Hi all, I hope you are all well.
I have a question for you. This is a dilemma. Now, I have ALREADY asked a few doctors about what I am going to ask here and I got very conflicting opinions, so, I will ask here. I know you can't give medical advice, this is just a question about YOUR experience and YOUR opinion.
I am post-op and I have stopped estrogens a few weeks ago because I was only getting the bad side effects. Since I have stopped estrogens, I feel much better, my body looks slimmer, I am less puffy, less flabby/sagging (despite working out a lot). However, what is the lowest amount of estrogen one can take post-op? To be honest with you, after evaluating the pros and cons, hormones have certainly given me a slightly better skin, but, to what price? Water retention, skin is much thinner and prone to injury, collagen fibers very weak, veins show through, much, much, much harder to lose weight. Virtually impossible to keep fit and firm, tight, despite working out 6 days a week. I tried different type of hormones (premarin, estradiol valerate). I stopped the hormones, and, bang, everything gets better: better metabolism, better ability to concentrate, body contours are firmer and nicer, less cravings. So, I am between a rock and a hard place because I am trying to figure out what is the sweet spot to avoid remasculinization and losing the very few benefits that hormones have given me. Thanks a lot
post op hrt is basically to stop early onset menopause. So it would depend on your age what is appropriate levels. You don't want to mess up your bones. Your endo should be able to adjust your dosages to get you in a the lower end of an acceptable range.
Having more fragile skin and being less responsive to exercise is just part of being female.
Quote from: Serenation on November 30, 2015, 11:48:35 PM
Having more fragile skin and being less responsive to exercise is just part of being female.
Exactly. Too bad that women can get away with that since they have a female bone structure whereas, fragile skin and being less responsive to exercise in someone born male, with a male body structure, is not ideal. I feel as if I lost without gaining. The loss (fragile skin and being less responsive to exercise) was not counterparted by any gain (no change in the body structure, still masculine body structure.
You shouldn't have a problem with masculinization post-op, because you no longer have the ability to produce T at male levels. So a post-op trans woman is the same as a menopausal cis woman, in terms of needing at least a little sex hormones to keep the body working and prevent bone loss.
Personally, I was on a very very low dose pre-op and I stayed the same afterward (my dose is within the range of what's prescribed to cis women in menopause, in fact). If you're looking only for the very minimum, you probably do want to inquire about what is prescribed to a cis woman to fend off the worst effects of menopause.
PostOP I have the same dosage estrogen like ppreOP and I also have to take Androcur again because my T is to high. My "masculinization-factor" was preOP better. Dont know why, but after surgery a got hairloss, very unclear skin and lots of new hair on the body. Doctor has no answers.
I was curious and asked my endo about post-op estrogen, and he keeps the blood levels the same as pre-op.
Regarding high T, it doesn't seem to be commonly known, but Suporn's Post Op Care book says (edited)
In most cases, post-operatively there is no need to continue anti-androgens post-operatively.However, in some cases (about 5-10%) patients find that unwanted male characteristics can returnimmediately post-operative. ... The solution is simply start taking anti-androgens again at the same rate as one was taking pre-operatively for at least 3 months, and then gradually and steadily reduce the dosage of anti-androgen until at 12 months post-operatively the dosage can stop.
You can find it with google if you want.
I've seen other medical references say much the same.
I know this - Suporn was my surgeon ...
I some case LH/FSH-section rises and it causes higher T. But my LH is nearly 0 and my T is in a good range. But for my defect hormone balance its to much! The paragraph from this handbook dont explain my own situation.
Years on Premarin made my skin fragile to the point where I was getting very worried about it, but now I'm on Climara patches my skin has improved a lot. Premarin would also cause me to get into cycles of water retention and then having to constantly pee which isn't happening now I'm on patches. I haven't had GRS, I had an orchie done, but the final effect is the same. It's going to take some time for your body and metabolism to adjust post-op and finding the right HRT that will suit you best may take a little fine adjusting before you hit the sweet spot.
With Spiro I had to gradually adjust it down to a smaller dose post-op. Excessively dry and flaky skin was the clue that my dose was too high and it did take some months before the right dosage to suit me was found. After I changed to patches my Spiro needed to be adjusted again too.
