Susan's Place Transgender Resources

Hi everyone. I am a little worried about my estrogen patches. I was originally on tablets of ethinyl estradiol for about 4 weeks and I noticed changes, but now I am on a higher dose with patches of β-estradiol. Since being on the patches, although my nipples still hurt, I haven't noticed any other effects. My erections are rock solid for example and my sex drive is higher. I have been on the patches for over 2 weeks. Is there an adjustment period to get used to the different form of estrogen? xxx

Mod edit: no doses please

Hi, you haven't been on HRT long, your body is still changing hormone gears. Even people who stay on the same delivery system notice the effects start and stop. I'm not sure if patches are absorbed as effectively through the skin as those taken orally... it is something you really need to discuss with your endo and have a blood test to ensure they are appropriate for you. Things really don't start to kick into top gear until the six month mark.

Oh okay. I understand :). Thanks xxx

When I changed over to patches there seemed to be a settling in period while my body re-adjusted.  I'm using Climara patches which seem to be working Ok for me, but before being able to get Climara patches here in New Zealand I was on a German made patch for a while (sorry can't remember the brand) and they were terrible.  They were expensive and nothing I could do could keep them from lifting off my skin within a day of putting them on.

I agree its too early to tell yet, but I was on patches for years and my blood levels were low. According to my endo some people don't absorb estrogen very well though patches, so I changed to implants. Big difference...

Could the placement of the patches affect it. I am sure that a week ago I had strong effects from it but since changing the patch I feel different. Are there specific areas where it is absorbed better? I have heard it best to place them on an area with lots of veins xxx

Hi

You might have them on upside down?

If you don't feel they are working call your endo and see what other options you could try.
Tablets seemed to work well, Implants an option?

J

Upside down? You mean with the adhesive side away from the body?

You might have a look here:
https://www.susans.org/forums/index.php/topic,189624.msg1687824.html#msg1687824

you might talk with your endo about dosage... many people carry more than one...

and I'd second implants... stable dose, no hassle, close to the natural form of application...


hugs

Thanks very much. One more question though. How is the dosage determined? I have heaed that it is based on height and weight. I am 5'7 and I am about 154lb


You have been asked not to post dosages. Please don't!
Cindy

Quote from: tesseract49 on June 06, 2015, 06:39:03 AM
Thanks very much. One more question though. How is the dosage determined? I have heaed that it is based on height and weight.

The patches come in different strenghts 20, 50, 100 for example.
And there are weekly and biweekly patches. Biweekly might be of more advantage because the weekly ones might get weak at the end (nice word play).

Talk the dosage through with your endo.
As said there are people who carry more than one.
Its not an exact calculation, people react differently and i.e. skins are different.


hugs

I was told by my doc to place them on my lower abdomen and to change them twice a week. They usually start you on a low dosage or if you are switching from another form of hrt a comparable dosage. Then blood work is taken after a few months and dosage adjusted to get you to the right level, usually by adding another patch.

I actually get my medication from an online private service whoch is run by a GP. She prescribes hormones and antiandrogens for you. I musy have blood tests in a few months. I started on a low dosage deliberately becasue I was scared and wanted the option to stop if I wasn't comfortable xxx


Mod edit- any reference to self medication is against TOS 8.

Are you taking any antiandrogen medication along with estradiol? You can't expect any significant libido change anytime soon without Testosterone reduction. It might take a while and lower with estrogen only, but it might also won't. People react differently.

Apart from breast budding and little growth over then next months, you can't really expect any prominent changes anytime soon. Body changes happen really slow. You might notice softer skin, thinner body hair, and such things early, and you must be happy for that and enjoy little changes! Bigger changes sadly need more time, literally years... Body needs its time to adjust to new hormones.

I am on  of finasteride a day as my antiandrogen. It is commonly prescribed for transgender people in the UK where I live. Even without the estrogen, my level of semen has gone down a lot xxx


Mod edit- no doses please. TOS 8.

You should probably keep the dosages out of the post  ;).

I can offer this slight advise. Finasteride is not a proper anti androgen, it only blocks DHT and leaves testosterone mainly intact. A doctor should be able to place you on a proper testosterone blocker.

Here is a deeper look into DHT blockers effects on testosterone driven functions:

http://www.bu.edu/news/2012/03/07/study-examines-the-relative-roles-of-testosterone-and-its-metabolite-dihydrotestosterone-dht-in-men/ (http://www.bu.edu/news/2012/03/07/study-examines-the-relative-roles-of-testosterone-and-its-metabolite-dihydrotestosterone-dht-in-men/)

Edit/clarification: Finasteride is a proper anti androgen but not whats going to reduce actual testosterone levels. Consult your doctor for help finding a more suitable option for you.

Thank you for the heads up and true it won't do a real good job at lowering overall testosterone levels.
Mariah

Quote from: naomi599 on June 06, 2015, 10:47:48 AM
You should probably keep the dosages out of the post  ;).

I can offer this slight advise. Finasteride is not a proper anti androgen, it only blocks DHT and leaves testosterone mainly intact. A doctor should be able to place you on a proper testosterone blocker.

Here is a deeper look into DHT blockers effects on testosterone driven functions:

http://www.bu.edu/news/2012/03/07/study-examines-the-relative-roles-of-testosterone-and-its-metabolite-dihydrotestosterone-dht-in-men/ (http://www.bu.edu/news/2012/03/07/study-examines-the-relative-roles-of-testosterone-and-its-metabolite-dihydrotestosterone-dht-in-men/)

Edit/clarification: Finasteride is a proper anti androgen but not what need to reduce actual testosterone levels. Consult your doctor for help finding a more suitable option for you.

