Susan's Place Transgender Resources

Community Conversation => Transitioning => Hormone replacement therapy => Topic started by: Harley Quinn on February 27, 2017, 01:49:04 PM

Title: Failed progesterone and the battle continues...
Post by: Harley Quinn on February 27, 2017, 01:49:04 PM
Well, good times...  After 12 long weeks on medroxyprogesterone, I called it quits.  My mood issues became a problem that I couldn't muscle through.  So I pitched it and after 3 days I started feling better...  I am still persuing micronized progesterone, but I fear its going to be a long fight to get the prescription.  So until then I'm content with estrogen and spiro...  Not much of an update, but hey, cant win them all.
Title: Re: Failed progesterone and the battle continues...
Post by: ainsley on February 27, 2017, 01:52:47 PM
Glad you came to a decision that you agree with.  Do what is right for your body and mind. ;)
Title: Re: Failed progesterone and the battle continues...
Post by: LShipley on February 27, 2017, 09:41:21 PM
It is very weird, my women's health calendar says this:

"25 - The percentage by which women at a higher risk for Breast Cancer can lower their levels of Progesterone (a hormone that may promote cancerous cell growth) by exercising 45 minutes a day.

lol such a confusing hormone.

Title: Re: Failed progesterone and the battle continues...
Post by: KayXo on February 28, 2017, 08:53:24 AM
Doctors, media and many other entities confuse progesterone with other progestogens, namely medroxyprogesterone acetate.

PROGESTERONE is the hormone that is naturally produced in the human body, in greater quantities in women during the second part of their menstrual cycle and in very high quantities during pregnancy. It is available as oral Prometrium, Utrogestan, in suppositories as Cyclogest and as IM injection and it can also be compounded. During pregnancy, it is sometimes prescribed to women to prevent abortion or pre-term delivery. It is also prescribed to women going through in-vitro fertility. Studies have never shown an association of progesterone with breast cancer and pregnancy, a time when progesterone levels are VERY high, has been associated with a decreased risk of breast cancer.

MEDROXYPROGESTERONE ACETATE, on the other hand, was associated in a very large randomized trial from 2003 (Women's Health Initiative), with an increase in breast cancer incidence relative to women who weren't taking it. The bad press comes from this progestogen and also other progestogens that have been linked in other studies to an increased risk of breast cancer. This progestogen is NEVER prescribed to pregnant women as it can be mildly androgenic and can be harmful for the female fetus. It is not produced in the human body. It has also been associated with an increased risk of clots, vascular problems and mood problems.

Now you know. :)

Title: Re: Failed progesterone and the battle continues...
Post by: AshleyP on February 28, 2017, 11:04:36 PM
Thanks for the update, Harley. I've been quite interested in the use of MPA for a while. As I noted in one of your other threads on the topic, I had a feeling that my clinic leaned towards the use of it for their regimen. Sure enough, at my scheduled checkup last week, the doctor suggested that I add it to the mix. Based on your experience, Kay's input and other things, I asked about progesterone instead. The doctor suggested that I give this a try, that "others have had good results from it." So I left with a script for what I thought was a pretty high dosage.

I still had some reservations, so I asked for a consultation with the pharmacist. It was a curious conversation. I asked about the risk of mood swings and depression. The pharmacist said that taking any hormone can incur mood swings, noted that I was already taking a lot. She asked if I was experiencing mood swings already. I said no, not at all. Then she asked if I was prone to depression. I said no to that, too. Funny, she said almost the same thing as the doctor, "I think it's probably worth a try then." She did suggest that progesterone could be an alternative and looked up the cost for me. The price difference is huge.

Anyway, I got the prescription filled and have been taking half the prescribed dosage for a week now. I hadn't really noticed any effect. I'm suspicious, though, of several bumps on my arms that I originally attributed to possible insect bites. It borders on a rash, one of the less common side effects. I'm gonna stop for a few days and then possibly restart to see what happens.

Thanks again, everyone, for the input.

