Susan's Place Transgender Resources

And it is driving me insane.

After sixteen months of high dose estradiol and spironolactone, my hormone levels are still in the male range.  I went to an endo yesterday and he suggested upping my estradiol 25% and adding progesterone.  I brought up to him that I've heard mixed reviews for its efficacy and safety.  His response was

"it is safe and efficacious"

Then I go online on Trans forums and sites and I get mixed information and it's driving me bat->-bleeped-<-.  I mean prairiedogging panic attacking crazy.

I read the insert. I understand the risks, but frankly, every medication seems to have violent death as a side effect so I have no idea what to believe.  before you naysay abou progesterone, I'd like to get the opinions of people who have actually taken it as opposed to reading about it on wikipedia.

#goingsocrazyiusedahashtag

I think it's because no one's done any research on how HRT affects us (or about just about any aspect of transgender medical treatment) so it's all conjecture one way or the other.

If you find out please let me know. I'm due for a shot of it myself at my next endo appointment in a week  ???

I think this is the usual case that no two endocrinologists agree on anything. My endo doesn't routinely use it, not for any saftey reason but she feels I would not benefit, others may. I would just trust your doctor and not get worried about it. I think I have formed the opinion that every woman whose treatment is working is happy with that treatment.

I've noticed an increase in breast growth since going on P 3 months ago, but I don't know if that is down to the P or I was due a growth spurt anyway... I'm not dead though, so if it's not going to kill me where's the harm in trying.

I've been on progesterone for the past 7 months when I first took it my testosterone level was 226 just this week it was 211 so I don't know of the effectiveness of it as far as dropping your T into a feminine range. Now I have noticed that my breast seem fuller since starting I have heard progesterone can do that but I don't know that for a fact it was the P that did it on it's on. I really don't know how safe it is I guess I've made it 7 months and I haven't dropped dead so that's a plus. But maybe you should just try it out and see how you feel if you don't like it quit.

They put me on progesterone because of my testosterone levels. Since I go to the VA, I see an endo team, not just one doctor. They believe that progesterone helps block your body from absorbing testosterone. This has allowed me to be on a lower dose of estrogen which from what they told me is the dangerous medication.

I don't know if it is related or not, but I have had good breast growth, and hip development.

I hope this helps a little.

Cindy is right.  Follow advice, but watch for changes you don't like.  Let them try to find out if P can get the E level up where it's above the average female range, and lower the T way down.  I quit taking Progesterone because I started loosing hair.  >:(.  As with anything else we take, your mileage may vary.

Quote from: Cindy on January 17, 2014, 08:25:06 AM
I think this is the usual case that no two endocrinologists agree on anything. My endo doesn't routinely use it, not for any saftey reason but she feels I would not benefit, others may. I would just trust your doctor and not get worried about it. I think I have formed the opinion that every woman whose treatment is working is happy with that treatment.

I go with this.

I also found so much mixed information that i just went for it, I have been on p for 2 months and find it has no bad effects at all, much more sensitivity in my breasts and nipples, my t was still 575 that is why i need to do or try something and I was pretty high on my spiro so this was an option my doc offered. i will blood work done this afternoon so will know in a few days how well it is defeating the production of t and will post an update when i have that data. bottom for me I have no reason to consider not keep p as a standard component of my hrt program for as long as the endo will write it in.
Jerri

P is recommended by some UK doctors but liek any other potentially dangerous medciation it is probably the basic state of health that makes some drugs kill some people - anyone doing HRT woudl be eating and drinking healthy anyway?

Thanks for your responses. I've decided I will go ahead and try the p. When i get my blood test next month, hopefully I'll see a change

Thanks again and ofc feel free to keep discussing it

Quote from: suzifrommd on January 17, 2014, 07:37:40 AM
I think it's because no one's done any research on how HRT affects us (or about just about any aspect of transgender medical treatment) so it's all conjecture one way or the other.

There's been so many studies with tens of thousands of transsexuals monitored long-term about the effects of HRT.

As far as P, don't take the advice of people on forums regarding meds. Take your docs. It will bring down T and it works in synergy with E and in MTFs who took P as opposed to ones who didn't, there's been one study, the P taking trans women had breasts identical to genetic females whereas the non-P group had tissue that could clearly be differentiated.

