Susan's Place Transgender Resources

Hi,

I am still in the discovery phase and really confused about my path forward.  I'm 44 with wife, kids, career, etc.  To be truthful, I am really having a hard time keeping focused on anything lately...its been tough.

I have my second appointment with my family doctor in 2 weeks to discuss things and set some next steps.

The topic of HRT came up very briefly and may come up again, but may be too early.

I have read that a very low dosage/level of HRT may help with calming the mind. No idea what a low dose means.LOL

I can't really come out fully yet, but calming the anxiety and mind really sounds appealing.

I could deal with some body changes.  Some slight changes to my face and body, would be ok. Breasts might be a difficult thing.  I've read that at my age and with a low dose, body changes would be minimal (?) I guess it does vary.

I have lost over 30 lbs in the last couple of months, so people have already been saying I look different.  Wasn't ever really overweight to begin with. 

I wonder if anyone can share their experiences of low level HRT.

I might be going on Finasteride in the next few weeks anyways, because I want to slow the hair loss, so not sure how that would have an effect with/without low level HRT.

As always, I appreciate all your help. [emoji274]



Sent from my iPhone using Tapatalk

Hi Amber,

Luna has a great thread on low dose.
https://www.susans.org/forums/index.php/topic,130268.0.html

Take care,
Paige :)

Quote from: Paige on June 02, 2016, 09:26:56 AM
Hi Amber,

Luna has a great thread on low dose.
https://www.susans.org/forums/index.php/topic,130268.0.html

Take care,
Paige :)

Thanks Paige.  That's a great thread.  Lots of info :-)


Sent from my iPhone using Tapatalk

I never knew that low dose HRT was an option.

I was on low dose for three months and i found an immediate and positive effect. I was through this process that i found peace with my situation. We have very similar circumstances, and would fully encourage you to consider low dosage HRT. For me, it ended the anxiety and was without any real negatives or side effects. Body changes were minimal, but my state of mind really improved quickly. Since then i have fully committed to transition. For me, low dose HRT was a great indicator and primer. My anxiety about self acceptance and the consequences thereof, shifted to getting good results and the road ahead. HRT won't be a magic bullet, but it really helps.

I have always wondered and have never got a clear answer, on what is low dosage, say E? Is it 2,4,6,8 mg of E? Just curious. I also have never got an answer to the question - "What is transition dosage?" I know that dosage varies from individual to individual.

Islandgirl, dosages are not discussed on this site, due to forum rules. I started a low dose trial last week, I can't say I've noticed anything yet aside weird dreams! My doctor has prescribed the lowest of the Everol Estradiol patches. And I'm continuing finasteride which I've been using for hair loss for over a year. Because everyone reacts differently and our starting points are different, only regular blood testing and how you respond can determine the correct and healthy dosage. It's very important to work with trained medical specialists where at all possible.

Thanks Megan. I do know that individual dosages are not to be discussed. I was asking a general question as I cannot find anywhere in the literature, at least that I have found on the internet, as to even ranges. I guess this still is a question for me.

To tell you the truth, I don't know what low dosage is either. I have been on a full transition dosage, a half dose and a quarter dosage. I have heard of people being on an eighth dosage which is not a normal transgender dosage but this Endo prescribed it. Really it boils down to how fast you want your body to change and what the Endo thinks is right for you. In my case, I am currently at a half transition dosage because it's though that has I have been on HRT for a long time, I should be in the menopause range with my dosage. This conflicts with my feelings because my dosage was so low for so many years that my body never fully developed. Even at the dosage I currently am receiving, I am seeing far more development far faster than I have see at any point in the past. I guess in about 5 months I am going to have an argument discussion about my treatment being far to conservative but that's for another post.

Thanks Dena. I too started on a very low dosage. This has been bumped up three times. I have been on HRT for almost 18 months and have seen many changes. Some came quickly, such as skin tone, and some later, breasts. I am finally seeing some development there (approx B cup).  My age was taken into consideration my my endo. I trust her!

I relied on low dose HRT several times over the decades for the much needed, and appreciated, "Brain Reset". I simply wanted to be a "normal(ish)" male. I relied on CD'ing and the occasioned low dose HRT to survive.

The HRT stopped after several months, and long after the reset occurred. It stopped because things below the belt started to feel the affects which was in direct conflict with "Normal Male".

Hi, Amber!

I started on finasteride several years ago for prostate problems.  Ending the hair loss was a nice bonus that I wish I had done 20 years ago, when I would have had enough for grafts. :)  It's a weak anti androgen, with very few side effects in most assigned male bodies.  There are small changes in body hair (finer and softer) and occasionally a mild case of man boobs (which I consider a running start...).

I'm just starting HRT, and the endocrinologist is easing me into this with a dose that is a fraction of the Endocrinology Society guidelines for transgender care.  We'll be monitoring blood electrolytes frequently, and hormone levels every few months for a while as we determine what my particular body can tolerate and finds effective.  (Which is why we don't talk dosage.  What I can tolerate and what works for me may be really hard on another body.  There is a huge variation.)

So, I'll be on a low dosage and carefully monitored for a while.  We'll see what happens and tinker for the desired result, transition without medical complications in my case.

Quote from: JoanneB on June 09, 2016, 08:32:30 PM
I relied on low dose HRT several times over the decades for the much needed, and appreciated, "Brain Reset". I simply wanted to be a "normal(ish)" male. I relied on CD'ing and the occasioned low dose HRT to survive.

The HRT stopped after several months, and long after the reset occurred. It stopped because things below the belt started to feel the affects which was in direct conflict with "Normal Male".

How long did you go off HRT?  Do the changes you experienced while on HRT revert back?



Sent from my iPhone using Tapatalk

I think the only reasonable definition of low dose is that where it's not as effective as having more. There's a point where when you increase its no more effective; that's not low dose, and is a transitioning dose. Low dose is where you decrease it and it's less effective.

Different for each person no doubt.

Hi Amber.  I am in a very similar situation to yourself, wife, family, good job.  To counter crippling dysphoria I have been on low dose E for just about 5 months, although was on periodic HRT over the last 20 years.

It has helped the brain hugely, although I do get the occasional relapse.  My mood has levelled, jealousy has moderated and I feel more at ease.  That said, the physical changes are there: skin, lips, hips, and of course nipples and expanding bust (now getting hard to disguise). Here's the thing, I initially thought I would never transition, but feeling the way I do, and seeing the changes, my mindset has changed.  I no longer try to "hide". Be prepared!

Quote from: Amber42 on June 02, 2016, 08:45:54 AM

I have read that a very low dosage/level of HRT may help with calming the mind. No idea what a low dose means.LOL

I can't really come out fully yet, but calming the anxiety and mind really sounds appealing.

A 'trail' definitely cannot hurt I rediscovered HRT therapy around your age but be prepared for the worst as far as 'family life' is concerned. You do not mention 'gender dressing' which is a good start, No such thing as 'low dose' really and if worried about your hair must still have plenty atop to cultivate.

There is much info here as Susan's if you search - - found an old relevent thread (click on quote link) which you mght find amusing.

Quote from: Renate on December 21, 2007, 02:48:28 AMHormones have had a profound positive effect on my cognition and emotion.

Quote from: Alex123 on June 10, 2016, 02:50:49 AM
Hi Amber.  I am in a very similar situation to yourself, wife, family, good job.  To counter crippling dysphoria I have been on low dose E for just about 5 months, although was on periodic HRT over the last 20 years.

It has helped the brain hugely, although I do get the occasional relapse.  My mood has levelled, jealousy has moderated and I feel more at ease.  That said, the physical changes are there: skin, lips, hips, and of course nipples and expanding bust (now getting hard to disguise). Here's the thing, I initially thought I would never transition, but feeling the way I do, and seeing the changes, my mindset has changed.  I no longer try to "hide". Be prepared!

Even though there are many personal hurdles in my life, I'd very much enjoy the brain relief and some of the physical changes.  The breast development might be too soon for me, but I guess from what I've read, it's a roll of the dice around what you can expect on HRT.

I can just imagine that when the changes start to happen, the desire for more can easily follow.

How has your wife accepted the changes?


Sent from my iPhone using Tapatalk

I've been on HRT for about 8 year, the first 6 low dose, and I'm still not out. It's kept me sane.

It really takes the eyes of a good endo and some time to be able to determine what 'low dose' is and then it is entirely individual.  I have sisters that take what would be high dose for me that do not really show any outward effect...just an obvious inner effect.  At the same time, I have seen sisters where very low doses have quick outward effect.  It is up to genetics.  There really is no point in posting what works for one person as that same will have completely different outcomes for the next.  Work with your doctor and they will determine a good starting point for you.  Explain what it is that you are desiring at this phase in the here and now and then form a partnership to keep things as close to where you want to be as possible.

Remember, even low dose can produce very visible result over time.

Quote from: Kiera on June 10, 2016, 04:24:32 AM
A 'trail' definitely cannot hurt I rediscovered HRT therapy around your age but be prepared for the worst as far as 'family life' is concerned. You do not mention 'gender dressing' which is a good start, No such thing as 'low dose' really and if worried about your hair must still have plenty atop to cultivate.

There is much info here as Susan's if you search - - found an old relevent thread (click on quote link) which you mght find amusing.

I've always had a decent head of hair.  The last couple of years, it's been receding slightly and thinning. I started minoxidil about a month ago, until I figure out my complete course of action (fun or spiro or HRT or nothing).  If I can slow down the hair disappearing act for now, it will give me some time to find my path going forward.

That thread is funny.  I definitely feel like a brain floating in water some days - LOL



Sent from my iPhone using Tapatalk

Quote from: kaitylynn on June 10, 2016, 09:15:01 AM
It really takes the eyes of a good endo and some time to be able to determine what 'low dose' is and then it is entirely individual.  I have sisters that take what would be high dose for me that do not really show any outward effect...just an obvious inner effect.  At the same time, I have seen sisters where very low doses have quick outward effect.  It is up to genetics.  There really is no point in posting what works for one person as that same will have completely different outcomes for the next.  Work with your doctor and they will determine a good starting point for you.  Explain what it is that you are desiring at this phase in the here and now and then form a partnership to keep things as close to where you want to be as possible.

Remember, even low dose can produce very visible result over time.

Thanks for the advice.  I agree, these things are very individual and unique to each person.  I have my first official appointment next week, with my GP to discuss all this.  I came out to him during an appointment and albeit quite surprised, he was very supportive and booked an appointment to truly discuss things.

I want to know what to ask and make the discussion with him as useful as possible.

This forum has been a lifesaver for me.  You girls are awesome and I'm lucky I have someplace to come and ask things without fear and just be what I feel is my version of 'normal'.




Sent from my iPhone using Tapatalk

Quote from: Amber42 on June 09, 2016, 11:21:57 PM
How long did you go off HRT?  Do the changes you experienced while on HRT revert back?

I never stayed on long enough for any physical changes. Besides the dose was low compared to transitioning dosing.

The emotional changes I have idea. In hindsight I have to say they do fade away. Unnoticed as it is happening over the course of years. Part of it is also the...euphoria? of getting over the dysphoria hump. YEAH! I beat it again!  :D  But without any followup. Without putting in the hard work on yourself and just hoping a magic pill will fix you, the GD will slowly creep back to take over your life. So, as in Groundhog Day, you repeat the cycle, again. Eventually I got it right, sort of

Quote from: Amber42 on June 10, 2016, 09:45:33 AM
Thanks for the advice.  I agree, these things are very individual and unique to each person.  I have my first official appointment next week, with my GP to discuss all this.  I came out to him during an appointment and albeit quite surprised, he was very supportive and booked an appointment to truly discuss things.

I want to know what to ask and make the discussion with him as useful as possible.

This forum has been a lifesaver for me.  You girls are awesome and I'm lucky I have someplace to come and ask things without fear and just be what I feel is my version of 'normal'.

It is a big step opening up to your doctor as they hold a lot of keys.  When I came out to mine, he did not even skip a beat.  He simply ordered my initial hormonal panel and set up an appointment with an endo to address what he did not feel comfortable with.  It was the start of guided medical transition for me.  Congrats on this step!

As for what I think would have been the most relevant questions to have answers to at that point...the main for me would have to be, 'how is this going to effect my moods'.  Having had some...interesting...experiences with HRT some 20 years ago in the mood swing department, I would have loved to have had an understanding of the various delivery methods of HRT.  My endo picked up my question without my even asking and put me on transdermal as it is one of the most consistent applications of Estradiol available.

It might be helpful to take some time to compile a list of questions you have and get them down on paper so you remember to actually ask them.  The first appointment was over an hour with my endocrinologists and they answered everything I asked in depth.  Most will not give this level of time, but they will answer the questions posed.  Ask until you are satisfied with the answers.  Also, any concerns you might have with effects...this is a good time to have them addressed.

The process itself is actually straight forward.  For MTF, control and diminish T while replacing the primary hormone with E and then monitor.  I found that the little effects that happened along the path of HRT brought on more questions than the obvious "BIG" ones in the beginning.  It is an ongoing process that will last a lifetime :D