Quote from: galaxy on December 01, 2015, 08:48:15 AM
I know this - Suporn was my surgeon ...
I some case LH/FSH-section rises and it causes higher T. But my LH is nearly 0 and my T is in a good range. But for my defect hormone balance its to much! The paragraph from this handbook dont explain my own situation.
Sorry, I misread another post.
Have you tried an endocrinologist? I have one who specializes in trans medicine his expertise is very impressive. Way more knowledge than any GP I've met.
Hi Teresita,
From what you've described, it probably worth the effort to be checked out by an Endocronologist. There may e a thyroid condition in the making here. You'll only ever know after a full blood lab including your T3 & T4.
You should always check with your PCP especially anything concerning side effects. They can be the precursor for other issues.
Check it out and see how you go.
Speak to you as soon as I've finished my night cap.
Huggs
Catherine
-imo estrogen should be in the normal female range. Not below, like in the menopausal range.
The neovagina reacts to estrogen like a cis vagina. Estrogen levels above the menopausal level should help avoid atrophy.
There are even reports of some women regaining depth after dilation and having sufficient estrogen levels.
-You might add bioidentical progesterone. Cis women also have bioidentical progesterone.
It has some anti androgen effects and might help with rounding of breasts, and mood, and counter some side effects of estrogen.
-its possible some glands produce testo, because a feedback mechanism reports low testo in the system. It might take some time for this to taper off. Testo should not be zero though, in cis women some testo is also present. It can help with orgasmic ability and overall drive. There are some forms of small dose testo applictions available for menopausal women for example.
Hello Everyone, post SRS my Estradiol Valerate level was at least doubled. I no longer take Sprio, my thin, dry and flaky skin issue disappeared. Oh and no frequent need to pee.
Urologist who preformed the surgery alongside Dr. Sinclair prescribed Finasteride to deal with possible prostrate infection. He said I can stay on it to deal with any other T blocker needs, such as DHT. Even though I don't have a hair loss issue. Also back on bioidentical progesterone which I stopped taking 5 months prior to SRS.
Since SRS my development has really kicked into high gear. Skin is much softer and pore size greatly reduced. Breasts are growing with no weight gain. The increase of Estradiol Valerate has amplified results. I also feel much more frisky!
Not sure a minimum dosage approach would help me feminize or keep what I have achieved. But I was only on HRT 9 months before SRS. Age could also factor in. I'm old and need all the help I can get! As they say YMMV.
Thank you,
Anne
Added: Estradiol Valerate via injections.
Quote from: OOAnne on December 01, 2015, 11:46:05 AM
Hello Everyone, post SRS my Estradiol Valerate level have at least doubled. I no longer take Sprio, my thin, dry and flaky skin issue disappeared.
Yes, this is a hrt without anti androgens. Its only considered safe with implants and injections.
An estrogen level well in the female range can drive down testosterone into the female range as well.
hugs
What does it mean LH and YMVV and LHS? I am confused by all these acronyms, sorry, and it is hard to follow.
Anyway, thanks for all the responses. LIke I said numerous times, I have ALREADY checked with MORE than one doctors. I have ALREADY had my tests done, but, I still wanted to ask YOUR opinion, here on these boards, regardless of what the doctors said. So, I reiterate that I have ALREADY Checked with doctors and got conflicting opinions, that is why I am here.
LH/FSH I have no idea what that is.
One poster mentioned remasculinization. To what degree, apart from having more hair? I saw NO improvement from hormones in my facial appearance. If anything, they made my facial appearance worse (more puffiness on an already masculine skull is not an ideal situation). I had to have FFS to see some results.
Also, some Post-op women take testosterone supplementation to help with sex drive, metabolism etc.
I checked my thyroid and everything is fine. I know it's the HRT that is causing the problems.
PS: may I ask you all a favor? Can you please avoid to tell me to check with my doctor? I have ALREADY done that numerous times. I am here to hear about YOUR experiences and YOUR opinions.
Quote from: teresita on December 01, 2015, 04:36:44 PM
One poster mentioned remasculinization. To what degree, apart from having more hair? I saw NO improvement from hormones in my facial appearance. If anything, they made my facial appearance worse (more puffiness on an already masculine skull is not an ideal situation). I had to have FFS to see some results.