All the best,
--AshleyP
Title: Re: Failed progesterone and the battle continues...
Post by: KayXo on March 01, 2017, 01:19:38 PM
The issue with medroxyprogesterone acetate is not only onset of depressive moods in some which may also occur, by the way, with progesterone (although usually to a lesser degree and the opposite may also occur) but has more to do with its adverse effects on the cardiovascular system, breast tissue and coagulation whereas progesterone appears to have none of those adverse effects. MPA reduces estrogen's beneficial effects on lipids and its vasodilating effects in arteries. Medroxyprogesterone is also slightly androgenic (in contrast to progesterone) and given our circumstances, even if also having an anti-androgenic effect (antigonadotropic effect), the overall effect may not always be in our best interest.

If progesterone is too expensive, there are other, safer options, it would seem. You can have progesterone compounded at a lower cost or opt for hydroxyprogesterone caproate injections.

Personally, I would rather take no progestogen than take medroxyprogesterone acetate. The evidence in favor of not using medroxyprogesterone acetate is just too strong, in my opinion. I'm baffled as to why it is still on the market... or not when one considers how much money can still be made from it.
Title: Re: Failed progesterone and the battle continues...
Post by: apsharas on March 01, 2017, 01:43:55 PM
I have tried both. With medroxy, nothing ever happened. With natural, my libido was boosted, sensation of calm and better sleep.
Title: Re: Failed progesterone and the battle continues...
Post by: Harley Quinn on March 03, 2017, 11:59:47 AM
Officially one week off the MPA and feeling like my old self. I have a phone in update with my provider, who tried to say that my depression was brought about by too high of an estrogen level while on MPA. I don't buy it, but looks like they're going to cut my estrogen again and put me back on MPA before they will consider other options , that's "if" they are going to consider an alternate prescription. So cheers to more red tape and hoops!
Title: Re: Failed progesterone and the battle continues...
Post by: ainsley on March 03, 2017, 12:06:20 PM
Quote from: Harley Quinn on March 03, 2017, 11:59:47 AM
Officially one week off the MPA and feeling like my old self. I have a phone in update with my provider, who tried to say that my depression was brought about by too high of an estrogen level while on MPA. I don't buy it, but looks like they're going to cut my estrogen again and put me back on MPA before they will consider other options , that's "if" they are going to consider an alternate prescription. So cheers to more red tape and hoops!

OMG...  ???  I mean, seriously....  :insertSwearWords:
Title: Re: Failed progesterone and the battle continues...
Post by: Harley Quinn on March 03, 2017, 12:25:06 PM
Not proud of it, but I do think that I may have cursed her out on the phone in my MPA haze when she suggested that my estrogen was too high (same dose for the past 7 months), and that the MPA is not likely the culprit.
Title: Re: Failed progesterone and the battle continues...
Post by: ainsley on March 03, 2017, 12:33:26 PM
So, other people without HRT would react similarly when confronted with something like that.  Correlation does not result in causation. :)
Just be cause you popped off does not mean it is from any HRT you are on....
Title: Re: Failed progesterone and the battle continues...
Post by: jentay1367 on March 03, 2017, 12:59:34 PM
Hi Harley....what did your estrogen numbers come back at?  I'd think anything up to 250 pg/ml would be fine. If your numbers are out of line, they should at least be able to support that assertion with your results.
Title: Re: Failed progesterone and the battle continues...
Post by: Harley Quinn on March 03, 2017, 06:11:45 PM
76 pmol end of cycle... not high at all as far as I'm concerned. Any lower and I get hot flashes.
Title: Re: Failed progesterone and the battle continues...
Post by: KayXo on March 03, 2017, 06:17:59 PM
No one can force you to do anything you don't want to do.

Quote from: Harley Quinn on March 03, 2017, 06:11:45 PM
76 pmol end of cycle... not high at all as far as I'm concerned. Any lower and I get hot flashes.

That is very low indeed but levels fluctuate in time. Typical levels in pre-menopausal women during a menstrual cycle range anywhere from 73 to 2,400 pmol/L.
Title: Re: Failed progesterone and the battle continues...
Post by: jentay1367 on March 04, 2017, 12:15:06 AM
Fluctuation at her age should run about 30 percent at end of cycle. So these numbers are ridiculously low. On the other hand, your avatar reveals you to be more than quite feminine in appearance. Your receptors must be like sponges...l.o.l.

Anyway, the purpose of these things is to look and feel female. I don't know how you feel, but you look 100 percent woman.
Title: Re: Failed progesterone and the battle continues...
Post by: Harley Quinn on March 04, 2017, 06:50:42 AM
Quote from: jentay1367 on March 04, 2017, 12:15:06 AM
Fluctuation at her age should run about 30 percent at end of cycle. So these numbers are ridiculously low. On the other hand, your avatar reveals you to be more than quite feminine in appearance. Your receptors must be like sponges...l.o.l.

