Susan's Place Transgender Resources

Community Conversation => Transsexual talk => Male to female transsexual talk (MTF) => Topic started by: Valleyrie on May 25, 2015, 08:24:32 PM

Title: Smoking and HRT
Post by: Valleyrie on May 25, 2015, 08:24:32 PM
So I've been on HRT for about a month now and during this time I haven't had much success in quitting. Aside from the obvious risks and increased potential of blood clots and whatnot, does smoking actually affect development in any way at all? I take oral estradiol pills if that makes any difference. Thank you!

edit: Also, I know it's different for everyone but I haven't noticed anything in regards to breast growth. I smoke about 8 cigarettes a day on average - could this be why?
Title: Re: Smoking and HRT
Post by: Lady Smith on May 25, 2015, 08:46:38 PM
As an ex social worker smoking has been something I've found very hard to entirely give up,  While I was working I used to smoke like a chimney mostly due to the stress of the job, but now I manage to keep it under 6 handrolled cigarettes a day.  My doctor would prefer it if I stopped, but acknowledges that at my age I'm not going to make a big difference to my health if I stopped smoking altogether.
Smoking is supposed to affect T levels in a negative way and it's just as well I didn't find that out when I was a young teenager or I'd be dead by now  :laugh:
Title: Re: Smoking and HRT
Post by: Tessa James on May 26, 2015, 02:24:31 AM
Hey Valleyrie,

I am an ex smoker for 4 years and I quit a thousand times before.  I am also a retired anesthetist and have looked into lots of throats and seen the damage.  But knowing better doesn't always mean acting better. ;) The fundamental impact of nicotine smoking on blood vessels, especially the tiniest, is constriction.  We girls want to maximize our ability to actually expand and grow tissue with more tiny blood vessels open to providing nourishment. 

It is simply a fact that, if you are a smoker, quitting is the single best thing one can do to improve health, longevity and quality of life.  70% of smokers want to quit and some endos won't even prescribe HRT for smokers as it adds considerably to risk.  No one can assure you of greater boobage but no doubt it will add to feeling better overall. 

Please keep on trying and focus on what worked best the last time you were able to quit.  Your transition is worth the best shot possible for success.
Title: Re: Smoking and HRT
Post by: Cindy on May 26, 2015, 03:08:13 AM
While it can be hard to find an endo to help you if you smoke it can be next to impossible to get a surgeon to operate on you for GRS as the healing of the microcirculation is so much slower.

So hold onto your dreams to help you give up!
Title: Re: Smoking and HRT
Post by: Ever on May 26, 2015, 03:25:57 AM
Consider taking wellbutrin, which really helps, or non-tabaccoo nicotine (even vaping).  Nicotine itself isn't bad for your health, in fact, at low doses it can help prevent against brain degenerative diseases, but from what I've seen, it seems the problem is the tar and carcinogens and effects of tobacco.
Title: Re: Smoking and HRT
Post by: Ms Grace on May 26, 2015, 03:37:33 AM
Nicotine is in fact highly addictive. While the tar and smoke and other additive will do the majority of the damage to your lungs, circulation and endocrine systems you really want to be getting off it altogether. Unsurprisingly they're starting to find that vaping is not all that safe (http://www.theguardian.com/society/2015/feb/04/e-cigarettes-toxic-chemicals-research-finds-lung-damage) either...
Title: Re: Smoking and HRT
Post by: Tessa James on May 26, 2015, 04:17:58 AM
We must be skeptical of vaping, patches and nicotine gum as the tobacco industry recommend them on their websites.  Cynically so as they are least effective at helping us quit.
Title: Re: Smoking and HRT
Post by: Ever on May 26, 2015, 06:06:07 AM
Quote from: Ms Grace on May 26, 2015, 03:37:33 AM
Nicotine is in fact highly addictive. While the tar and smoke and other additive will do the majority of the damage to your lungs, circulation and endocrine systems you really want to be getting off it altogether. Unsurprisingly they're starting to find that vaping is not all that safe (http://www.theguardian.com/society/2015/feb/04/e-cigarettes-toxic-chemicals-research-finds-lung-damage) either...