Also, some Post-op women take testosterone supplementation to help with sex drive, metabolism etc.
I checked my thyroid and everything is fine. I know it's the HRT that is causing the problems.
Here is a study showing that bioidentical progesterone can have som anti androgen effects:
https://www.susans.org/forums/index.php/topic,192953.msg1733564.html#msg1733564
In summary, its a system with a few variables.
You might think about:
-estro levels high enough, well in the female range, maybe even high enough to drive down t into the female range.
-t should be in the normal female range, not above. Cis women do not have much masculinization by this.
-bioidentical progesterone could act as a support with a few effects
Imo its in the mix.
How much of each component should be tried out, people react differently.
And if after some time t levels produced drop doses can be adjusted.
There are not many people really very versed with this.
Many for example do not know all effects of bioidentical progesterone... like helping with breast form, and parts of the breast tissue...
hugs
Thank you.
One important thing that we have to mention here is that we do NOT have the same receptors as genetic females. So, saying that testosterone in genetic women is within a certain range, doesn't mean much in the case of someone who is XY genetically (male).
To sum up, genetic women have different receptors and respond DIFFERENTLY to estrogens. That is why so many trans-women on HRT do not get much benefit from HRT.
Also, I use this example to explain something. Our body is like a car. Our engine can be designed to work with fuel or with diesel. Even after SRS, our body (our car) is still designed to be working with the same fuel it was designed for. That is why, the SAME amount of testosterone in a genetic woman does NOT have the same effect on a neo-woman like me. It is a slippery slope and that is why I am constantly researching and it's a process of trial and error
Teresita : I apologize, then; you should disregard my experience above. I've been told by several doctors now that I do have the same estrogen receptors as a cis woman. (I don't see any reason why this wouldn't be true of any trans woman, but I won't argue with you about your own body and neither of us knows for sure about anyone else's.) That's why I was successful on a dose of estrogen low enough to be supplemental even for a cis woman (and no anti-androgens at all), and presumably that responsiveness means my post-op experience is not applicable to your situation.
Sorry about that.
Quote from: teresita on December 01, 2015, 06:02:14 PM
Thank you.
One important thing that we have to mention here is that we do NOT have the same receptors as genetic females. So, saying that testosterone in genetic women is within a certain range, doesn't mean much in the case of someone who is XY genetically (male).
To sum up, genetic women have different receptors and respond DIFFERENTLY to estrogens. That is why so many trans-women on HRT do not get much benefit from HRT.
Also, I use this example to explain something. Our body is like a car. Our engine can be designed to work with fuel or with diesel. Even after SRS, our body (our car) is still designed to be working with the same fuel it was designed for. That is why, the SAME amount of testosterone in a genetic woman does NOT have the same effect on a neo-woman like me. It is a slippery slope and that is why I am constantly researching and it's a process of trial and error
Well transgender people are already a mix.
Especially the comparison with diesel was given as how transgender people react to hormones:
one person described it as a diesel engine running on gas... and finally being switched back to diesel...
thats the relief effect many transgender people feel...
and quite a few transgender people outgrow their siblings concerning boobies...
it simply takes time, cis people need 5-10 years to grow...
also quite a few docs are conservative...
when switched for example to injections or implants and the right dosage quite a few people had good results...
imo part of it is also in the mix.
Its in some way similar to vitamins.
When using vitamins from non natural sources a multiplication factor is needed. Why ? The vitamins are the same. But in fruit there are additional substances which help the body to accept the vitamins.
Same for sugar by the way. Refined sugar cannot be built down by the body soon because additional substances are missing. So it stays in the circulation for quite some time, making for an addiction like effect.
So a proper mixture of hormones which are also present in cis people, namely bioidentical estrogen, bioidentical progesterone and testosterone should be beneficial.
People are different so different mixtures hve some different effects. Someone said endocrinology is the adaption to patients reactions.
hugs
Laura, thank you very much. Your posts are very informative. I appreciate. If sometimes I am considering a viewpoint opposite to yours it is NOT, in any way, to confront you or anyone else. I see this exchange as an educational dialogue so, it is important to consider ALL factors and ALL circumstances, even the ones that contradict another poster's viewpoint. If it is done politely, like we are doing here, it is very beneficial.