Anyway, the purpose of these things is to look and feel female. I don't know how you feel, but you look 100 percent woman.
I do make up magic... not that feminine. And how do you know I'm 36... are the wrinkles that bad!?!? Lol... (sorry, had to be done).
Title: Re: Failed progesterone and the battle continues...
Post by: Paige on March 04, 2017, 09:21:06 AM
Hi Harley,
This all sounds a bit ridiculous.  Is there a possibility of getting another medical practitioner that knows what they're doing?
Take care,
Paige :)
Title: Re: Failed progesterone and the battle continues...
Post by: jentay1367 on March 04, 2017, 09:48:20 AM
Quote from: Harley Quinn on March 04, 2017, 06:50:42 AM
I do make up magic... not that feminine. And how do you know I'm 36... are the wrinkles that bad!?!? Lol... (sorry, had to be done).


QuoteI do make up magic... not that feminine 




Well...if that's true, then you should be teaching the subject.
Title: Re: Failed progesterone and the battle continues...
Post by: Harley Quinn on March 04, 2017, 08:33:15 PM
Paige - not possible because I use the VA.

Jentay - thanks... I'm still learning, but I have posted on some of my experience with make up application.
Title: Re: Failed progesterone and the battle continues...
Post by: TechGirl on March 05, 2017, 12:29:19 PM


Quote from: Harley Quinn on March 04, 2017, 08:33:15 PM
Paige - not possible because I use the VA.

Gives me something to couch my expectations with. I retire from active navy next year, and already can't stand military medical wrt transgender care.
Title: Re: Failed progesterone and the battle continues...
Post by: JeanetteLW on March 05, 2017, 01:20:48 PM
 Have you tried the patient advocate? Or taking it up the chain to the LBGTQ care coordinator?
Title: Re: Failed progesterone and the battle continues...
Post by: Harley Quinn on March 06, 2017, 09:42:15 AM
I've considered talking with the LGBTQ coordinator, but I am attempting to ride out the request through my doctor. I may have the Frank conversation with her about using the patient advocate and LGBTQ coordinator to get past the pharmacist.
Title: Re: Failed progesterone and the battle continues...
Post by: JeanetteLW on March 06, 2017, 11:05:03 AM
  Good for you Harley. If you don't push for what you need who will. Best of luck for a happy resolution.

  Jeanette
Title: Re: Failed progesterone and the battle continues...
Post by: Paige on March 07, 2017, 07:38:01 AM
Quote from: Harley Quinn on March 06, 2017, 09:42:15 AM
I've considered talking with the LGBTQ coordinator, but I am attempting to ride out the request through my doctor. I may have the Frank conversation with her about using the patient advocate and LGBTQ coordinator to get past the pharmacist.

Hi Harley,

Do you think you could have a conversation with your doctor about the numerous HRT studies that support your point of view?  Or is she just stuck in her ways?  If you walk in with studies in hand, what we she do?

Good luck,
Paige :)

Title: Re: Failed progesterone and the battle continues...
Post by: Harley Quinn on March 09, 2017, 10:36:53 PM
She's very much a checklist doctor. She quotes the standards... aka the arbitrary numbers of standards of care from the endocrine society.

Today, over the phone she decided to cut my estrogen again because my end of cycle at 7 days was 518 pmol. She wants 200 pmol as her magic number. And had me split my Spiro into 2 separate doses every day rather than all at once. Another month like this and then she'll check back over the phone. And brought up lowering my finasteride again. My intuition tells me that I am going to have to spend another 6 months changing everything else before she will consider progesterone again. And more than likely medroxyprogesterone with different combos of every other med. I mean endless combinations of my other 3 prescriptions...

So next week I will try and see the LGBTQ coordinator... ** fingers crossed that there's no backlash.
Title: Re: Failed progesterone and the battle continues...
Post by: JeanetteLW on March 09, 2017, 10:51:58 PM
Quote from: Harley Quinn on March 09, 2017, 10:36:53 PM
She's very much a checklist doctor. She quotes the standards... aka the arbitrary numbers of standards of care from the endocrine society.