Nicotine addiction is an extremely hard addiction to get off of.  "Not all that safe either" is a bit strong to say when the article you cite reads:

"E-cigarettes generated just 1% of the amount of free radicals in tobacco smoke, but this still posed a potential health risk, said the researchers"

I think 1% is a good tradeoff in exchange for quitting cigarettes, but preferably you'd want either nicotine lozenges or perhaps something like wellbutrin to just outright replace nicotine.

In any case, the surprising and interesting health benefits of nicotine (http://discovermagazine.com/2014/march/13-nicotine-fix) can't be ignored.
Title: Re: Smoking and HRT
Post by: Ms Grace on May 26, 2015, 06:15:21 AM
That was one of numerous articles I found talking about the risks of vaping. And given nicotine is also a toxin I'm quite happy to ignore it's "health" benefits.
Title: Re: Smoking and HRT
Post by: Ever on May 26, 2015, 07:43:21 AM
Almost anything can be a toxin when not taken in moderation, just like high levels of fluoride consumption can have ill effects, even though regulated water fluoridation can have well-recognized benefits in helping prevent tooth decay.

Nicotine has really surprising health benefits, which are only now being appreciated.  I understand it's hard for many to dissociate nicotine from the bad associations to tobacco health concerns, and of course despite any benefits, you certainly don't want to sit there and drink a toxic dose of the stuff.



Okay, I'm not suggesting that the OP not try to quit smoking, but if nicotine is the main issue, then there are certainly healthier ways to consume it (vaping can help because it still carries that inhalation of particles that smokers are so used to).
Title: Re: Smoking and HRT
Post by: noleen111 on May 26, 2015, 10:08:25 AM
Quote from: Valleyrie on May 25, 2015, 08:24:32 PM
So I've been on HRT for about a month now and during this time I haven't had much success in quitting. Aside from the obvious risks and increased potential of blood clots and whatnot, does smoking actually affect development in any way at all? I take oral estradiol pills if that makes any difference. Thank you!

edit: Also, I know it's different for everyone but I haven't noticed anything in regards to breast growth. I smoke about 8 cigarettes a day on average - could this be why?

Valleyrie, I am a smoker. I smoke from  1 to 5 a day, rarely there is a day I smoke none. I dont think it affected my HRT development. I have nice hips and D Cup breasts.

I am not saying dont try and quit.. To be honest I Have never tried to quit.
Title: Re: Smoking and HRT
Post by: Seras on May 26, 2015, 10:28:24 AM
Nicotine is in fact an estrogen agonist and will negatively effect your uptake of estrogen. However assuming you are not on pills and are on one of the modern forms of bio-identical estrogen the risks of thrombosis do not even approach what they once were.  My doctor allowed me to start despite being a smoker when I did. I have since quit.
Title: Re: Smoking and HRT
Post by: Jayne on May 26, 2015, 12:53:59 PM
It's time for me to fess up, I still smoke & I'm not likely to be quitting for a while as I'm seeing my gp this week to ask to be put back onto anti depressants.
I've been on HRT for over 18 months and I accept that every time in light up I'm rolling a dice, I previously quit for over two years but I need my head to be in a better place to succeed in quitting.

I'm going to break a personal rule and be the thing I hate most, a hypocrite. If you want the best from your transition then you really should try to quit.
That made me feel dirty, I don't like being a hypocrite one bit
Title: Re: Smoking and HRT
Post by: on May 26, 2015, 03:32:34 PM
My Endo said that tobacco is an estrogen inhibitor (besides the obvious DVT risk) and that in his experience, smokers generally don't get good results.  He said that even cis-females who smoke are estrogen deficient.

So.... it's either a scare tactic to minimize DVT risks or it's truly something to avoid.  I mean, I know every doctor will probably use ANY health issues to make a point to quit smoking, but I've read too many things, both medical journal stuff and anecdotal stuff about it to simply think it's not legitimately bad for transitioning.