Thansk again
Quote from: Laura_7 on December 01, 2015, 06:33:48 PM
Well transgender people are already a mix.
Especially the comparison with diesel was given as how transgender people react to hormones:
one person described it as a diesel engine running on gas... and finally being switched back to diesel...
thats the relief effect many transgender people feel...
and quite a few transgender people outgrow their siblings concerning boobies...
it simply takes time, cis people need 5-10 years to grow...
also quite a few docs are conservative...
when switched for example to injections or implants and the right dosage quite a few people had good results...
imo part of it is also in the mix.
Its in some way similar to vitamins.
When using vitamins from non natural sources a multiplication factor is needed. Why ? The vitamins are the same. But in fruit there are additional substances which help the body to accept the vitamins.
Same for sugar by the way. Refined sugar cannot be built down by the body soon because additional substances are missing. So it stays in the circulation for quite some time, making for an addiction like effect.
So a proper mixture of hormones which are also present in cis people, namely bioidentical estrogen, bioidentical progesterone and testosterone should be beneficial.
People are different so different mixtures hve some different effects. Someone said endocrinology is the adaption to patients reactions.
hugs
Quote from: Serenation on November 30, 2015, 11:48:35 PM
Having more fragile skin and being less responsive to exercise is just part of being female.
Exactly. I've also noticed estrogen makes it easier to gain fat esp in certain areas (lower belly). I just take that as being female and move on.
Hi Teresita,
LH = Luteinizing hormone. It's a pituitary gland hormone. It's measurement is used to help diagnose dysfunction of the ovaries or testicles.
FSH = Follicle stimulating hormone. Again a pituitary gland hormone, responsible for sustaining ovarian follicular growth and spermatogenesis in males.
YMMV = Your milage may vary. The effect of a particular 'thing' may be different across a variety of people.
LHS = Not particularly sure. Maybe a derivative of LH by way of Luteinizing Hormone Serum.
Usually a blood test will include the neumonics of LH/FSH to investigate pituitary gland function.
I'm interested in your resource that has evidence XY exponents don't have the same receptors as genetic females. There appears to be conjecture within medical science on this matter.
Speak to you as soon as I clean out the bird cage.
Huggs
Catherine
Quote from: OOAnne on December 01, 2015, 11:46:05 AM
Hello Everyone, post SRS my Estradiol Valerate level was at least doubled. I no longer take Sprio, my thin, dry and flaky skin issue disappeared. Oh and no frequent need to pee.
Urologist who preformed the surgery alongside Dr. Sinclair prescribed Finasteride to deal with possible prostrate infection. He said I can stay on it to deal with any other T blocker needs, such as DHT. Even though I don't have a hair loss issue. Also back on bioidentical progesterone which I stopped taking 5 months prior to SRS.
Since SRS my development has really kicked into high gear. Skin is much softer and pore size greatly reduced. Breasts are growing with no weight gain. The increase of Estradiol Valerate has amplified results. I also feel much more frisky!
Not sure a minimum dosage approach would help me feminize or keep what I have achieved. But I was only on HRT 9 months before SRS. Age could also factor in. I'm old and need all the help I can get! As they say YMMV.
Thank you,
Anne
Added: Estradiol Valerate via injections.
Hi Anne
I am post-op 8 weeks now and feel great My Doctor did the labs on me and my levels are crazy
testosterone= 4
testosterone free= 0.4
Progesterone= 0.3
Estradiol- 502
PSA=0.68
Good reason why lots of thing have been going on with me.
Dose anyone know if this is normal ?
Hug's Lyndsey
Quote from: Lyndsey on December 14, 2015, 07:58:52 AM
Hi Anne
I am post-op 8 weeks now and feel great My Doctor did the labs on me and my levels are crazy
testosterone= 4
testosterone free= 0.4
Progesterone= 0.3
Estradiol- 502
PSA=0.68
Good reason why lots of thing have been going on with me.
Dose anyone know if this is normal ??????