Today, over the phone she decided to cut my estrogen again because my end of cycle at 7 days was 518 pmol. She wants 200 pmol as her magic number. And had me split my Spiro into 2 separate doses every day rather than all at once. Another month like this and then she'll check back over the phone. And brought up lowering my finasteride again. My intuition tells me that I am going to have to spend another 6 months changing everything else before she will consider progesterone again. And more than likely medroxyprogesterone with different combos of every other med. I mean endless combinations of my other 3 prescriptions...

So next week I will try and see the LGBTQ coordinator... ** fingers crossed that there's no backlash.

Hi Harley,

   My guess is that they are not her magic numbers but more than likely she is following VA guidelines.
  I think I would stick to your guns though and at least find out if that is the case. Talking to the LGBTQ coordinator may help with that. And If there are any repercussions I would bring it up with the Patient Advocate.

I may run into the same issues as I will be discussing an increase in E after my next lab tests and I think it will discuss Progesterone too.

Wishing ya luck,
  Jeanette
Title: Re: Failed progesterone and the battle continues...
Post by: KayXo on March 16, 2017, 08:47:01 AM
Quote from: Harley Quinn on March 09, 2017, 10:36:53 PM
She's very much a checklist doctor. She quotes the standards... aka the arbitrary numbers of standards of care from the endocrine society.

Today, over the phone she decided to cut my estrogen again because my end of cycle at 7 days was 518 pmol. She wants 200 pmol as her magic number.

I think you mean 200 pg/ml and not pmol/L. 200 pg/ml = 734 pmol/L. That is the maximum level recommended by the Endocrine society and appears to have been based on what they deem to be the average levels in premenopausal women forgetting to take into account that:

- ciswomen get pregnant so that average levels during their premenopausal years are probably higher
- we don't have the same history as ciswomen: growth hormone levels, age at "female puberty", prior masculinization.
- levels vary to quite an extent in ciswomen so that narrowing down an ideal level to such a degree for everyone ignores the fact that we are individuals with different sensitivities. For some, a level of 100-200 may be good but for others, more may be needed to achieve optimal results and this needs to be determined by doctor and patient together based on psychological/physical results.
- levels of E vary in time and hence testing levels is not accurate.
- SHBG binds E and SHBG is sometimes higher in us due to oral intake of E so that even if our E level is in the 'ideal' range, our free E may be lower in comparison.
Title: Re: Failed progesterone and the battle continues...
Post by: LexiDreamer on March 16, 2017, 10:13:55 AM
Quote from: KayXo on March 16, 2017, 08:47:01 AM

- levels vary to quite an extent in ciswomen so that narrowing down an ideal level to such a degree for everyone ignores the fact that we are individuals with different sensitivities. For some, a level of 100-200 may be good but for others, more may be needed to achieve optimal results and this needs to be determined by doctor and patient together based on psychological/physical results.


Can you elaborate on this point?
What criteria could I base my "optimal results" on?
Unfortunately, as I'm sure often is the case for many trans-women, my prescribing GP only knows as much as shes been trained for by following Callen-Lorde written protocols.
They know enough to prescribe the meds and know what target levels to look for in the blood labs, but don't have any real knowledge of what  psychological/physical results should be.

Title: Re: Failed progesterone and the battle continues...
Post by: KayXo on March 16, 2017, 12:01:56 PM
Psychological: you feel good, you have energy, positive outlook on life, you sleep well
Physical: breast growth, female fat distribution, less body hair/slower growth, less/no body odor, facial changes, skin less oily, softer/translucent, overall feminization

Signs of too little may include anxiety/depression, trouble concentrating/brain fog, hot flashes, night sweats, feeling very tired/unmotivated, memory problems, overall health deteriorating, bone loss, ageing faster than normal, etc.
Title: Re: Failed progesterone and the battle continues...
Post by: LexiDreamer on March 16, 2017, 03:34:57 PM
Quote from: KayXo on March 16, 2017, 12:01:56 PM
Psychological: you feel good, you have energy, positive outlook on life, you sleep well
Physical: breast growth, female fat distribution, less body hair/slower growth, less/no body odor, facial changes, skin less oily, softer/translucent, overall feminization

Signs of too little may include anxiety/depression, trouble concentrating/brain fog, hot flashes, night sweats, feeling very tired/unmotivated, memory problems, overall health deteriorating, bone loss, ageing faster than normal, etc.

