So I may be starting Provera tablets in the near future - what can I expect? From my research, some people find it very helpful in terms of reducing testosterone levels, and some find the side effects really rather unpleasant (depression). Others seem to find it neither helpful or harmful.
Is the jury still out on this medication?
I've been on it for about ten months (?) and haven't had any bad effects.. As for benefits it's hard to say since I can't compare to what I'd be like without it. It is, as you've noted, a case of YMMV.
Quote from: Brenda E on October 20, 2014, 01:23:14 PM
So I may be starting Provera tablets in the near future - what can I expect? From my research, some people find it very helpful in terms of reducing testosterone levels, and some find the side effects really rather unpleasant (depression). Others seem to find it neither helpful or harmful.
Is the jury still out on this medication?
Quote from endo after questioning its safety and efficacy:
"It's safe an efficacious."
I've been taking it for close to 9 months or so. No side effects. Can't gauge what changes I've had because I upped my E level when I started taking MPA. Pretty sure it's doing something. My E and T went to female range after starting it. Again, really hard to gauge the effects when so many other medications are in play.
Quote from: Hideyoshi on October 20, 2014, 02:29:48 PM
My E and T went to female range after starting it.
That's the reason it's being given to me: E too low, T too high, and this is supposed to block T in a way that spiro can't and push the T down to a female level and allow the E to rise.
It's worth a shot, right?
After having read the side-effects commonly associated with it, from several, some quite large studies, and hundreds of anecdotes AND considering there is a form of progestogen identical to that produced by our bodies, bio-identical progesterone (micronized), I PERSONALLY see no reason to take it and the risks outweigh its benefits. As far as i'm concerned, I would stay away from it and have a hard time understanding how it's still offered and available on the market. It's up to you and the doctor to do the research and decide together in the end...Just citing my own opinion based on several thousands of hours of research on the subject. I am NOT a doctor though. ;)
Thanks KayXo. Just curious - any idea why medical opinions differ so widely on this?
My 2 cents ,my GYN prescribed Prometrium suppose to be bio identical. All I can say is overall I just feel better.can't put my finger on just one thing its just my body seems to be working and feeling better. Let me add one thing I do sleep a LOT better.
Quote from: KayXo on October 20, 2014, 04:16:39 PM
I am NOT a doctor though. ;)
Thanks, so I can take your internet research with a grain of salt, and instead listen to my seasoned MTF endocrinologist and my GPs who have all accepted MPA as a safe, legitimate, and effective medication.
Quote from: Brenda E on October 20, 2014, 07:11:27 PM
Thanks KayXo. Just curious - any idea why medical opinions differ so widely on this?
You can't get two endos to agree on anything. If your doctor recommends it, and has had previous patients who have used it with good results, I would say try it.
Quote from: Hideyoshi on October 21, 2014, 06:29:27 AMIf your doctor recommends it, and has had previous patients who have used it with good results, I would say try it.
Sounds like a sensible plan. I see no harm in trying it for six months or more, and if it works, great. If not, it's not as if the endocrinologist is going to be standing in my kitchen every morning forcing me to continue taking it for years and years like my mom used to do with vitamins when I was a child.
I do have every confidence that my endocrinologist is (a) not an idiot, and (b) not trying to harm me! Worst case, my E and T levels are unchanged at my next checkup and we try something else.
Well it gave me a BAD headache at first LOL Never cared for it much, always made me feel like crap and I tried it a few times...
I take bio identical P and spiro along with IM injections and my T was 6 ng/dl on my last test... Them little ->-bleeped-<-ers are NOT working at all but really I guess I dont need a lab analysis to know that... We just tested again yesterday for my first 6 month checkup and if T is still cratered Im going to start to taper down the spiro a bit...
Im no doctor but my feeling is E is a more effective AA than MPA or Spiro or straight P in a high enough dosage... I also think its safer, Im no doctor though... I can tell you that for me anyway Its a much better feeling to be on higher dose EV IM injections compared to MPA and low dose E....