I'm on estradiol
progesterone for the first 10 days of the month
no spiro.
Hug's Lyndsey
Hello,
could you leave out the dosage ? Its because of possible misuse. You can edit your posting.
Would it be possible to add units to the lab values ?
Its a difference if estro is in pg/ml or a different unit for example...
hugs
Hi Laura
Sorry about the mix up
All my labs are in pg/ml
Hugs
Lyndsey
Quote from: Lyndsey on December 14, 2015, 08:35:32 AM
Hi Laura
Sorry about the mix up
All my labs are in pg/ml
Hugs
Lyndsey
Progesterone should be
ng/ml
Post-Menopausal 0.1 - 1
might be higher...
testo levels should be good...
estro levels are well imo...
If testo should drop too far a supplement might help... there are gels and implants...
a certain amount of testo might help with overall drive and orgasmic ability...
but of course first should be estro and progesterone levels high enough...
a neovagina reacts to hormones like a vagina, so having high enough levels, above menopausal levels, might help avoid atrophy...
hugs
I guess testo is 4 at ng/ml ... its much to high, really to much.
Maybe thats the "post-op-flush".
Quote from: galaxy on December 14, 2015, 11:07:29 PM
I guess testo is 4 at ng/ml ... its much to high, really to much.
Maybe thats the "post-op-flush".
ng/dl ng/ml
Females 6 - 86 0.1 - 1.2
Males 270 - 1100 2.4 - 12
and 1 ng/ml = 3.47 nmol/l
Quote from: galaxy on December 14, 2015, 11:07:29 PM
I guess testo is 4 at ng/ml ... its much to high, really to much.
Maybe thats the "post-op-flush".
I'm not sure if it is but my Endo said it was good
Hugs
Lynn
Quote from: Lyndsey on December 16, 2015, 10:52:12 AM
I'm not sure if it is but my Endo said it was good
Hugs
Lynn
Well it depends on the unit... if its ng/dl or ng/ml ...
hugs
Quote from: Lyndsey on December 14, 2015, 08:35:32 AM
Hi Laura
Sorry about the mix up
All my labs are in pg/ml
Hugs
Lyndsey
All my labs are as stated above
Lynn
I am post-op 8 weeks now and feel great My Doctor did the labs on me and my levels are crazy
testosterone= 4
testosterone free= 0.4
Progesterone= 0.3
Estradiol- 502
PSA=0.68
Quote from: Lyndsey on December 16, 2015, 10:55:27 AM
All my labs are as stated above
Lynn
Well Progesterone should be in ng/ml ...
same for free testosterone ?
Free testosterone with .4 :
FREE TESTOSTERONE
ng/dl pg/ml
Females 0.3-1.9 0.6 - 6.8
Males 9-30 47.0-244.0
this might point to total testosterone with 4 as ng/dl
ng/dl ng/ml
Females 6 - 86 0.1 - 1.2
Males 270 - 1100 2.4 - 12
hugs
*
Thank you for the comparison.
My endocrinologist acts rushed - rush me in, rush me out, no real talk or discussion about what it all means or comparisons, she mostly tells me that my blood work is within normal and sends me on my way every six months. Maybe because I'm her first and only transsexual and she is learning.
I scored estrogen at 281 pg/mL at my July blood draw but my December crashed to 31 pg/mL. My endo gave no explanation to me - just told me that 31 is okay for 59 years old menopausal female. I am on negligible estradiol ERT (can't get much lower other than zero) and no progesterone (she refuses to prescribe it; have not had it since 1979). The estrogen difference might have been that I took myself off phyto-estrogen these past six months, which suggests to me that my system accepts phyto-e so back I go when I felt better at higher estrogen.
My endo told me my testosterone is as low as it can go, but your levels are lower than mine - according to your standard basis, mine is actually high and outside the range (maximum is 6.8 pg/mL) while 'total' is at high within the range (maximum 86 ng/dL).
These are my December numbers:
Free testosterone 8 pg/mL
Free testosterone 1.1%
Total testosterone 76 ng/dL
What is: 'Sex hormone binding' (mine is 68 nmol/L)?