Interesting.
I still suffer from anxiety and depression,but I had that before HRT.
When I'm not feeling depressed my outlook is positive.
I do sometimes feel tired and unmotivated, but not sure if that is related to my depression or the cruel winters we have here in the northern US.
I don't know that my sleep patterns have changed much.
No hot flashes or night sweats.
I do have substantial breast growth, but I don't see a lot of the fat distribution happening yet though.
My body hair doesn't seem to have slowed down. It is lighter and finer now, but I've also done laser treatments and epilate my body hair.
My body odor has disappeared completely. That is amazing. I can go without deodorant for several days and no smells.
I just don't see the facial changes. But I'm not exactly sure what to expect.
My skin is definitely clearer and less oily.

I feel like some of those changes (like skin and BO) could be attributed to lower T levels as opposed to the E levels.

I did lose about 30 pounds and my frame got smaller.  And my butt has gotten smaller. I went from a 7 to a 5 in panties. I would think the E would increase my butt size.

7.5 months on HRT. Maybe, I'm just being impatient?
Title: Re: Failed progesterone and the battle continues...
Post by: KayXo on March 17, 2017, 08:26:49 AM
Personally (and I'm not a doctor), as long as there is substantial breast growth and mood is good or attributable to something else, I wouldn't change a thing. The doctor and the patient must come to an agreement as to whether HRT needs to be adjusted or not.
Title: Re: Failed progesterone and the battle continues...
Post by: TechGirl on April 02, 2017, 09:10:28 PM
Quote from: KayXo on March 16, 2017, 12:01:56 PM
Psychological: you feel good, you have energy, positive outlook on life, you sleep well
Physical: breast growth, female fat distribution, less body hair/slower growth, less/no body odor, facial changes, skin less oily, softer/translucent, overall feminization

Signs of too little may include anxiety/depression, trouble concentrating/brain fog, hot flashes, night sweats, feeling very tired/unmotivated, memory problems, overall health deteriorating, bone loss, ageing faster than normal, etc.
Funny, my Endo (male) and Endo office manager (female) both David hot flashes entries a sign I was in the normal range, and welcome to womanhood.

Mind you, I think they both live in a different works and couldn't disagree with them more.

And, despite any evidence I might provide, my Endo ID bound to follow his rules.

But that is the life under military health care.

Sent from my Nexus 6P using Tapatalk

Title: Re: Failed progesterone and the battle continues...
Post by: LexiDreamer on May 01, 2017, 03:45:46 PM
Well, I talked to my doctor about my low sex drive and asked her if I could start taking progesterone She told me she wanted me to hold off until the latest lab results to see where my levels were at.
She only had me dial back my Spironolactone as the lab showed my Testosterone at 25 ng/dL. Personally I'm fine with it that low, but I'm thinking she thought that level was affecting my sex drive?
So I dialed my Spironolactone back as she told me to (about 5 weeks ago), but I haven't noticed any change in libido.

Well, my girl friend dumped me last weekend, mostly because of my lack of sexual desire for her. Thanks for the help doc! :(

What is the best progesterone to take? I have read some girls reporting on here that some are good and some are very bad.

Thanks in advance...

-broken hearted
Title: Re: Failed progesterone and the battle continues...
Post by: ainsley on May 01, 2017, 03:53:28 PM
Quote from: LexiDreamer on May 01, 2017, 03:45:46 PM
Well, I talked to my doctor about my low sex drive and asked her if I could start taking progesterone She told me she wanted me to hold off until the latest lab results to see where my levels were at.
She only had me dial back my Spironolactone as the lab showed my Testosterone at 25 ng/dL. Personally I'm fine with it that low, but I'm thinking she thought that level was affecting my sex drive?
So I dialed my Spironolactone back as she told me to (about 5 weeks ago), but I haven't noticed any change in libido.

Well, my girl friend dumped me last weekend, mostly because of my lack of sexual desire for her. Thanks for the help doc! :(

What is the best progesterone to take? I have read some girls reporting on here that some are good and some are very bad.

Thanks in advance...