Quote from: tesseract49 on June 06, 2015, 10:25:11 AM
I am on  of finasteride a day as my antiandrogen. It is commonly prescribed for transgender people in the UK where I live. Even without the estrogen, my level of semen has gone down a lot xxx

Finasteride doesn't effect testosterone, it's 5α-reductase inhibitor which prevents conversion from testosterone to DHT. It does nothing for testosterone lowering, and is therefore useless as an antiandrogen apart from preventing hairloss, which is why it is used as an additional medicine to hormonal replacement therapy.

You need to start using proper antiandrogen like Androcur (cyproterone acetate) for example.

Okay. I will ask my doctor for another antiandrogen. I got finasteride mainly because I have male hair loss. Because of the way I obtain my medication, it would be impossible to get an injectable form, so are there patches or oral antiandrogens that I could get? xxx

Yes, give it time, and follow the instructions about where to place the patch. Basically anywhere the manufacturer says to do it is good, though a) Climara apparently showed better absorption through the buttocks and b) it's true that even the weekly patches deliver slightly less estrogen on the last day or two than on the first day, so changing twice a week may be a good idea.

Patches actually cause so much *better* absorption that there is much less E necessary than in a pill - using hypothetical numbers, a pill with X amount of E is equivalent to a patch with about 1/20th X in it when it comes to producing the same blood levels.

That said, I do think maybe some people respond better to some methods than others, given how often someone swears that injections worked for them but a second person insists pills were better, etc.

I started on a low dosage too. One patch for first three months to see how I got along, then I moved to one and a half patches. I see you're based in the UK so you should have bloods done every three months at least.

Quote from: tesseract49 on June 06, 2015, 10:10:52 AM
I actually get my medication from an online private service whoch is run by a GP. She prescribes hormones and antiandrogens for you. I musy have blood tests in a few months. I started on a low dosage deliberately becasue I was scared and wanted the option to stop if I wasn't comfortable xxx

I must everyone. Is it actually proven that finasteride is only effective on DHT? Is it okay as an antiandrogen or am I wasting my time? xxx

The best bet is to consult your doctor. Different doctors have different reasons why they prefer one medication over another. Hugs
Mariah

Quote from: tesseract49 on June 06, 2015, 12:49:35 PM
I must everyone. Is it actually proven that finasteride is only effective on DHT? Is it okay as an antiandrogen or am I wasting my time? xxx

The mods properly enforced TOS 8B and 8C on this thread.  If the drug is a prescription medication, issued by a doctor, or is frequently used in self medication; then these TOS items applies.

QuoteFinasteride (Proscar, Propecia)

Another good choice for an anti-androgen is finasteride (Proscar, Propecia), and is able to be used in concert with spironolactone. The primary use of Proscar (finasteride) was in the treatment of benign prostatic enlargement, but with its reintroduction as Propecia (finasteride), the drug is being largely marketed to promote scalp hair growth.  For transgendered women, finasteride when given in the larger dose promotes not only scalp hair growth but acts as an potent anti-androgen as it is highly effective in inhibiting the conversion of testosterone to DHT (dehydrotestosterone) responsible for male sexual characteristics.  Finasteride is usually physically well tolerated over long durations, but is expensive.

It is a prescription medication, that means you cannot post how to get it without a prescription. It is sometimes used in HRT, which means you cannot post recommended, or actual dosages.

This has been a long term policy, here is a notice from 2 years ago.

Quote from: Jamie D on June 12, 2013, 04:16:22 PM
Folks, although we are talking about medications that have an application for blocking DHT and helping stop, or reverse, male pattern baldness, we need to keep in mind that finasteride and duasteride are also prescribed as anti-androgens for the purpose transsexual HRT.

Consequently, an Administrator has advised that the dosages for these two medications be redacted in conformity with Rule #8 of the terms of service.

Thanks for your cooperation.

So the complaint I received is not valid.

I just want to add that I have done patches from the beginning.  When I first started them I had an increase in libido.  But after a month or so that settle to be below what I experienced before starting HRT, but still a happy medium amount :)

I wouldn't worry too much, especially early on.  Your body goes through a major shift in the beginning and it takes a while to adjust.

The only difference I noticed in the first month was decreased sexual desire. I don't recall when I went clear. I noticed the breasts going crazy in month 2. Just after month 3 was when my mind started changing for the better. I was happier and get a little more emotional. Now at month 6 my mind is usually at peace. I can relax. I still feel I'm missing some emotions though. I'm still hoping it will work itself out. My Endo is happy with my progress and won't make any adjustments to my meds. I was hoping she might give me a little more E, but I guess not.

I use the "Alora" patch on a twice weekly regimen.  Have only been on this mode of delivery since March. I have found that the best location for me is just above the buttocks (it's quite level there) and adhesion is pretty good.  Only issue is placing them without getting a wrinkle in it.  As far as results go, libido was the first thing I noticed - way down, which is great.  Male odor vanished early on. Body hair growth slowing including facial hair.  Skin softer and becoming more translucent. No real changes in the breast or nipples yet, but I'm only 90 days in.  Blood work drawn last Friday.  Awaiting the results anxiously. Yes, it's slower than I would like, just need to be patient.  It's not like the quick fix of surgery.  We are shocking a system that has taken years to develop and asking it to reverse course.  It will slow down gradually before it is able to recognize its new direction and re-gain momentum.