I think its strange nobody can point out any kind of paper that explains how it works as an antiandrogen at the low dosage usually given with MTF HRT... There is just a lot of disagreement and conflict and there are other proven safer and more effective approaches... I think Spiro and bio identical P complement each other well in low dosage with high E injected IM... Just my opinion though and thats worth nothing I guess compared to a doctor... However as smart as he is and as much as I like my doc.... I love to point out to him that HE has NO CLUE what its like to be me, what it feels like to be essentially castrated and to change sex... My feelings SHOULD carry more weight than some very universal one size that cant fit all "guidelines"...
Anyway I'll take E2 over MPA any day ;D
Quote from: Brenda E on October 20, 2014, 07:11:27 PM
Thanks KayXo. Just curious - any idea why medical opinions differ so widely on this?
I believe that those doctors that still prescribe it have been influenced by pharmaceutical reps, are just prescribing it out of habit and are not familiar with all the literature highlighting the side-effects commonly associated with medroxyprogesterone acetate. They also don't know much about bio-identical progesterone, the differences, etc. Some just don't have the time to keep themselves updated or minimize research findings, giving them an excuse not to dig further which they are not interested in doing. Unfortunately, sometimes, the patient's well-being is not at the top of their priority list which it should be. That's just my opinion though...I could be wrong.
Quote from: Hideyoshi on October 21, 2014, 06:29:27 AM
Thanks, so I can take your internet research with a grain of salt, and instead listen to my seasoned MTF endocrinologist and my GPs who have all accepted MPA as a safe, legitimate, and effective medication.
I think it's important to keep ourselves informed and be proactive in our treatment so that we know what's going on. Take an active role in our health. I personally question everything and everyone, even doctors, endos as I've many times come across physicians making mistakes, they are human after all, not infallible Gods. Reading the science behind it is important as it starts to give you a better idea of how things work, what is safe and then with that knowledge, you can discuss with your doctor, suggest research papers that could be read by them that they might have missed due to lack of time. It is important, I think, to form a partnership with your doctors, discuss honestly and openly. This will lead to the best treatment possible for you and for their future patients in the same situation. By acquiring knowledge, you are contributing positively to the medical field, and making a difference.
This is the kind of relationship I have with my endocrinologist especially. We argue and discuss. We learn from each other. He may be a doctor with a diploma but I have my say as well and he respects my opinions, my input.
You could always get a second and third opinion from other physicians as well. No harm in doing so. But, in no way, am I advocating that you blindly accept what I say but simply consider it. I encourage people to do their own research, talk to their doctors and find the treatment that is most effective and safest for them. :)
There is no room for pride, egos. Truth and facts is what will benefit us all and when pride/ego gets involved, then there is the risk that some may suffer as a result. A good doctor/scientist, in my opinion, is someone who constantly questions, never accepts anything as the absolute truth unless there is ample evidence for it. Who remains open-minded, who has no interest in their pride as it relates to their job but interest only for the patient's well-being and as such, seeks facts. Someone who is always in tune with the latest research out there.
My 2 cents...
Quote from: Hideyoshi on October 21, 2014, 06:29:27 AM
If your doctor recommends it, and has had previous patients who have used it with good results, I would say try it.
But, what if there is an equally effective hormone that produces similar results without or with much less side-effects such as bio-identical progesterone. Then, I think it's a no brainer. Why take a progestogen that is not identical to what our bodies produce when we can just as easily take one that IS identical to what our bodies produce? Wouldn't it make sense to go with something that our bodies naturally produce and have been accustomed to for millions of years? Instead of a new molecule that is completely foreign to our bodies and that many studies have found long-term negative effects with vs much less or none with the bio-identical version?
Quote from: KayXo on October 21, 2014, 10:49:55 AM
I believe that those doctors that still prescribe it have been influenced by pharmaceutical reps
MPA is a dirt cheap generic. Costs me less than $5 or less /month even without going through insurance. Prometrium is more expensive, why wouldn't they try to push that instead?
Quote from: KayXo on October 21, 2014, 10:49:55 AMjust prescribing it out of habit and are not familiar with all the literature highlighting the side-effects commonly associated with medroxyprogesterone acetate. They also don't know much about bio-identical progesterone, the differences, etc. Some just don't have the time to keep themselves updated or minimize research findings, giving them an excuse not to dig further which they are not interested in doing. Unfortunately, sometimes, the patient's well-being is not at the top of their priority list which it should be. That's just my opinion though...I could be wrong.