Wow, I can't elieve people's T levels are so high when on spiro. I stopped taking HRT for a week and a half, enough time for the body to rebound somewhat, and my T was 180. Now, I'm prolly chemically castrated as my testes have vanished.

I do wnt to go on P though for the hip and butt development as I heard it contributd to overall body feminization, so on Monday, I'm asking my doc and sking him to say it's for depression so my Medicaid covers it. They won't cover HRT in general, just methadone and suboxone, which I don't need.

here's the straight scoop of progesterone...?  it can up T levels and cause bloating.

My doctor mentioned adding it in passing at a later date. Although that has yet to come.

I don't think it's so inherently dangerous on it's own, but simply another risk factor that we're exposed to along this medication route.. And some doctors don't believe it's effective: mainly; as someone else mentioned because of lack or research. So why add in that risk if we don't know it will do anything? Also as I understand it, the risk for complications with Progesterone is somewhat higher than Estrogen.

Provera hasn't exactly blown my T number up... but perhaps down.
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I tried P + E a long time ago while still battling my T levels, on the advice of my endo. Prior to that I was on spiro + E and still had T in the male range. After just over a week, I refused to take P any longer. I felt my T levels skyrocket and I was a complete raging mess. Spiro + E had a better effect than that so I went back on that after consulting with my endo.

From experience, I'm not a fan of either P or spiro for its anti-androgenic effects. My endo tells me that they use similar indirect mechanisms to try and slow T production. On me, they're practically useless. There are better anti-androgen medications out there which work differently, acting on the pituitary gland as my endo tells me, to stop T production.

So if you're like me and P does bad things for you, I'd highly recommend talking to your endo about more serious anti-androgens.

Good luck. Oh, and stay away from avocados. :)

Quote from: alabamagirl on January 17, 2014, 02:50:12 PM
Why? What happens if I eat an avocado?

As I recently discovered, they counteract HRT in some ways.

They encourage T production, and slow absorption of E. Certainly had a big effect on me :(.

Quote from: Cindy on January 17, 2014, 08:25:06 AM
My endo doesn't routinely use it, not for any saftey reason but she feels I would not benefit...

That's what my endo said, too. He said he'd gladly prescribe it if I asked, but he said that it's outdated and unnecessary. He did tell me that some patients said that it helped, but he seemed to think the effects were too small to warrant the extra risk. My endo has gazillions of trans clients and is a very candid, upfront and altogether nice guy.

Quote from: SammyRose on January 17, 2014, 02:55:58 PM
As I recently discovered, they counteract HRT in some ways.

They encourage T production, and slow absorption of E. Certainly had a big effect on me :(.

How did you measure that effect?

I feel like you are what you eat, and I would be more than happy if my body were more avocado shaped ;)

Quote from: JS on January 17, 2014, 03:03:48 PM

How did you measure that effect?

When I have T in my system, I can get irritable and angry at silly things ( like traffic ).

Oh, and morning erections that I'd not had in months.

Avocados were the only thing different, started eating them for breakfast.

Have a google about their hormonal effects

Quote from: Jennygirl on January 17, 2014, 03:09:15 PM
I feel like you are what you eat, and I would be more than happy if my body were more avocado shaped ;)

Ardis, Esther or Edranol variety?

Quote from: SammyRose on January 17, 2014, 03:11:15 PM
When I have T in my system, I can get irritable and angry at silly things ( like traffic ).

Oh, and morning erections that I'd not had in months.

Avocados were the only thing different, started eating them for breakfast.

Have a google about their hormonal effects

Nnnnnnooooooooo!!! But I love avos! They are nature's butter! Nnnooooo....  :'(

Quote from: JS on January 17, 2014, 03:14:22 PM
Ardis, Esther or Edranol variety?

Pinkerton avocado, of course! I mean it even has "pink" in there. That's a good sign. But if I had to choose from those options, Edranol.

http://www.livestrong.com/article/556633-avocado-progesterone/

QuoteProperties of Avocado

Avocados are considered an antiestrogenic food, which means they contain plant sterols that block estrogen receptors on cells and reduce estrogen absorption in your body, according to the book "Principles and Practice of Phytotherapy." As a consequence of blocking estrogen, progesterone levels in women and testosterone levels in men are both increased. High levels of estrogen have been linked to weight gain, but avocados can promote weight loss by balancing hormone levels despite the fact they are high in fats.

No wonder my levels seemed to balance out when I stopped taking so much Progesterone, I eat a full avocado almost every day... Sometimes more.

I love avocados too :(.

But I'm not risking more hormone imbalance like I felt. Not until the T factories are gone anyway.

Good, next time my dingbatter neighbor asks me to try an avocado yet again, I can tell him that it interferes with my medication instead of that they just taste nasty.

See? Clear as mud. I can only state my hard evidence that Provera-progesterone doesn't inflate T numbers. I may have had weight effects, then again I track every calorie I eat and I ate more simple as that.

Quote from: SammyRose on January 17, 2014, 04:08:32 PM
I love avocados too :(.

But I'm not risking more hormone imbalance like I felt. Not until the T factories are gone anyway.

The avocados may not necessarily be to blame. After reading some of the peer-reviewed scientific literature on avocados (and grapefruit) and hormone levels, it appears that a lot of so-called "health" and "nutrition" sites have, as usual, disseminated cherry-picked points from various research papers. The authors of these papers state that their findings require further confirmation and that nothing is conclusive.

All of the papers that I read discuss the effects of avocado (and grapefruit) on both Estrone (E1) and estradiol (E2). One of the important factors was the difference that these foods have on either endogenous (internal in origin) or oral hormones (like HRT). Effects also differ between the ingestion of whole fruits and juice or juice-based drinks. So while there is interaction between certain foods and hormones, there are a number of variables to take into consideration. In some instances these foods may not change hormone levels at all, or perhaps even elevate them.

A lot of "health and nutrition" sites are renowned for running with simplistic health narratives that are based on very complex scientific studies, just to amass traffic for their sites (and reap the advertising revenue). Just consider some of their ridiculous approaches to such things as cancer.

I've been on provera for two months and I've already noticed my boobs getting fuller and are constantly sore. I couldn't get a straight answer about progesterone either, and yes I know provera is a progestin, but i decided to give it a try and haven't regretted it yet. Indie have to ask my doctor on two separate appt's though.

Quote from: Jennygirl on January 17, 2014, 03:51:53 PM
Nnnnnnooooooooo!!! But I love avos! They are nature's butter! Nnnooooo....  :'(

Pinkerton avocado, of course! I mean it even has "pink" in there. That's a good sign. But if I had to choose from those options, Edranol.

About 80% of the avocado production in the United States, and almost all the commercial production in California, is the Hass (aka Haas) variety, developed in Whittier, CA.

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Hass

The Pinkerton variety (cultivar) was developed and is still grown in the Santa Paula/Saticoy/Ventura area.  It has a lovely, large, creamy fruit.  It is a relatively new variety, related to the Hass.

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Pinkerton

I have a Bacon Avocado in my yard.  What I would really like to grow is the "Daily 11" variety, developed in the early 1900s.  It is now an heirloom variety.

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Daily 11 denoted with "?"

I think you can ignore the so-called anti-estrogenic properties.  Plant sterols are exceedingly weak.  The oil (monunsaturated fat) is the fruit is very healthful and makes your hair naturally shiny.

Avocados also contain Vitamins C and E, as well as calcium and zinc.

wow, haven't had avocado for a while. The guys on night crew would always make fresh avocado dip to go with our chicken tacos.

Avocados have a tiny amount of stigmasterol (2 mg per 100 g serving); campesterol (5 mg per 100 g serving), and; β-sitosterol (76 mg per 100 gram serving).

These sterols have a proven effect in lowering LDL and total serum cholesterol levels.  In Europe, β-sitosterol is a popular ingredient in herbal BPH remedies.

Quote from: Joanna Dark on January 17, 2014, 11:57:43 AM
As far as P, don't take the advice of people on forums regarding meds. Take your docs.

I do want to go on P though for the hip and butt development as I heard it contributd to overall body feminization, so on Monday, I'm asking my doc and sking him to say it's for depression so my Medicaid covers it. They won't cover HRT in general, just methadone and suboxone, which I don't need.

Joanna, I think you are getting your HRT from the same Philly practice I go to.  My first Prometrium script is due to arrive by the end of this month.  I notice many have requested P due to high T levels.  That is not the case with me (T=c.30, E=c.135).  I requested it primarily because I am hoping it will let me lower the amount of Spiro I take (my B.P. is very low already, 100/52 last week, & I take less than half the usual starting dose of Spiro).  I admit I am hoping for the same results you mentioned, but I am a bit more concerned about my blood pressure dropping too low again. 

I will post to this thread later if I have anything to report (which means I am likely to necro it in several months  ::) )

Tessa

I really want an avocado now! Thanks guys!

I've been on Provera for a while now, lower dose first then doubled it. I had an awful time, was moody, felt hungry more and ate heaps etc. so I went back to the original dose and had no problems again.

I then went back on the higher dose more recently and have had no issues since. My endo says he has had several clients who have used it and had good results, some who said no difference. I guess its one of those things that works for some and not for all. I agree with the OP that it can be frustrating with such little research into specific HRT regimes for trans people. We need to agree that if we become multi-millionaires, other than funding Susan's, we need to make some philanthropic donations to HRT research!

Now I am off to find something with avocado in it!

Here's an optimistic Wikipedia entry...

"There is at present no clinical evidence that either progesterone or progestins enhance breast size, shape, or appearance in either trans women or cisgender women, and one study found no benefit to breast hemicircumference over estrogen alone in a small sample of trans women given both an estrogen and an oral progestogen... However, the authors of the paper state that the sample size was too small to make any definitive conclusions, and that further studies should be carried out to confirm whether progestogens do significantly affect breast size and/or shape in trans women or not. As of 2012, no additional study has looked at the issue again (italics mine)."

The study they refer to (above) was conducted in 1986, so obviously there's a real passion for this subject.

When I started HRT I asked my doc what his opinion on micronized progesterone is. His response was "You'll see a lot of stuff on the internet about it making your boobs bigger, fuller, more glandular, or whatever. It's all nonsense."

Then later in the conversation he said he'd be willing to prescribe it if I had mood swings, because he firmly believes it can level out emotions.

I dunno. The internet is awash with plenty of people on every side of that fence. Personally, I want to base my opinion on firsthand experience. So, next time I go in for bloodwork I'm going to be discussing my "mood swings" with my doc.  ;D

I would not take or recommend it to anyone but....

QuoteProgesterone: The risks and benefits of progesterone are not well-characterized. Some providers have found it to have positive effects on the nipple areola and libido. Mood effects may be positive or negative. Different progesterone regimens include daily 5 to 10mg medroxyprogesterone orally, 100-200mg prometrium at bedtime of oral or compounded micronized progesterone, or Depo-Provera 150mg IM every 3 months, for 2-3 years. There is a risk of significant weight gain and depression in some individuals.
As per other studies using oral progesterone in post-menopausal women (e.g., the Women's Health Initiative [WHI] study), the use of medroxyprogesterone orally may increase the risk of coronary vascular disease whereas IM injections (i.e., Depo-Provera) may minimize this additional risk.

http://transhealth.ucsf.edu/trans?page=protocol-hormones

as far as avocados, there is not an shred of evidence that consumptions of avocados will increase your T or interfere with the effects of E...

It is like the soy! Eating soy is supposed to increase your estrogen, right? Yeah, only if you eat a bucket each day, right? the same for avocados, eat a bucket of avocados a day, and you will see where you  will end up spending your evening...LOL

SANITY CHECK FOLKS, DO NOT BELIVE ALL THE BS YOU SEE IN THE NET!

I eat avocados often and never had a problem with my HRT in the past 20 years. I love! them and would eat more if they weren't so damn expensive. They are often my hors d'oeuvre and even my desert, they are that delicious. They are very healthy too.

I've never intentionally taken progesterone, except the tiny bit contained in cyproterone acetate. I think I've done fine, 'despite'.