*
Hi ... Just a "benchmark" for me, 30 years post-op. I went to see my doctor (an MtF Transgender herself) and she had some fresh blood-test lab results for me. Estradiol level was 345 ng/dl, testosterone was 4 ng/dl ... really low. She didn't like 345 for the estrogen, and told me to keep it down to < 200, so I have another lab test next month to make sure I'm "obeying her rules". I went many years with no HRT post-op, because in 1985 they sent me on my way with no HRT. The result was that now I have mild osteopenia, which is "pre-osteoporosis". (Determined by a bone density X-ray she ordered in addition to the blood-work lab tests.) Not serious though, and she said I could recover the bone density with proper HRT & calcium monitoring over the next two years. The message: Pay attention to such things. We don't want to end up broken-hip basket cases or hunchbacks in our old age!
Quote from: Roberto on December 30, 2015, 07:37:40 PM
Hi ... Just a "benchmark" for me, 30 years post-op. I went to see my doctor (an MtF Transgender herself) and she had some fresh blood-test lab results for me. Estradiol level was 345 ng/dl, testosterone was 4 ng/dl ... really low. She didn't like 345 for the estrogen, and told me to keep it down to < 200, so I have another lab test next month to make sure I'm "obeying her rules". I went many years with no HRT post-op, because in 1985 they sent me on my way with no HRT. The result was that now I have mild osteopenia, which is "pre-osteoporosis". (Determined by a bone density X-ray she ordered in addition to the blood-work lab tests.) Not serious though, and she said I could recover the bone density with proper HRT & calcium monitoring over the next two years. The message: Pay attention to such things. We don't want to end up broken-hip basket cases or hunchbacks in our old age!
Hi Roberto
Thank You noting that as My estrogen has been 523 and that is way to high. My T was .04 which is basically non existent Big adjustments coming for me.
Lyndsey
I stopped HRT for a year before SRS and recently just started again on Proginova <Not Permitted> per day after 4 weeks of SRS done by Dr Suporn. He said i may start HRT back again. Hooray
Sent from my iPhone using Tapatalk
Mod Edit:Dosage
Welcome to Susan's Place Qcammy. I hope you enjoy the site and if there is anything we can do to help you, let us know.
We issue to all new members the following links so you will best be able to use the web site.
Things that you should read
Site Terms of Service & Rules to Live By (http://www.susans.org/forums/index.php/topic,2.0.html) | Standard Terms & Definitions (http://www.susans.org/forums/index.php/topic,54369.0.html) | Post Ranks (including when you can upload an avatar) (http://www.susans.org/forums/index.php/topic,114.0.html.) |
Reputation rules (http://www.susans.org/forums/index.php/topic,18960.0.html) | News posting & quoting guidelines (http://www.susans.org/forums/index.php/topic,174951.0.html) | Photo, avatars, & signature images policy (http://www.susans.org/forums/index.php/topic,59974.msg383866.html#msg383866) |
Quote from: Roberta on December 30, 2015, 07:37:40 PM
I went many years with no HRT post-op,
Interesting, thanks for posting this. I quit all meds quite a few years ago. Less is more. Moderation is best. I don't ever get sick so going to the Dr. seemed pointless other than to enter into the "payment for prescriptions" scheme of gatekeeping, science experiments, and extortion. We moved a few times and I just haven't bothered even trying. It's a bit like taking your perfectly working car to a shady repair shop and asking them to see if there's anything they can find wrong with it - isn't it? I'll pass, for now.
The lack of hormones post-op can cause osteoporosis, cognitive deterioration, accelerated ageing, mood problems, lack of energy and motivation, dry skin/hair/vagina, contribute to the onset of early diabetes, perhaps increase the risk of cancer and heart disease, etc.
Quote from: ShotGal on May 02, 2016, 10:01:58 PM
Interesting, thanks for posting this. I quit all meds quite a few years ago. Less is more. Moderation is best. I don't ever get sick so going to the Dr. seemed pointless other than to enter into the "payment for prescriptions" scheme of gatekeeping, science experiments, and extortion. We moved a few times and I just haven't bothered even trying. It's a bit like taking your perfectly working car to a shady repair shop and asking them to see if there's anything they can find wrong with it - isn't it? I'll pass, for now.