There is a laundry list of side effects for EVERY medication. It's important to be monitored regularly by a professional when taking any medication, much moreso HRT (yes even your bioidenticals) given the potential dangers involved.
And if you don't think your doctor's priority is the health and well being of their patients, I'd suggest finding a different doctor.
Quote from: Brenda E on October 21, 2014, 08:00:44 AM
Sounds like a sensible plan. I see no harm in trying it for six months or more, and if it works, great. If not, it's not as if the endocrinologist is going to be standing in my kitchen every morning forcing me to continue taking it for years and years like my mom used to do with vitamins when I was a child.
I do have every confidence that my endocrinologist is (a) not an idiot, and (b) not trying to harm me! Worst case, my E and T levels are unchanged at my next checkup and we try something else.
I'd get a blood test after a month on it to make sure nothing's going wrong. My doctor did that with all of my medications as he added them.
As for me taking MPA, I might stop eventually if it did its job at lowering my T levels. I'd like to take the least amount of medication possible, but if it works, take it.
Quote from: Hideyoshi on October 21, 2014, 11:13:46 AM
MPA is a dirt cheap generic. Costs me less than $5 or less /month even without going through insurance. Prometrium is more expensive, why wouldn't they try to push that instead?
My health matters more to me than $$$. I would rather pay more for something that is less harmful and native to my body.
Quote
There is a laundry list of side effects for EVERY medication. It's important to be monitored regularly by a professional when taking any medication, much moreso HRT (yes even your bioidenticals) given the potential dangers involved.
Indeed. But, if you take the time to carefully read those side-effects associated EXCLUSIVELY with bio-identical progesterone which is said in the leaflet to have VERY low toxicity compared to those side-effects noted with medroxyprogesterone acetate, you will realize there is quite a difference. Side-effects, always but to what degree should be considered as well and the one with the less side-effects would be safest. Ciswomen are regularly exposed to bio-identical progesterone, VERY high levels during pregnancy throughout their lifetime whereas medroxyprogesterone is not something their bodies are accustomed to. Interestingly, medroxyprogesterone acetate is NEVER prescribed to pregnant women for pre-term labor or to prevent miscarriage whereas bio-identical progesterone is, sometimes in quite high doses. The reason for it is MPA's androgenic effects which may affect the female fetus and perhaps other harmful effects on the body. Not good when a drug is contraindicated in pregnant women whereas another can be safely prescribed.
QuoteAs for me taking MPA, I might stop eventually if it did its job at lowering my T levels. I'd like to take the least amount of medication possible, but if it works, take it.
Estrogen can lower T as anti-androgens can do as well. It's a question of choosing the safest hormones/medications that can do the job.
Quote from: KayXo on October 21, 2014, 11:22:57 AM
My health matters more to me than $$$. I would rather pay more for something that is less harmful and native to my body.
The health aspect wasn't the point. Your response ignores the point you tried to bring up, which was big pharma is pushing MPA over bioidentical, which is nonsense. This is because pharma reps aren't going to push cheap generics when there are more expensive alternatives to push
QuoteIndeed. But, if you take the time to carefully read those side-effects associated EXCLUSIVELY with bio-identical progesterone which is said in the leaflet to have VERY low toxicity compared to those side-effects noted with medroxyprogesterone acetate, you will realize there is quite a difference. Side-effects, always but to what degree should be considered as well and the one with the less side-effects would be safest. Ciswomen are regularly exposed to bio-identical progesterone, VERY high levels during pregnancy throughout their lifetime whereas medroxyprogesterone is not something their bodies are accustomed to. Interestingly, medroxyprogesterone acetate is NEVER prescribed to pregnant women for pre-term labor or to prevent miscarriage whereas bio-identical progesterone is, sometimes in quite high doses. The reason for it is MPA's androgenic effects which may affect the female fetus and perhaps other harmful effects on the body. Not good when a drug is contraindicated in pregnant women whereas another can be safely prescribed.
Pregnant women aren't supposed to even touch finasteride. Guess no MTF should ever take it since pregnant women can't have it. Spiro is also contradinicated in pregnancy and breastfeeding. Estradiol (oral and otherwise) is also not to be taken while pregnant. Oops.
edit: And I thought you conceded to me
months ago that MPA's 'androgenic effects' are negligible to non-existent, as it would require hundreds of times the concentration of MPA to get the same androgenic effect of testosterone, and even then, it might not even behave the same way as actual T would. Yet you still, without fail, on every thread regarding MPA/progesterone, talk about MPA's 'androgenic effects'
If you don't want to take it, and think it's so dangerous, just don't take it. If other people want to try it and their doctors have patients who have taken it and have experienced no ill effects, what business do you have in shoving bioidenticals in their face
every time progesterone is brought up? It gets old.
Quote from: Hideyoshi on October 21, 2014, 08:04:03 PM
The health aspect wasn't the point. Your response ignores the point you tried to bring up, which was big pharma is pushing MPA over bioidentical, which is nonsense. This is because pharma reps aren't going to push cheap generics when there are more expensive alternatives to push
Pregnant women aren't supposed to even touch finasteride. Guess no MTF should ever take it since pregnant women can't have it. Spiro is also contradinicated in pregnancy and breastfeeding. Estradiol (oral and otherwise) is also not to be taken while pregnant. Oops.
edit: And I thought you conceded to me months ago that MPA's 'androgenic effects' are negligible to non-existent, as it would require hundreds of times the concentration of MPA to get the same androgenic effect of testosterone, and even then, it might not even behave the same way as actual T would. Yet you still, without fail, on every thread regarding MPA/progesterone, talk about MPA's 'androgenic effects'
If you don't want to take it, and think it's so dangerous, just don't take it. If other people want to try it and their doctors have patients who have taken it and have experienced no ill effects, what business do you have in shoving bioidenticals in their face every time progesterone is brought up? It gets old.
You do realize she has every right to offer her PERSONAL opinion like the OP asked for just as you offered yours? If she believes it to be better and offers her opinion even saying she's not a doctor who are you to say anything? You aren't a doctor either regardless if you trust your own doctor more than everyone else. Doctors are human and their knowledge only is as far as they stay updated themselves but that's besides the point
No one is forcing you to listen to anyone else especially when they preface their comments with "PERSONALLY" and "I'm not a doctor". PERSONALLY I don't know why you WOULDNT research for yourself what you put into your body for extended periods of time. Not everyone has the same blind trust you may have. I've encountered too many doctors and nursing staff that are wrong and follow the wrong protocols. I work closely with doctors and nurses every day, they are all too human.
Bottom line everyone has an opinion and trusting anyone blindly without your own research or verification is foolish. That said many doctors don't like being questioned and may not treat you if you do. if I found out on my own something different then what they are telling me though I would ask WHY to understand.
PERSONALLY I find the comments about blindly trusting their doctor just because he is the professional far more annoying than those offering their own research.
/rant
My 2 cents
Medroxy started depression in me again, I was taking it for about 6 months before I noticed its ill effects and then I switched to the bioidentical form, been feeling great ever since
Quote from: TSLexiknight on October 22, 2014, 10:14:41 AM
You do realize she has every right to offer her PERSONAL opinion like the OP asked for just as you offered yours? If she believes it to be better and offers her opinion even saying she's not a doctor who are you to say anything? You aren't a doctor either regardless if you trust your own doctor more than everyone else. Doctors are human and their knowledge only is as far as they stay updated themselves but that's besides the point
No one is forcing you to listen to anyone else especially when they preface their comments with "PERSONALLY" and "I'm not a doctor". PERSONALLY I don't know why you WOULDNT research for yourself what you put into your body for extended periods of time. Not everyone has the same blind trust you may have. I've encountered too many doctors and nursing staff that are wrong and follow the wrong protocols. I work closely with doctors and nurses every day, they are all too human.
Bottom line everyone has an opinion and trusting anyone blindly without your own research or verification is foolish. That said many doctors don't like being questioned and may not treat you if you do. if I found out on my own something different then what they are telling me though I would ask WHY to understand.
PERSONALLY I find the comments about blindly trusting their doctor just because he is the professional far more annoying than those offering their own research.