-broken hearted

I am sorry you are having trouble like that.  Also for your relationship issues. :(
I have tried several progesterone and I recommend Prometrium (oral take with fatty food for best absorption), or the generic version of it.
Title: Re: Failed progesterone and the battle continues...
Post by: LexiDreamer on May 02, 2017, 08:43:58 AM
Quote from: ainsley on May 01, 2017, 03:53:28 PM
I am sorry you are having trouble like that.  Also for your relationship issues. :(
I have tried several progesterone and I recommend Prometrium (oral take with fatty food for best absorption), or the generic version of it.

Thank you for your sympathy and your recommendation.
I'll try to get her on board with the Prometrium. At this point, I don't know what else to do.
Title: Re: Failed progesterone and the battle continues...
Post by: LexiDreamer on May 02, 2017, 08:55:03 AM
I know some of the girls on here talk about a Progesterone cream. Have you any experience with it?
Title: Re: Failed progesterone and the battle continues...
Post by: KayXo on May 02, 2017, 09:22:17 AM
Progesterone cream doesn't usually absorb well and you don't end up with very much in the blood. Best to stay away as you'll be throwing your money away, IMHO. Progesterone definitely has an impact on libido and how much I lubricate. I added some T recently (I'm post-op) and it didn't do much in terms of libido. P has a much greater impact on me but maybe my T is still too low, as far as libido goes.
Title: Re: Failed progesterone and the battle continues...
Post by: ainsley on May 02, 2017, 09:39:17 AM
Quote from: LexiDreamer on May 02, 2017, 08:55:03 AM
I know some of the girls on here talk about a Progesterone cream. Have you any experience with it?

I have not, but KayXo has and I would recommend her advice regarding that.  Progesterone definitely increased my libido and my T levels are null (reference ranges are for women...I am post-op):

Testoster Free
0.16 ng/dL
Reference Range: 0.06-0.95

Testoster Tot
10 ng/dL
Reference Range: 8-60
Title: Re: Failed progesterone and the battle continues...
Post by: JeanetteLW on May 02, 2017, 11:14:50 AM
Quote from: ainsley on May 02, 2017, 09:39:17 AM
I have not, but KayXo has and I would recommend her advice regarding that.  Progesterone definitely increased my libido and my T levels are null (reference ranges are for women...I am post-op):

Testoster Free
0.16 ng/dL
Reference Range: 0.06-0.95

Testoster Tot
10 ng/dL
 
Reference Range: 8-60

  I'll get my 4 month labs done on the 22nd. (My doc can't add 3 to January and come up with April so it is 4 and May) I am hoping to talk him into progesterone  and double my estradiol.  My first labs were all well within female ranges.
  I have some progesterone I ordered before telling him about me. I could...  well, we won't discuss that here.  Besides I'm trying to be a good girl now.  lol

  Hugs,
   Laurie
Title: Re: Failed progesterone and the battle continues...
Post by: ainsley on May 02, 2017, 11:31:54 AM
Quote from: JeanetteLW on May 02, 2017, 11:14:50 AM
...  I have some progesterone I ordered before telling him about me. I could...  well, we won't discuss that here.  Besides I'm trying to be a good girl now.  lol

  Hugs,
   Laurie

I am not ashamed about it:  I self medicated completely for several years.  I supplementally self medicate now even though I am under a doctor's care for my HRT.  When they don't listen and will not do what I want, I take action if their reasons are not logical.  My body, free country, my transition.  :)  My labs are always spot on...
Title: Re: Failed progesterone and the battle continues...
Post by: JeanetteLW on May 02, 2017, 12:40:31 PM
Quote from: ainsley on May 02, 2017, 11:31:54 AM
I am not ashamed about it:  I self medicated completely for several years.  I supplementally self medicate now even though I am under a doctor's care for my HRT.  When they don't listen and will not do what I want, I take action if their reasons are not logical.  My body, free country, my transition.  :)  My labs are always spot on...

I could agree and I sympathize with you but like I said, "I'm trying to be a good girl" I'm just getting started and want to give him a chance.  This will be only my second lab series. Well see where I am and go from there. He knows my desires and I'll remind him again after the results are in and see what he says.

   Hugs,
      Laurie
Title: Re: Failed progesterone and the battle continues...
Post by: LexiDreamer on May 03, 2017, 08:56:07 AM
Quote from: ainsley on May 02, 2017, 09:39:17 AM
I have not, but KayXo has and I would recommend her advice regarding that.  Progesterone definitely increased my libido and my T levels are null (reference ranges are for women...I am post-op):

Testoster Free
0.16 ng/dL
Reference Range: 0.06-0.95

Testoster Tot
10 ng/dL
Reference Range: 8-60

Thanks Ainsley!