Example quote:

"Based on the preponderance of evidence, smokers are likely to require higher doses of hormone replacement therapy (HRT) to achieve comparable clinical effect to that observed in nonsmokers. However, uptitrating the dose of HRT in smokers to achieve a desired systemic level or clinical response may simultaneously increase risk for adverse effects that are primarily driven by hepatic rather than systemic exposure."

Best bet:  Don't smoke.
Title: Re: Smoking and HRT
Post by: Dodie on May 26, 2015, 05:13:04 PM
Sorry to you girls who smoke.. I hate it.. My mother quit when she was 40 but died of lung cancer at 52.
My father smoked and died at 54
I am older than both and healthy as a horse.
One of my best friends, who shall die any day from smoking, smoked even after his Dad died of lung cancer at a young age.  His brother just died of it and he was 4 years older. But my friend keeps smoking.

No one will ever convince me smoking is ok.. I look so much younger than my mother did at 40 and I am 56..


Smoking is not good for you in any way.
You need to take care of your body. stop now..
Its bad for your skin, bad for everything.. period..
Sorry, but smoking is not as important as your healthy future.. you will die from it. And if you don't die from it, well it will affect your long term health in a negative way.
Dodie
Dodie
Title: Re: Smoking and HRT
Post by: noleen111 on May 27, 2015, 10:25:21 AM
Quote from: Dodie on May 26, 2015, 05:13:04 PM
Sorry to you girls who smoke.. I hate it.. My mother quit when she was 40 but died of lung cancer at 52.
My father smoked and died at 54
I am older than both and healthy as a horse.
One of my best friends, who shall die any day from smoking, smoked even after his Dad died of lung cancer at a young age.  His brother just died of it and he was 4 years older. But my friend keeps smoking.

No one will ever convince me smoking is ok.. I look so much younger than my mother did at 40 and I am 56..


Smoking is not good for you in any way.
You need to take care of your body. stop now..
Its bad for your skin, bad for everything.. period..
Sorry, but smoking is not as important as your healthy future.. you will die from it. And if you don't die from it, well it will affect your long term health in a negative way.
Dodie
Dodie

Dodie, us smokers are just stupid that way.. we know it can kill us, but we don't stop. The addiction can have such a strong hold on you, that you cant stop.

Me, personally, I am hooked, i need to smoke everyday and I do get cravings if I don't. When I am stressed, to smoke really unwinds me. I have never tried to stop. I have a friend who started smoking about a year ago, actually told me that she is now hooked and she wants to have a baby and is not sure if she could stop smoking. Its sad, but nicotine addiction is strong, and you need to be mentally ready to quit, otherwise you never will. I am not ready to quit, but I know I don't want to be a smoker for life.

Title: Re: Smoking and HRT
Post by: Jayne on May 27, 2015, 11:48:57 AM
I agree with Noleen, through my life i've screwed my body up with many addictive drugs (both prescription & illegal), I regret all of them & urge people to run a mile from anything that is known to be harmful and/or addictive, if you don't start you'll never have to struggle with quitting.
Nicotine is the one drug that I struggle to stay away from (not counting coffee), I gave up for two years & all it took was one poorly timed comment from a family member to have me runing back to nicotine.
Now, every time I try to quit the stress caused makes my eczema flare up like crazy & that stresses me out enough to make me run back to that damn nicotine stick.

Please read this next line in the voice of comic book guy from the Simpsons: Worst life decision EVER!
Title: Re: Smoking and HRT
Post by: Lady Smith on May 27, 2015, 07:42:45 PM
With smoking the best thing to do is never start.  Nicotine is shockingly addictive and you have to be seriously motivated to give it up.  When I was younger I ended up addicted to benzos due to a doctor's careless prescribing and they were a walk in the park to kick as compared to tobacco.

I haven't had much luck using nicotine patches or gum because for me they were about as addictive as smoking.  The only thing I found worked for me was sheer bloody minded determination.  Last time I gave up I was clean for two years until my elderly Mum had to go into 24hr care due to advancing dementia and the stress of trying to attend to all the endless paperwork as well as look after Mum's finances while I was ill myself sent me back to the ciggies again.

But I've decided to stop smoking (again!) because it isn't smart to be smoking with the chronic illness I have and the other thing is tobacco here in New Zealand is shockingly expensive due to the high health tax the government has put on it.  And that tax increases by a set formula every year with the intention of making tobacco so insanely expensive that no-one will buy it.  Personally I think all that will happen is that people who are presently growing and selling marijuana illegally will change over to growing tobacco instead, but that's none of my concern.

The local medical clinic where I live has a free program for anyone who wants to quit smoking so I'm going to sign on to that.  What I was thinking though was that it could be good to start a quitting smoking thread here on Susan's as a way of providing support and encouragement for anyone who wants to quit.  What are your thoughts on that?
Title: Re: Smoking and HRT
Post by: Rachel on May 27, 2015, 08:29:03 PM
I quit for good 7 years ago. I used Chantix and a method called fading.

I really hurt my body and 17 years ago stopped alcohol and drugs (by then pills when available with alcohol ). 7 years ago I had it with smoking. I just hated the smell and how it made me feel.

My PCP (at a very large trans practice) would only allow me to go on the dose I am on after I promised I would not do drugs, alcohol or smoke. He knows my history. Also, he knows I am now a health nut and my weight is normal and my hA1c is 5 to 5.2 for 2 years.

You most likely will get HRT but at a lower dose and you must be smoke free for GCS for  period before and after.
Title: Re: Smoking and HRT
Post by: Dodie on May 27, 2015, 08:48:43 PM
Sorry girls to be so direct. Going to a funeral for a woman who died if lung cancer last night.
Funer next Tuesday.  Ugh.
Dodie
Title: Re: Smoking and HRT
Post by: Jayne on May 28, 2015, 04:40:28 AM
I'm really sorry to hear that Dodie, best wishes to you in this rough time.

Whilst in my late teens I entered into a decade of addiction, I had issues with speed, lsd, alcohol, sniffing various chemicals & mushrooms are just the tip of the iceberg that nearly sunk me. Giving those up was hard, it took me almost killing myself by falling asleep & almost into a large piece of moving machinery due to being awake for days on end due to speed to make me give up.
Givimg those up was a walk in the park compared to nicotine
Title: Re: Smoking and HRT
Post by: allisonsteph on May 28, 2015, 06:38:41 AM
Quote from: Ms Grace on May 26, 2015, 03:37:33 AM
Nicotine is in fact highly addictive. While the tar and smoke and other additive will do the majority of the damage to your lungs, circulation and endocrine systems you really want to be getting off it altogether. Unsurprisingly they're starting to find that vaping is not all that safe (http://www.theguardian.com/society/2015/feb/04/e-cigarettes-toxic-chemicals-research-finds-lung-damage) either...

I agree... I was a smoker for over 30 years and quitting was the hardest thing I have ever done. Harder in fact than quitting heroin or pain pills. I had a very bad experience with vaping. About a year before I quit for good I switched to an e-cigarette. Within three weeks I had a horrible respiratory infection and was coughing up blood. I'm not saying it will happen to everyone, but it did to me.
Title: Re: Smoking and HRT
Post by: Lady Smith on May 28, 2015, 04:04:12 PM
When people told me I should try e.cigarettes instead of smoking tobacco I had my doubts about just how 'safe' they were supposed to be.
Title: Re: Smoking and HRT
Post by: Sarah leah on May 28, 2015, 04:21:52 PM
They are looking at banning them in South Australia due to reported health concern's and the ease of access for youth
Title: Re: Smoking and HRT
Post by: Urban Christina on May 28, 2015, 06:13:27 PM
Yes, any smoke is bad for the lungs. However, if you need to smoke; cigarettes is NOT the way to go.