/rant
The stark difference between me and Kayxo is that Kayxo bases their conclusion on:
1. Internet research
I base my conclusion on:
1. Internet reasearch
2. Physician recommendation
3. Personal experience actually TAKING the medication for an extended period of time
Kayxo trashes MPA based on their findings on the internet. They push bioidential P every time MPA or progesterone is mentioned. It's not so much that I don't want them offering their opinion, it's that their opinion is 'I DON'T KNOW WHY ANYBODY WOULD TAKE IT IT'S TOXIC POISON TAKE X INSTEAD.'
I love how just because I take my physicians' opinions into account, therefore that somehow makes me someone who blindly accepts their decisions as gospel. What a strawman.
Quote from: Hideyoshi on October 21, 2014, 08:04:03 PM
The health aspect wasn't the point. Your response ignores the point you tried to bring up, which was big pharma is pushing MPA over bioidentical, which is nonsense. This is because pharma reps aren't going to push cheap generics when there are more expensive alternatives to push
Anyone can manufacture or import bioidentical progesterone because it's not a prescription medicine, so the pharmaceutical companies probably can't leverage much profit off of it. MPA on the other hand, is a lot cheaper to manufacture per dose, plus restricted to pharmaceutical sales channels, so yes, I'd say pharma companies do have an incentive to promote it.
My guess is that it's more likely to be ignorance and inertia on the doctor's part though. Doctors shouldn't be prescribing MPA as part of trans HRT for two reasons. Firstly, in the 2002 WHI study, the patients given it had considerably higher mortality rates from coronary heart disease, pulmonary thromboembolism, venous thromboembilism and breast cancer. On top of that, it's been linked to severe depression and suicides in transwomen. MPA is one of the potentially lethal hormones of yesteryear (along with premarin and ethinyl estradiol) that used to be used for trans HRT decades ago, but should never be used any more due to there being much safer alternatives.
People seem to think that doctors are these all knowing wizards, but the reality is that most of them have little or no knowledge of endocrinology and are likely to be relying on pharmaceutical company "guidelines" (or maybe even just winging it). Having spent a fair bit of time over the last 3 years talking to people who were exposed to DES (and to another hormone treatment called Primodos), I know for a fact that, when it comes to hormones, most doctors don't have the first clue and are just following whatever the pharmaceutical sales rep told them.
Quote
Pregnant women aren't supposed to even touch finasteride. Guess no MTF should ever take it since pregnant women can't have it. Spiro is also contradinicated in pregnancy and breastfeeding. Estradiol (oral and otherwise) is also not to be taken while pregnant. Oops.
The reason finasteride and spiro are contraindicated in pregnancy is because they're antiandrogens, and a male fetus exposed to them will end up partially developing as female instead of male. That actually touches on one of the things I've been trying to make people aware of - drugs that interfere with testosterone production should, in theory at least, carry exactly the same risk of causing female development in males as antiandrogens do, and yet there are no warnings or restrictions against their use during pregnancy.
P.S. I'm fairly sure that MPA cross reacts with androgen receptors, since it's one of the progestins that turned out to have virilizing effects on female fetuses.
To be fair my endo did warn me about the pros and cons of synthetics vs bioidenticals and did say prometrium is better since it's easier on the body side effect wise. He offered me both and I choose medroxy cause of the cost and thought nothing of it. However since I was just starting hrt, I didn't realize how sensitive my body would become to it's side effects. I now seem sensitive to everything, so tread carefully is my advice to those that have sensitive bodies like mine and are just starting.
Quote from: HughE on October 22, 2014, 07:16:24 PM
Firstly, in the 2002 WHI study, the patients given it had considerably higher mortality rates from coronary heart disease, pulmonary thromboembolism, venous thromboembilism and breast cancer. On top of that, it's been linked to severe depression and suicides in transwomen.
Wasn't that WHI study conducted with MPA + premarin, and not MPA + estradiol?
Quote from: HughE on October 22, 2014, 07:16:24 PM. . . in the 2002 WHI study . . .
I looked that study up, and while interesting, it's a study of a specific group of women (post-menopausal), being given a specific drug combination and dose (premarin and medroxyprogesterone), for a specific purpose (prevention of cardiovascular disease). To draw conclusions about the safety of medroxyprogesterone in an entirely different group of people (MtF), using vastly different drug combinations and dosages (countless), and for entirely different purposes (feminization) is misinterpreting the study and drawing conclusions that simply cannot be drawn. Inferences could be made perhaps, but nothing more.