I thought it strange that she had me dial back my Spiro for my T being at 25 ng/dL.

One more question please...

Do you cycle the Prometrium or take it every day?

Title: Re: Failed progesterone and the battle continues...
Post by: ainsley on May 03, 2017, 09:14:38 AM
I don't cycle.  I take it daily with food. 
I have recently begun adding inject-able progesterone to my regimen, too.  Very much liking the effects from that.  My nails stopped peeling and splitting, my hair is healthier, my libido is even better, and my hips are getting padding, albeit minor.  I have a voracious appetite, gain weight easily, and my workouts aren't as easy to get through, but, hey, that is what girls battle, right?
Title: Re: Failed progesterone and the battle continues...
Post by: KayXo on May 03, 2017, 09:33:16 AM
Quote from: ainsley on May 03, 2017, 09:14:38 AM
I don't cycle.  I take it daily with food.

+ 1

QuoteI have recently begun adding inject-able progesterone to my regimen, too.

Injectable progesterone needs to be injected daily or at the very least every 2 days because its half-life is very short. On the other hand, hydroxyprogesterone caproate, another relatively safe progestogen can be injected less frequently (weekly to biweekly). FYI, for others. I know you know Ainsley. :)

Quote from: LexiDreamer on May 03, 2017, 08:56:07 AMI thought it strange that she had me dial back my Spiro for my T being at 25 ng/dL.

I don't think it is. Some T may be needed for some for energy, well-being, etc. BUT, some also do well on very low T so it depends. I think it best that a doctor adjusts according to the patient's feedback (how they feel, overall feminization) rather than numbers. Did you tell her things were alright for you on this dose?
Title: Re: Failed progesterone and the battle continues...
Post by: LexiDreamer on May 04, 2017, 11:15:45 AM
Well, my total Testosterone level was at 99 ng/dL back in November so she had me up my daily dosage by 20%.
Two and a half months later my lab showed me at 37 ng/dL on the slightly higher dosage (perfect if you ask me).
My last lab in March had my level at 25 ng/dL (which seemed like a normal fluctuation from the 37 to me), and she had me drop the extra 20% of Spiro because she felt this was too low.
The Quest Diagnostic range for females is 2-45, so I can only assume she thought the lower level was somehow affecting my libido. 
I've been on the lower Spiro dosage for 6 weeks now (I'm assuming my level is probably back to around 99 again)  and my sex drive has not improved... much to the detriment of my relationship.
I think the only effect it's had on me is making my leg and facial hair grow a little bit faster again. :(

Now I've read where some doctors wait to prescribe progesterone until after 1-2 years of Estradiol, as it somehow may mark the end of breast growth. But, I have also met at least one girl that had both Estradiol and Progesterone prescribed right from the beginning of her HRT.
I know some of you are post-op so I assume you've been on HRT for several years.

I'm a 34-36 B bra size right now but my breasts are still tender, so I am assuming they're still growing.

Can I ask where you were in your transition when you added Prometrium?
I have been taking Spiro and Estradiol for almost 10 months now. I wan't to consider the possible unintended effects of taking Prometrium now, before I lobby my doctor for some (again).

Sorry for all the questions, but you girls seem to be very knowledgeable and experienced in this area, and I really appreciate your help here.
Title: Re: Failed progesterone and the battle continues...
Post by: Laurie on May 04, 2017, 01:13:18 PM
 Hi  LexiDreamer

    I have been asking my doctor about adding progesterone to my regimen. I've only been on HRT for 5 months now. His last answer is that he wants me on a full dose of estradiol before prescribing it. I'm not sure at this point what he considers a full dose yet but I know I at the lower end of the "normal dose range". I guess I'll be interrogating him more on the 22nd for that information.

  Hugs,
   Laurie
Title: Re: Failed progesterone and the battle continues...
Post by: KayXo on May 04, 2017, 03:44:00 PM
I took Androcur within two months of starting HRT and this is a progestogen. I took progesterone 1 yr into my HRT for no specific reason other than just to see if it would make a difference.

