposed and rejected.  I can't remember the reason why :O

Anyway, thank you for all of your input Jill, Grace, Jenna Marie and Gwynne.  It's good to know that it is a fairly common regimen and that is working or has worked for you. 

I guess I wanted some more aggressive T-blocking in the hope that it would reverse some of my hair loss.  If E blocks T production then alone then maybe I don't need to worry.