Going with the car analogy, why bother going to a service shop to get the oil changed, or the tires checked? Its its been doing fine so far, so you don't ever need to worry about it?
You do need to find a decent repair shop though, not a shady one, and its just the same with doctors. In general I trust doctors about as much as I'd trust a repair shop, but I've managed to find a couple of good ones.
Quote from: ShotGal on May 02, 2016, 10:01:58 PM
Interesting, thanks for posting this. I quit all meds quite a few years ago. Less is more. Moderation is best. I don't ever get sick so going to the Dr. seemed pointless other than to enter into the "payment for prescriptions" scheme of gatekeeping, science experiments, and extortion. We moved a few times and I just haven't bothered even trying. It's a bit like taking your perfectly working car to a shady repair shop and asking them to see if there's anything they can find wrong with it - isn't it? I'll pass, for now.
People are different.
Some people may have enough t produced by glands for a good well being.
Estro might help with libido, and the neovgina reacts to estrogen like a vagina, so there may be less dryness and atrophy, and there might be an overall better well being. Transgender women are not menopausal women, estrogen levels well in the female range might help.
hugs
Quotewhat hormone regimen is best for post-op woman?
Actually i take no hormones. Very simple.
Lyndsey: Your post op levels rival mine. I'm 13 weeks post op now. My 1st labs after surgery were at approx. 9 weeks. My Estradiol was high like yours around 525. My injectable dosage was decreased by 1/2 and the next labs showed that it dropped all the way to an 80. Labs were run again & it jumped back to 530. My Endo doesn't have an answer. Last week, I started noticing a return of male BO which really surprised me. So I added a patch to my regimen. I'm only doing injections 2 x mon. will have more labs in about 10 days. Who knows where they will be then!
I have been on 'mones since March '15 & my endo was never able to attain the level that he want of approx. 200. I'm receiving treatment at a govt. run facility The scary thing is that he is the Director of the Dept. He's only tested my Progesterone levels once and that was last year. Guess I'll have to prod him to check the progesterone levels again now that I'm post op. I been on Progesterone for over a yr.
What a ride!
E levels fluctuate quite a bit on injections so there is really no use in measuring them, they will be over the place. Ask your doctor why he aims for 200 pg/ml and what this decision is based on. Higher levels in men with prostate cancer of a certain age and in pregnant women have not shown to significantly increase health risks, I can provide these studies and statistics to you, if you so wish. I'm post-op since 2005, my E levels are around 1,000-4,000 pg/ml. My health is fine and I'm supervised by three doctors. Injecting every 2 weeks can cause too wide fluctuations in levels leading to menopausal symptoms in some in the last few days but if you feel fine, then alright. I inject every 5 days.
Lastly, shouldn't feminization and well-being be more important than levels? Obviously the return of BO is not a good sign and this goes to show you that reliance on levels alone is not in your best interest. If instead the focus was your health, psychological well-being and overall feminization, I think things like this would not happen. Just my 2 cents, I'm not a doctor but worth discussing these matters with your doctor, I think.
I have been taking the same dosage of estrogen for at least 15 years now and I still take the same dosage as what I took as a pre-op. Truthfully I feel fine. I actually feel like a chemically balanced normal person if that makes any sense. I wouldn't want to change my dosage because I do well on what I take now. My endo seems to agree as well when I pay my annual visit.
*
This addendum is in case any future user seeks this thread for reference.
I had my periodic gynecology exam today. This is my first gyn exam with this gynecologist. She and I discussed estrogen levels typically approved for M-F post-op at my age (60 years old). My gyn is experienced with multiple post-op M-F patients; I am my endo's first and only trans patient.
- My endocrinologist has maintained my estrogen dose at 'X' mg per day; my gynecologist told me that she considers the correct dose at least twice that amount and will recommend it in her medical notes.
- My endocrinologist's dosing has kept my estrogen levels at 20s to 40s. My gyn told me that post-op M-F estrogen levels at my age should be at upper-100s to lower-200s and that a gradual increased dose should achieve those correct levels.
Work with your physician to be certain that you receive the correct dose to sustain your correct blood levels. I have few risks; I am a non-smoker, in good health, no risk of embolism.
Of course, the well-worn phrase is applicable: YMMV.
*
Do your endos recommend progesterone? Mine said it would be pointless to take, since it's main role is to prepare the milk ducts during pregnancy. Yet I've read some girls on here swear by it. ???
Quote from: Sharon Anne McC on August 24, 2016, 01:00:37 AM
- My endocrinologist's dosing has kept my estrogen levels at 20s to 40s. My gyn told me that post-op M-F estrogen levels at my age should be at upper-100s to lower-200s and that a gradual increased dose should achieve those correct levels.
My endo said:
QuoteThe Endocrine Society guidelines recommend a target estradiol between 50-150 pg/ml. 200 is the upper end of the range.
I started HRT about 20 years ago and am 18 years post op (well to be accurate it will be 18 years in 4 more days) and about your age. I was off HRT for 6-7 years and just restarted a couple of months ago. I was on injectables for many years with very high E2 levels with no issues.
For most of the time I was on HRT originally, those guidelines did not exist and I was not aware, until recently, that they existed at all.
This new (and much younger) endo put me on patches... After a the first month my blood level 3 days after putting on the patch on (the day before i was supposed to put the new one on) was 63 pg/mL... i was horrified at how low it was ... but she said that was within the target range and that is when she told (well wrote) me about the guidelines.
Given that my blood work (lipid levels , cholesterol, triglycerides etc) was very good, particularly considering my age and the fact that I am heavy, she agreed to double my patches..
When tested again (again at 3 days after) my blood level was 111 pg/mL and she does not want it any higher. She worries about possible clotting - but given I was ay MUCH higher levels for many years, and given i'm using patches so no first pass through the liver, I am not worried and would not be if my levels were much higher.
Right now about a day after I put on the patches I sometimes have a little breast tenderness, which is gone by the next day. BTW even on the high does I never got much breast growth.
- Karen
*
My endo placed me on progesterone a couple months ago after I lobbied her about it for more than a year. I mentioned to her that others in my similar circumstance (post-op, age 60, good health, no risk factors, etc.) were on it. I asked her what she says it is supposed to do and how will it show on my blood draws to be certain that it is not harming me. She was not much help in any of that. It remains to be seen with my next blood draw in October how it affects those issues.
Otherwise, I really do not know what it is doing, or not doing, or maybe it needs to be a higher dose, or a lower dose, or how it needs to be in relation to estrogen (I dissolve that pill under my tongue). More than a few months seem to be needed to assess what progesterone is doing for me, to me. We shall determine this early effect at that October appointment.
I lost my then-primary about 16 years ago and had to continually hunt for a physician who would work with me. They lasted maybe one or two years; at least they continued my prescription level at more than double what my current endo prescribes - until I came to my current endo (2012). She dropt me to bare minimum and has not raised it since then.
It seems that though there are target levels, each endo or primary wants to do their own.
*
Quote from: KayXo on May 04, 2016, 12:17:31 PM
The lack of hormones post-op can cause osteoporosis, cognitive deterioration, accelerated ageing, mood problems, lack of energy and motivation, dry skin/hair/vagina, contribute to the onset of early diabetes, perhaps increase the risk of cancer and heart disease, etc.
I guess I am still catching up on all the information that is available here at Susan's Place. Kay, when I saw your comment on some of the problems caused by no HRT, I thought you were talking to me! :o A few months ago I went to my MD to find out why I was so tired all the time. Sometimes pretty moody too, although in my eyes to a lesser degree.
Anyways, a follow up to MD found I
am prediabetic and possibly osteopenic, along with what i mentioned already. So now, I am back on HRT, and making adjustments to it as needed. I find using some progesterone is beneficial for me, and there are others who likely don't need it or want it. I feel better about pretty much everything. I found that getting back on female hormones motivated me to take better care of myself, and this makes my life a little more bearable. But my bones are still a little sore, esp some of my joints.
I am also trying to shed a few pounds, and already people are commenting on how I look like I lost some weight. Some are aware of the HRT, others not so much.
I guess what I want to say is that hormones play a pretty big job in keeping us going, and finding the right dosages for each individual is necessary. Some more, some less.
Hugs