The idea is to mimic young girls in puberty and wait to give progesterone but that's far as the rationale goes. No real science behind it.
Title: Re: Failed progesterone and the battle continues...
Post by: LexiDreamer on May 05, 2017, 11:11:27 AM
Thank you Ladies!

My doctor sent the script in for Prometrium, but she doesn't think my insurance is going to cover it. Is there a generic I can suggest or should I really stick with the brand name version?
Title: Re: Failed progesterone and the battle continues...
Post by: AshleyP on May 05, 2017, 01:20:02 PM
Quote from: LexiDreamer on May 05, 2017, 11:11:27 AM
Thank you Ladies!

My doctor sent the script in for Prometrium, but she doesn't think my insurance is going to cover it. Is there a generic I can suggest or should I really stick with the brand name version?

Yes, there is a generic, but it's still pretty expensive. Kay once suggested to me that I ask a compounding pharmacy, and it cheaper there. The two I talked to have some weird dosage rules that they can't compound a med if it's a standard dosage, i.e. 100mg or 200mg. I don't know if I understood them right though. They didn't really want to talk to me when they discovered I didn't already have a prescription.

All the best,
--AshleyP
Title: Re: Failed progesterone and the battle continues...
Post by: KayXo on May 05, 2017, 04:09:20 PM
Maybe your insurance will cover it if you mention you can't tolerate the progestin, medroxyprogesterone acetate (i.e. depression). It worked for me. I get it for free. :)

Apparently, Prometrium is just as expensive as the generic. No difference, is what Merck claims.
Title: Re: Failed progesterone and the battle continues...
Post by: LexiDreamer on May 05, 2017, 11:02:42 PM
My insurance covered it. They gave me generic though. Round pink balls. They look strange for meds.
I started it tonight as the instructions say to take it once a night.

Anything I should watch out for?

Sent from my SAMSUNG-SM-N910A using Tapatalk
Title: Re: Failed progesterone and the battle continues...
Post by: ainsley on May 06, 2017, 11:29:32 PM
Quote from: LexiDreamer on May 05, 2017, 11:02:42 PM
Anything I should watch out for?

Vivid dreams. :)
Title: Re: Failed progesterone and the battle continues...
Post by: LexiDreamer on May 07, 2017, 01:59:36 AM
Quote from: ainsley on May 06, 2017, 11:29:32 PM
Vivid dreams. :)

OMG... you are so dead on with that one!
Title: Re: Failed progesterone and the battle continues...
Post by: AshleyP on May 07, 2017, 02:12:46 AM
Quote from: ainsley on May 06, 2017, 11:29:32 PM
Vivid dreams. :)

Funny that you'd mention that. While I'm not taking progesterone, it seems that my dreams have been much more vivid since beginning HT. As a practiced lucid dreamer, I've also found it much harder to "enter" my dreams, too.

All the best,
--AshleyP
Title: Re: Failed progesterone and the battle continues...
Post by: ainsley on May 07, 2017, 06:55:17 AM
I could not believe the vivid dreaming I began to do when I started progesterone.  They are unlike anything I have dreamt before taking it.  I still dream very vividly, and they seem so real!  Also, I remember them--another thing I never used to do.

It's crazy, but I like it, tbh.   :eusa_dance:
Title: Re: Failed progesterone and the battle continues...
Post by: LexiDreamer on May 08, 2017, 09:41:28 AM
I'm already a dreamer... hence my username. ;)

But the Prometrium has definitely amplified my dreaming! And yes, my dream recollection seems to be sharper too.

I've only taken it for 3 nights and overall I'm feeling pretty good. My mood was very calm and upbeat this weekend.

Hopefully it won't be long for the libido lifting effects to kick in. :)

Thank you so much for the recommendation!
Title: Re: Failed progesterone and the battle continues...
Post by: ainsley on May 08, 2017, 10:43:02 AM
Quote from: LexiDreamer on May 08, 2017, 09:41:28 AM
I'm already a dreamer... hence my username. ;)

But the Prometrium has definitely amplified my dreaming! And yes, my dream recollection seems to be sharper too.

I've only taken it for 3 nights and overall I'm feeling pretty good. My mood was very calm and upbeat this weekend.

Hopefully it won't be long for the libido lifting effects to kick in. :)

Thank you so much for the recommendation!

So glad to hear you are seeing good results thus far from it! 
Keep us posted.   :eusa_dance: