Susan's Place Transgender Resources

In septemeber i will have FFS
They say you need to stop t clokers and estradiol????
when and how to wean off, any tips whats the best way?????

Going in the opposite direction, but I've had to stop testosterone before every surgery I've had so far. When you need to stop seems to vary by doctor. For chest surgery, I had to go to a half dose 1 month in advance, and stop completely 2 weeks prior. For hysterectomy I did not have to stop. For SRS, I have to stop 3 weeks in advance.

Maybe consider halving the doses in the week before you completely stop?

bless you sunshine

For my FFS, my doctors wanted me to stop estradiol 2 weeks before surgery. Just do what your doctor feels is best.

It depends on the surgery and the doctor. Often they will allow T blockers for all but a short moment where you have to take a break, but the longer break is with the estrogen due to the DVT Risk. Hugs
Mariah

I didn't stop E prior to surgery (SRS) or just after. Risk of DVT appears to be quite low when the estrogen is bio-identical and given non-orally, according to some studies. One study even found the opposite, that trandermal estradiol in higher than usual doses protected against the risk of DVT. Are genetic women asked to stop their endogenous production of estrogen before major surgeries? In other words, are major surgeries contraindicated in ciswomen because they produce estrogens?

As always, follow your doctor's orders. Just food for thought...

How about after surgery?  Should you taper back up or just go right back to the usual doses?

That will be between you and your Endo. If you need additional development, the doctor may maintain your pre transition dosage. If you have pretty well completed development, you may be cut back. Development can continue at a lower dosage though it might be at a slower rate.

The surgeon usually has the say on pre-surgical instructions for his/her patients, right?

I know Brassard did for my vaginal reconstruction, which I followed, but I was told by Belanger I needn't stop HRT for my revisions...

I would ask my surgeon if he/she hasn't already made their preferences clear..

Missy

Whether the dose is reduced post-op or not is up to the doctor.

Some continue prescribing the same dose, regardless if development is incomplete or not, as they believe that, in order to maintain a good quality of life, youthfulness, firm breasts and what they've achieved in terms of feminization, a high enough dose is required. Also, it may help protect against degenerative diseases such as Alzheimer's, and prevent obesity and diabetes. Several studies suggest estrogen may be cardioprotective.

Others suddenly perceive us as post-menopausal women whose only concern is to keep away hot flashes and osteoporosis so prescribe lower doses. The practice whereby estrogen is reduced post-op is also somewhat due to the fact that back in the day when non bio-identical estrogen used to be prescribed to transsexual women without anti-androgens, the thinking was that now that testosterone is mostly gone, one doesn't need such a high dose of estrogen and given the risks associated with such forms of estrogen, reducing the dose minimizes potential health problems. Times have changed though (we now take anti-androgens pre-op and safer forms of estrogen) so that this practice may be obsolete in the present day. At least, I think so but I'm not an expert in the matter.

Once again, my 2 cents. You have the right to bring this up when chatting with your doctor but in the end, they decide and have the final word. You can always find another doctor and get a second and third and fourth opinion. The ball is in your court!

I'm 11 yrs post-op and take a high dose of estrogen with some progesterone. I still believe that my genetic potential has not been achieved and so, with my doctors' approval, I continue testing different combinations all the while considering health risks and keeping them at a minimum. To each their own.

Quote from: KayXo on February 04, 2017, 12:20:44 PM
Others suddenly perceive us as post-menopausal women whose only concern is to keep away hot flashes and osteoporosis so prescribe lower doses.

I have no intention of ever going through any kind of menopause, and had I had a normal female life, I would still opt out of it. It is unnecessary and an obsolete idea, as well as an unhealthy one. There is a book called "The Hormone Symphony" that is very informative and represents a fresh approach to women's geriatric heath care. My endo agrees with me, and says menopause is the result of increased life expectancy, there is no biological imperative to starve women of the health benefits of their sex hormones just because they have lived to a certain age. There will be a revolution in this field when the old, white men that dominate women's medicine pass on, and the torch is passed to the younger, better trained, open-minded women and men that fill their shoes, and their positions at the top of their respective fields.

Missy

Quote from: RUBYYY on January 18, 2017, 10:40:23 AM
In septemeber i will have FFS
They say you need to stop t clokers and estradiol????
when and how to wean off, any tips whats the best way?????

Follow your surgeon's advice in conjunction too with other professional medics. None of us on here can, or should, advise you about this as there are potential life-threatening issues involved with prolonged GA, bed rest and flying. I had the start of a DVT when flying one week after surgery and ended up in hospital: this is from someone who runs every day.

Take their advice and err on the side of caution is all I can suggest honey. Coming off the meds feels awful at the time but think of the bigger picture. Hugs.

xx

Dr. Spiegel had me stop all HRT 2 weeks prior to ffs and 1 week after. I asked why after and he said because I am flying and due to the cabin pressure drop.

So what if ciswomen have facial or any cosmetic surgery and have to also take a plane? Are they asked to remove their ovaries, take a drug to temporarily halt estrogen production in their bodies, refused surgery? That's the question I would have asked. I'm curious what his answer would have been.