What should I expect at my first gynocologist visit i haven't had sexual reassignment surgery yet?
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Why the GYN visit since you are pre-op? Is this to interview the dr for when you are post-op?
No I'm going for horomones she also specializes in transgender mtf.
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Hello,
There will be some questions. Answer them truthfully.
If you are sure this is your path and know the consequences physically, financially and socially then state so.
Express why you want to go on HRT and how you feel about your assigned sex at birth in relation to how you see yourself and feel about yourself.
I was asked about partners and desired partners from my therapist, my HRT doctors and GCS/BA doctor. When I was young through college I thought I was gay but it turns out I am mostly hetero. So using labels can be confusing. Stating you like to receive X type of sex and give Y type of sex may be better.
Questions my be personal but it is no time to be bashful or hold back.
Most of all be yourself and be comfortable being you. Take deep breaths and tell yourself all will be ok ( it will be fine you are not the first nor will you be the last).
Good luck,
Rachel
A gyn prescribes my hrt too. My first visit she went over my lab results, reviewed the letters from my therapist. Then explained the changes that hrt would cause and asked if I was sure I wanted to go forward with it. Then she asked my dad if he was sure about giving his consent. ( I was only 17 at the time so he was with me). Then she asked me general health questions and gave me a basic exam. Then she gave me the prescriptions. She's never done any kind of genital exam on me but she does do breast exams to measure my progress.
The breast exam and lab work is nt a problem it's my lower male part I Guess it's a case of dysphoria
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I definitely know this is the path I want to take Rachel I've known for a long time since I was young I wanted to be a woman no turning back for me.Thanks
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I am also seeing a GYN for my HRT. It was simply the closest available doctor where I live. She has been seeing trans patients for over 10 years and the entire office is well trained to the point where the patient forms allow to specify a preferred name.
I am as a bit nervous going the first time nor knowing what to expect.
It was a basic health exam and urine test as well as a few questions on my health and trans history. She went on to explain her approach and the meds she is planning to use.
At the be I was given three prescriptions and two lab slips - one for the same day and one for a one month checkup. Follow ups and adjustments to meds have been done via phone and I now have to see her in person every 6 month.
I like her uncomplicated approach and she certainly looks at it from a female perspective. She already told me once I have past 18 month I should plan for Mammograms...
It will s very affirming being able to schedule GYN appointments [emoji846]
What three scripts did she give of you don't mind me asking Sarah?
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Spiro, Estrogen and Progesteron. Progesteron I take 14 days on, 14 days off. She said it is not entirely proven to do anything but it simulates more of a female cycle.
For me it does seem to help, I certainly notice my breast growth phases align with the Progesteron.
Good luck to you!
Quote from: bchigdon10 on September 23, 2017, 12:59:53 PM
What three scripts did she give of you don't mind me asking Sarah?
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Thanks will keep you posted
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One more question how long did it take before you noticed changes?
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About 10 days for mental changes. I was generally happier and much calmer.
Breast growth started about a month in but it is slow, made it to a full A cup in about nine months, but they are not done growing.
The biggest issue I faced was the first 5 weeks I was super tired from my body adjusting to Spiro.
Still would do I all again in a heartbeat...
Hugs Sarah
Quote from: bchigdon10 on September 23, 2017, 01:11:50 PM
One more question how long did it take before you noticed changes?
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Quote from: sarah1972 on September 23, 2017, 01:18:12 PM
About 10 days for mental changes. I was generally happier and much calmer.
Breast growth started about a month in but it is slow, made it to a full A cup in about nine months, but they are not done growing.
The biggest issue I faced was the first 5 weeks I was super tired from my body adjusting to Spiro.
Still would do I all again in a heartbeat...
Hugs Sarah
Spiro knocked me around as well, admittedly I was on Spiro only for several months but I'll second the tiredness that is causes.
Once your body adjusts to low T levels it seems to settle down as Sarah said.
I also found that the mental changes kicked in quite quickly once I started on the E
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Enjoy your visit with your OB/GYN. I have been working with mine for over a year now. When I first met with her it was about getting to know each other, beginning the relationship if you will. She has been working with the transgender community for some time, by choice and she is as interested in how to serve me as I am in receiving her service. It began with hrt and she is looking forward to helping me now that I am post op.
I assume that you have already done time with your therapist and have a referral letter. That is what your hrt provider needs, after that they are not there to judge you at all. They will talk what you are looking to achieve and will discuss drug regimes and will watch blood levels as you progress. They may do breast exams if your primary care doctor does not feel comfortable but your genitalia will be of no interest unless you go through surgery.
I have developed an enjoyable relationship with my OB/GYN and she is eager to work with me. Just enjoy this as another part of the wonderful journey.
I had low T before starting so the spiro only seemed to affect me once the weather was warm and I was outdoors sweating while working. I learned early on with that to carry multiple salt packets with me in my vehicle. Every time I felt weak or just off I'd pour two or three packets right on my tongue and get some water. When you need the salt it will taste pretty darn good.
I take spiro, estradiol, progesterone, and finasteride. I do not cycle my progesterone. There doesn't seem to be a point to it. Cis females go through an up and down cycle of estrogen and progesterone in synch with each other. Why deal with PMS if we don't have to?
A couple of warnings about these meds
Finasteride can have some serious side effects for a small percentage. For some the effects can be permanent. It blocks the enzyme that converts basic testosterone into DHT(dihydrotestosterone). This is the hormone that builds muscle and also causes male pattern baldness. That enzyme is also used in the brain, so some get depression from it. In a small number of people it changes their bodies production of the enzyme permanently even after quitting it. The side effects are mostly an issue for cismales who take it for hair loss or at higher doses for prostate enlargement and sometimes prostate cancer.
Spironolactone is a diuretic that does not flush potassium from the body. You will need to keep up water intake and cut out high potassium foods. What is does it latch onto the androgen receptors in your cells making them unavailable to testosterone. It can still active a low amount of receptors so one common effect is to continue to deposit belly fat and reduced deposit in the female areas that estrogen encourages.
Micronized progesterone is both safe and smart to have with estradiol. There are more than enough medical issues linked to excess estrogen /progesterone balance in cis women that any doctor should know it should be prescribed. Progesterone is required for complete breast growth. It interacts with HGH and two other factors to allow full development. Progesterone is know to counteract estrogen's negative effect on thyroid gland function. Estrogen dominance is found to often exist in cis women with hypothyroidism. Progesterone also counteracts the blood clotting factor increase caused by estrogen. Several of its byproducts are used in the body as well.
Ask for micronized bioidenticle progesterone. There is a cheaper progestin medroxyprogesterone or MPA that has known long term health effects and only provides the basic function of progesterone with none of the secondary beneficial effects.
Estrodial pills should be dissolved under the tongue or in the cheek. If you swallow them then it is absorbed through the small intestine and must pass the liver to reach the rest of the body. The liver will process much of the estradiol into estrone. This reduces the effectiveness and is also hard on the liver.
Quote from: josie76 on September 24, 2017, 08:53:27 AM
I do not cycle my progesterone. There doesn't seem to be a point to it. Cis females go through an up and down cycle of estrogen and progesterone in synch with each other. Why deal with PMS if we don't have to?
Agree. E and P both increase during the latter half of the cycle to prepare for the fetus and pregnancy and only drop if egg is not fertilized. Our situation is quite different and this is not needed. PMS = yuk!
If cycle wants to be reproduced, you also need to reduce anti-androgen 14 days out of 28 as T levels increase during the first half of a cycle. ;)
QuoteFinasteride can have some serious side effects for a small percentage. For some the effects can be permanent. It blocks the enzyme that converts basic testosterone into DHT(dihydrotestosterone). This is the hormone that builds muscle and also causes male pattern baldness.
Some studies have found that even when T cannot convert to DHT, muscle mass can still increase and that idea that DHT alone contributes has been challenged.
QuoteThat enzyme is also used in the brain, so some get depression from it. In a small number of people it changes their bodies production of the enzyme permanently even after quitting it. The side effects are mostly an issue for cismales who take it for hair loss or at higher doses for prostate enlargement and sometimes prostate cancer.
The enzyme is important for producing a host of neurosteroids that have anti-depressive/anxiolytic effects, helping us feel better. The negative effects have also been found in women taking it for hair issues. It seems rare though.
QuoteIt can still active a low amount of receptors so one common effect is to continue to deposit belly fat and reduced deposit in the female areas that estrogen encourages.
Spironolactone is a weak androgen receptor agonist, I wouldn't worry. Testosterone actually keeps belly fat away, much like estradiol and if belly fat increases in men, it's because of T levels going down, growth hormone levels also steadily dropping and excess carb intake. T and E are good to prevent belly fat. Women with higher T levels develop belly fat, not because of higher T but because of higher insulin levels which is the root cause of everything else, that overpowers T.
QuoteMicronized progesterone is both safe and smart to have with estradiol. There are more than enough medical issues linked to excess estrogen /progesterone balance in cis women that any doctor should know it should be prescribed.
Disagree. Many women actually feel much better with just E and feel worse with the P. Several studies to confirm this and E seems to have a beneficial effect on PMS whereas very few studies have found that P had any effect at all. The theory of estrogen excess seems to be fairly well-established as far as uterine/endometrium effects go but has no support insofar as other areas of the body are concerned. It is purely speculative and isn't supported by strong scientific evidence.
QuoteProgesterone is know to counteract estrogen's negative effect on thyroid gland function. Estrogen dominance is found to often exist in cis women with hypothyroidism. Progesterone also counteracts the blood clotting factor increase caused by estrogen. Several of its byproducts are used in the body as well.
Several studies would seriously challenge all these assertions. The data isn't consistent and associations alone do not prove causation.
QuoteEstrodial pills should be dissolved under the tongue or in the cheek. If you swallow them then it is absorbed through the small intestine and must pass the liver to reach the rest of the body. The liver will process much of the estradiol into estrone. This reduces the effectiveness and is also hard on the liver.
Oral bio-identical estradiol has never shown to be harmful to the liver, even in high doses. It can, however, slightly increase the risk of DVT but much less, compared to non bio-identical forms. I had better breast growth on oral E vs E taken non-orally and found no difference taking E sublingually vs. orally.
I know even that is a highly debated topic, but if you ask my SO, it is very real. She notices before I do, apparently I get quite cranky and my food cravings are all over the place after the 14 days of progesterone every month. She pokes a lot of fun at me...
Quote from: KayXo on September 28, 2017, 10:52:33 AM
PMS = yuk!
Quote from: sarah1972 on September 28, 2017, 12:46:34 PM
I know even that is a highly debated topic, but if you ask my SO, it is very real. She notices before I do, apparently I get quite cranky and my food cravings are all over the place after the 14 days of progesterone every month. She pokes a lot of fun at me...
Oh wow, you too? I get moody from the progesterone too. Insignificant things irritate me and I get in a really foul mood sometimes. My dad and brother call it being on my rag. When I remind them I don't have a period, they say I could have fooled them.