Susan's Place Transgender Resources

What is the best hormone to start with?? And about how much do they cost??

Check with your doctor.  Many will start you out on anti-androgens, some start with hormones.  And some even do a combination.

There are four types of hormones.


Oral:  You take both estrogen and progesterone through the mouth.

Patches:  You place a patch on your skin

Injections:  You get a doctor or yourself an injections.

Implants:  Estrogen and Testosterone can both be implanted. As of my last conversation with my endo several years ago, both an implant lasts 4 months.  There is a timed released progesterone injection, which lasts two months and mimics an implant.

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Which one is better?  That depends on your specific circumstance.  You should get a psychiatrist and endocrinologist and discuss the matter with the both of them.  Personally and from my discussions with both, implants are by far the best, although you have to like getting sliced open and not mind the costs, and oral is the worst, although it is by far the easiest and cheapest to take.

Your endo that you choose will have all this information.

Oh,

There is no start with.  If you start, then you take estrogen.  Taking male blockers will stop the hair and puberty, if you are young enough, but will not start female puberty.

Quote from: sarahla on November 23, 2010, 01:34:35 AM
Oh,

There is no start with.  If you start, then you take estrogen.  Taking male blockers will stop the hair and puberty, if you are young enough, but will not start female puberty.

I fully agree that it is somewhat pointless and even dangerous for the bones to be on blockers and not estrogens, but as I read it, many doctors prescribe blockers first and only start hormones within a few months if not more.

The last statement is absolutely true.  It was late.  The body cannot be without hormones, so blocking male hormones means taking female ones.  There are the bones, but everything else too that depends on them.  You either start transition or you do not, no start with.

Cheers.

the reason I guess that doctors prescribe T-blockers first and then E is that T level in men is ranges from low 200s to over 1200 ng./dl. considered normal (average 500 to 900) for men while it is from 15 to 70 ng./dl. considered normal for women.

My guess is they believe that slowly adding E later gives the body more time to adjust... or perhaps that the T levels will be so high that adding E early would produce little/no results...

However, once you are past puberty either estrogen or testosterone is important for the bones and other parts of the body so only T-blockers could be dangerous...

Quote from: Vibes6 on November 23, 2010, 11:49:24 AM
the reason I guess that doctors prescribe T-blockers first and then E is that T level in men is ranges from low 200s to over 1200 ng./dl. considered normal (average 500 to 900) for men while it is from 15 to 70 ng./dl. considered normal for women.

My guess is they believe that slowly adding E later gives the body more time to adjust... or perhaps that the T levels will be so high that adding E early would produce little/no results...

However, once you are past puberty either estrogen or testosterone is important for the bones and other parts of the body so only T-blockers could be dangerous...

I'm pretty sure that's how it goes. Mine told me that when they start me on HRT, it will be a blocker to first get T to a reasonably low level, then take it from there. Apparently using E to squelch T doesn't work as flawlessly as blockers.

As far as I know (I'm not an MD) the main purpose for the T-blockers is to give the Estrogen the maximum opportunity to function. When Testosterone is high, the competition between E and T is high leading to less efficiency (or a need for higher to extreme high dosis of E to ensure the desired outcome). So basically, it eases the stress on the body.

As such there is not one approach, there are different opinions and approaches. It depends on your endocrinologist and especially your constitution (there are contra-indications to HRT).

Side note on starting: the impact of T-blockers (chemical castration) is (again AFAIK) reversible to a larger extent than the impact of E directly.

Love,
Emma

The main idea is to go speak with a doctor who can measure your levels of Testosterone, and decide the best approach.

As mentioned, is common to start with T blockers, that reduce levels of T in your body, and add E to change the concentration of hormones in your body to match those of genetic females.

Be cautious as this is a process that have some irreversible consequences in your body.

Those consequences can be very welcome... or if you change your mind, can be disastrous! Hence the need to be monitored both, physically and psychologically!

My doctor started me on both T blocker and estrogen right away but at a very low dose to make sure I would not have any negative reactions. After three months she increased both then after another three months increased the dose again. Being I am pre-op I still take both at higher levels but not the highest for estrogen. I am currently taking X mg of estrogen per day and will not go higher as my doc and I talked about the risk of blood clotting in doses higher than X mg. I have developed fine and still have breast developement happening so I chose to stay at X mg. My last lab work showed my T is at a level that is normal for a female and my estrogen is right in the middle of the scale for a normal female. My doctor informed me that its important to adjust HRT according to the individual because we all, including genetic woman respond to HRT differently.

Quote from: Jalene E.....

Um, the site rules means you shouldn't be talking about specific dosages....

Quote from: EmmaSide note on starting: the impact of T-blockers (chemical castration) is (again AFAIK) reversible to a larger extent than the impact of E directly.

Well, it depends on how you look at it. E without blockers (physical or chemical) don't really do much as T is so much more dominant than E. Blockers on its own is enough to cause sterility, which depending on the type of drug, length of time & dosage used is permanent. Externally, the permanent effect is obviously not as visible as the permanent changes to breast that E causes but they're both permanent.

When I was taking hormones, my endo did not say that T had any effect on E levels or its usage in the body.  In fact, he drew me graphs on the whiteboard.

As far as starting off, he said that that was up to me that I can go maximum dosage right away or start off on a minimum dosage for the first four months and then move up.

He said nothing about T blocking E.  He said that they were independent.

I should point out that women naturally have T in the body, just in lesser amounts.

I presume that much depends on the type of hormones that the doctor prescribes (pellets, patches, injections, or oral).

Quote from: Vibes6 on November 23, 2010, 11:49:24 AMHowever, once you are past puberty either estrogen or testosterone is important for the bones and other parts of the body so only T-blockers could be dangerous...

In point of fact, or at least informed opinion, which one the cells need more of is determined at the chromosomal level - those of us born with a Y chromosome have cells that "require" T more than E, however for those of us with GID, the risks of NOT taking HRT outweigh the risks of doing so...

I have read nothing saying that genetic males NEED testosterones, while females NEED estrogen. I just believe a high level of one and a low level of the other is necessary at all times.

Well, like I said, I'm quoting informed opinion (not mine), and I am not a doctor or biologist, although I had an active interest in biology when I was young, and have read a lot.  Hormones are messengers, and they also act on tissues.  They are in fact required for proper functioning, and the informed opinion part comes from someone I know who does have a medical background and knows a great deal about endocrinology.  I do think he's generally right, although in his mind he worries about those of us who transition, but he doesn't understand really what it's all about, either - how it can be necessary for a healthy life for a trans person.

The cells would only need T to function the way the genes intend. Without T, it would make them go against their usual processes...I'm not sure what this could do to them. The worst case could be an increased risk of cancer.

Quote

Without T....The worst case could be an increased risk of cancer.

Quote from: heatherrose on November 27, 2010, 08:00:33 PM

Actually the opposite is true. In the absence of "T" the likelihood of testicular and
prostate cancer are greatly reduced, although a decrease in bone density similar
to that of post-menopausal women is likely. It might be more edifying to do some
actual research on the subject instead of posting amateur medical speculation.

You should not attack people for just posting mere words. Take your anger out elsewhere (like a pillow or something idk).

Know that the entire body is not made up of testicular or prostate tissues. Prostate and testicular cancers aren't the only cancers, y'know? Anything that messes with the cells can cause cancer in any part of the body really. It's even worse for those self-medicating because you have no idea what's really in those pills without professional testing...

Not saying that HRT is going to go give everyone cancer, either. Everyone should improve their nutrition and lifestyles to minimize risks and be sure to get proper medical care when needed so they (hopefully) don't develop it.

My advice: speak to someone with doctorate in endocrinology :)
Internet advice will be littered with misinformation.

*puts on Mod hat* Let's not take each others' input on the subject personally and try to stay on the topic at hand.

I have to agree with CaitJ on this one. The best thing you can do if you want to start hormones is to talk to an endocrinologist.