Which, I think, highlights the difference between actual medical advice and one's own internet research. A good endocrinologist - one who has been practicing for a decade or two and has guided dozens, if not hundreds of transwomen to their goals in relative medical safety - is without question a trusted, important source of information. Anyone discounting the value of experienced medical practitioners in the transition process is advocating for removing an important safety net from the transition process. The docs might not get it right first time, every time, but they get it right the vast majority of the time and they know what to do when they get it wrong.
I do appreciate the opinions about the effects of the medication in transition, but when the posts start to wander into crazyland where experienced doctors are portrayed as clueless idiots, I think the value of the conversation becomes not just worthless, but actually harmful. God forbid anyone read some of this and decide to completely forego having an endocrinologist involved in their transition and instead self-medicate.
Quote from: Brenda E on October 23, 2014, 08:50:50 AM
I looked that study up, and while interesting, it's a study of a specific group of women (post-menopausal), being given a specific drug combination and dose (premarin and medroxyprogesterone), for a specific purpose (prevention of cardiovascular disease). To draw conclusions about the safety of medroxyprogesterone in an entirely different group of people (MtF), using vastly different drug combinations and dosages (countless), and for entirely different purposes (feminization) is misinterpreting the study and drawing conclusions that simply cannot be drawn. Inferences could be made perhaps, but nothing more.
WHI 2002 was a large-scale clinical trial which (going on its wikipedia page) looks to have involved around 200,000 women in total, of whom around 26,000 were given the hormone therapy. Its end results show that none of the treatments made a jot of difference except the hormone therapy, which caused considerably increased mortality. There were only two hormone therapies tested in the trial: Premarin + progestin (MPA), or premarin on its own. Both had increased mortality from several different causes. Although they didn't trial MPA on its own, you can just subtract the premarin results from the premarin+MPA to work out the increased mortality from MPA, which shows an increased risk of heart disease, blood clots, breast cancer and dementia.
The results of that study tie in with experience with other synthetic hormones, for instance birth control pills (which also use synthetic estrogen+progestin), likewise carry an increased risk of blood clots. There's another synthetic hormone, called methyltestosterone, that was at one time used for HRT in men, but was dropped in favour of bioidentical testosterone because it was killing so many of the patients given it.
Over the short term synthetic hormones are generally fine, but they all appear to cause harmful side effects with higher dose and longer term use. From our point of view, that makes them a poor choice for HRT, especially since the proper bioidentical hormones have been shown to be safe for long term use (as long as their blood levels are kept in the normal physiological range). There's also the fact that there are millions of healthy young people with high levels of bioidentical hormones flowing through their veins, without it appearing to have any adverse effects on their health!
The reason doctors like synthetic hormones is, I think, a mixture of convenience, inertia (it's only recently become apparent how harmful synthetics can be over the long term), plus they're probably steered in that direction by pharmaceutical company marketing campaigns too.
Quote
Which, I think, highlights the difference between actual medical advice and one's own internet research. A good endocrinologist - one who has been practicing for a decade or two and has guided dozens, if not hundreds of transwomen to their goals in relative medical safety - is without question a trusted, important source of information.
I beg to differ. My own experience of doctors is that their knowledge of male hormonal problems is abysmal. Neither of the GPs I've seen appears to know the difference between primary and secondary hypogonadism, or how to interpret the blood work. Judging by what I've seen other people in a similar situation saying on the hypogonadism forums I subscribe to, this is a near-universal problem (although particularly bad in the UK). While I didn't manage to get as far as an endocrinologist referral myself, from what I've seen other people saying, all you get with most endocrinologists is an extra serving of arrogance on top of the ignorance. Doctors do a great job of making out that they know exactly what they're talking about, but the reality is that most of them don't have the first clue when it comes to hormones.
I don't know whether you've seen some of the stuff I've posted on here about DES, but between 1940 and about 1980, millions of pregnant women all over the world were given high doses of a powerful chemical castration agent called DES, in a misguided attempt to prevent miscarriages. One of the earliest case controlled studies carried out in medicine showed that DES was completely ineffective at preventing miscarriages, and actually increased the likelihood of them occurring. Nonetheless, the pharmaceutical companies continued to promote the stuff and doctors to prescribe it for a further 20 years. Even worse, for at least the last decade or so it was being used for miscarriage treatment, it must have been obvious to everyone dispensing it that the doses being used were insanely high. DES is an extremely powerful estrogen and towards the end, for most other purposes, was being dispensed in 0.1mg tablets. For miscarriage treatment, they were dispensing 25mg tablets - a 250x higher dose! The whole disaster was largely covered up, so that not many people today are even aware that it happened. If you look at some of the posts I've made on here in the past, I think DES is the underlying cause of many if not most cases of MTF gender variance in those of us who were born in that era (along with other intersex-related problems including hypogonadism, infertility and genital abnormalities).
Not long after DES was discovered, the first progestins were developed, which (although they're supposed to mimic a female hormone), were actually derivatives of testosterone. These drugs were likewise prescribed to large numbers of women (probably in the millions), until they were eventually discovered to cause male development in female fetuses. That disaster's been even more completely erased from history than the DES one, but I think could well explain most cases of FTM transsexuality from that period.
So doctors and the medical/pharmaceutical industry can and do make colossal mistakes that end up harming or killing large numbers of people. However, the way the system is set up, those mistakes rarely come to light.
Quote
Anyone discounting the value of experienced medical practitioners in the transition process is advocating for removing an important safety net from the transition process. The docs might not get it right first time, every time, but they get it right the vast majority of the time and they know what to do when they get it wrong.
I do appreciate the opinions about the effects of the medication in transition, but when the posts start to wander into crazyland where experienced doctors are portrayed as clueless idiots, I think the value of the conversation becomes not just worthless, but actually harmful. God forbid anyone read some of this and decide to completely forego having an endocrinologist involved in their transition and instead self-medicate.
While I agree that it's important for anyone taking hormones to have their blood work monitored and, if at all possible, to get everything done under the supervision of a competent doctor, I think you need to take off your rose tinted glasses. There's an online e-book about the DES disaster (written by one of the mothers who trusted her physician and was given the drug), which is available as a free download here:
http://www.lulu.com/shop/pat-cody/des-voices-995/ebook/product-17522743.html
It's more focused on the problems experienced by the daughters, however it does mention some of the problems experienced by "sons" (many of whom are now daughters!) as well.
I'm not sure whether this is viewable outside the UK, but here's an article about another medical hormone disaster from that era in which several million people were exposed, that was likewise covered up:
http://www.telegraph.co.uk/health/10819186/Is-this-the-forgotten-thalidomide.html
Quote from: HughE on October 24, 2014, 06:16:48 AM
WHI 2002 was a large-scale clinical trial which (going on its wikipedia page) looks to have involved around 200,000 women in total, of whom around 26,000 were given the hormone therapy. Its end results show that none of the treatments made a jot of difference except the hormone therapy, which caused considerably increased mortality. There were only two hormone therapies tested in the trial: Premarin + progestin (MPA), or premarin on its own. Both had increased mortality from several different causes. Although they didn't trial MPA on its own, you can just subtract the premarin results from the premarin+MPA to work out the increased mortality from MPA, which shows an increased risk of heart disease, blood clots, breast cancer and dementia.
No you canNOT just 'subtract premarin' and then deduce that MPA poses significant risk comparable to premarin. That's an error in reasoning. You're grasping at an inference you made from a study that doesn't even study MPA alone. Do you not see how damaged that is?
QuoteThe results of that study tie in with experience with other synthetic hormones, for instance birth control pills (which also use synthetic estrogen+progestin), likewise carry an increased risk of blood clots. There's another synthetic hormone, called methyltestosterone, that was at one time used for HRT in men, but was dropped in favour of bioidentical testosterone because it was killing so many of the patients given it.
Synthetic estrogen + MPA =/= MPA. Synthetic testoterone being dangerous does not mean MPA is dangerous.
QuoteMy own experience of doctors is that their knowledge of male hormonal problems is abysmal. Neither of the GPs I've seen appears to know the difference between primary and secondary hypogonadism, or how to interpret the blood work. Judging by what I've seen other people in a similar situation saying on the hypogonadism forums I subscribe to, this is a near-universal problem (although particularly bad in the UK). While I didn't manage to get as far as an endocrinologist referral myself, from what I've seen other people saying, all you get with most endocrinologists is an extra serving of arrogance on top of the ignorance. Doctors do a great job of making out that they know exactly what they're talking about, but the reality is that most of them don't have the first clue when it comes to hormones.
So because you asked two doctors you've seen who do not specialize in a field questions about that field and they didn't know, therefore doctors aren't meant to be taken seriously? And 'arrogance' only makes sense if you consider arrogance a doctor facepalming when an internet hero comes in and questions their knowledge and scoffs at them wondering why they don't know every condition that can afflict the human body.
QuoteI don't know whether you've seen some of the stuff I've posted on here about DES, but between 1940 and about 1980, millions of pregnant women all over the world were given high doses of a powerful chemical castration agent called DES, in a misguided attempt to prevent miscarriages. One of the earliest case controlled studies carried out in medicine showed that DES was completely ineffective at preventing miscarriages, and actually increased the likelihood of them occurring. Nonetheless, the pharmaceutical companies continued to promote the stuff and doctors to prescribe it for a further 20 years. Even worse, for at least the last decade or so it was being used for miscarriage treatment, it must have been obvious to everyone dispensing it that the doses being used were insanely high. DES is an extremely powerful estrogen and towards the end, for most other purposes, was being dispensed in 0.1mg tablets. For miscarriage treatment, they were dispensing 25mg tablets - a 250x higher dose! The whole disaster was largely covered up, so that not many people today are even aware that it happened. If you look at some of the posts I've made on here in the past, I think DES is the underlying cause of many if not most cases of MTF gender variance in those of us who were born in that era (along with other intersex-related problems including hypogonadism, infertility and genital abnormalities).
Not long after DES was discovered, the first progestins were developed, which (although they're supposed to mimic a female hormone), were actually derivatives of testosterone. These drugs were likewise prescribed to large numbers of women (probably in the millions), until they were eventually discovered to cause male development in female fetuses. That disaster's been even more completely erased from history than the DES one, but I think could well explain most cases of FTM transsexuality from that period.
I'm sorry, is DES MPA? No? Irrelevant. Also, MPA is category X in pregnancy. Not supposed to take it. Vioxx was also a disaster. Doesn't mean nothing good can come from the pharmaceutical industry.
QuoteSo doctors and the medical/pharmaceutical industry can and do make colossal mistakes that end up harming or killing large numbers of people. However, the way the system is set up, those mistakes rarely come to light.
So take their advice as having the same amount of merit as X non-peer reviewed study on some obscure website?
Returning to the OP's question, I haven't used MPA myself, however I've been told that it's not a good idea to take it as part of trans HRT, because it's associated with emotional instability and severe depression, and has caused a number of trans women to commit suicide. I won't post the link here because it contains dosages, but I just did a google search on "medroxyprogesterone suicide", and one of the links that came up was a rather scathing document about it on the Alberta Trans website. Probably if you do a search through what's been posted here on Susan's, you can find some people's first hand experiences of it, but my impression is that it's something to be avoided.
Another thing I should point out is that MPA's main use in men is for chemical castration of sex offenders, so the fact that it was prescribed it is a bit of a warning flag that the doctor might be one of the ones who secretly categorise trans folk with sex offenders and paedophiles. Hopefully not, but you never know. Obviously you don't want one with that kind of mentality responsible for your health care!
Ok, to bring this topic back to where it started...
A few days on MPA. Boobs hurt like crazy (good). Emotional stability is decreased (good - in a way...over the past couple of days I've been walking on emotional eggshells and have cried a few times where I probably could have controlled myself; that said, I welcome the emotional range.) Feels like the estrogen has been given a turbo boost or something, and it'll take a little while to get used to.
So far, so good.
YMMV. ;)
Quote from: Brenda E on October 25, 2014, 05:31:57 PM
Ok, to bring this topic back to where it started...
A few days on MPA. Boobs hurt like crazy (good). Emotional stability is decreased (good - in a way...over the past couple of days I've been walking on emotional eggshells and have cried a few times where I probably could have controlled myself; that said, I welcome the emotional range.) Feels like the estrogen has been given a turbo boost or something, and it'll take a little while to get used to.
So far, so good.
YMMV. ;)
Great