I have just been prescribed estrogen patches by my private doctor in london! Yay!
I thought that I would be prescribed an anti androgen too but my doctor said I don't need them I only need the patches.. Is this right? I was quite concerned about this as I thought I'd need an anti androgen to lower testosterone as well as estrogen.. Is this right??
To be frank jennifer, this is a decision that your Dr will have made, based upon the observations.
Can you speak to him again and ask him why he hasn't perscribed an antiandrogen. It does seem strange, but he really needs the benefit of the doubt.
Let's face it, you don't hire a mechanic then fix the car yourself!
Quote from: jennifer90 on March 04, 2011, 11:00:59 AM
I thought that I would be prescribed an anti androgen too but my doctor said I don't need them I only need the patches.. Is this right?
Is this right? Well, typically, no, it isn't. Very often, when someone begins HRT, an anti androgen will be initially prescribed, and the patient will be observed for any negative reactions. At a later point in time, estrogen will be added. What happens, is the anti androgen lowers the level of testosterone in the body so a lower dosage of estrogen is needed to achieve the desired feminization. Without the anti androgen, a higher dosage of estrogen would be needed, and with the higher dosage goes an increased chance of negative side effects. The aim is to achieve maximum feminization with the lowest levels of anti androgen and estrogen. Without an anti androgen, a higher dosage of estrogen would be needed for similar gains. Sometimes, both the anti androgen and estrogen are initiated at the same time. Sometimes, rarely, estrogen alone is prescribed; the client may not tolerate the anti androgen, or the prescribing physician may not be educated on modern HRT protocols for transitioning patients.
There's enough information concerning HRT theory and suggested regimens on the Internet; you may wish to copy some of this information and discuss it with your doctor. You may also consider finding a doctor, perhaps an endocrinologist, who has experience working with HRT for transitioning patients. You can also contact your local LGBT Center, and ask for a recommendation for a doctor.
My doctor is a specialised doctor who only deal with trans patients, and is actually a FTM. He looked at my blood test results which I provided to him and said my t levels were in normal range and then gave me these estrogen patches. I asked him about an anti androgen too and he said I don't need one, the patches are enough. I said every trans person I have spoken with online was also prescribed an AA and he said you don't need them that's an old way of medicating and the patches are enough for now. I am so confused...
you can do it that way but it's dogey if you ask me the theory goes that modern estrogen's will disrupt the feedback loop between the pituitary gland lowering T anyway with just E...
although it can work I'm extremely dubious of the claims and would ask for proof ¬.¬
The "old way" of medicating used a different form of estrogen which had a greater risk of side effects. An anti androgen was also used.
I'm not familiar with a medical doctor who specializes exclusively in trans patients. What, exatly, is his specialty, endocrinology? Your t levels are in the normal range for a female?
Yes my doctor is a private doctor I travel to london to see, his name is Dr Curtis and is very well known in the UK, google him.
Although I trust him, I am just unsure about why he hasn't prescribed me any anti antrogen. If he os so specialised in this matter, should I just take his word and go along with this? Its not like I havnt asked him...
Having read some, what I would frankly consider to be imbecilic and shortsighted papers about progesterone written by Dr Richard Curtis, my opinion of his ability as an endocrinologist is so poor it is quite literally off the scale! ::) My view is that just because someone may have been trans and may be a doctor, that does not equate to an automatic qualification to treat the condition.
However, there are many people who have gotten perfectly satisfactory results with him so my advice would be that, as you chose him, presumably in full knowledge of all the other possible private doctors like Michael Perring, and various others who operate in this field, you should at least give Dr Curtis a fair chance to prove himself.
Even though Dr curtis is quite literally the last person on earth that I would personally choose I would still strongly advise against chopping and changing at this early stage. It is not fair to anyone.
If, after a few months, things are not progressing as you would wish, then maybe review things, but for now stick with the doctor you have chosen and see what transpires.
It's impossible to know what Dr. Curtis's priority is, the maximum obtainable feminization results with safety, or the maximum obtainable profit margin with slow, but eventual feminization. He does offer convenience, doesn't he?
Many doctors administer HRT without ever doing blood work to determine testosterone or estrogen blood levels, preferring to rely upon the response of each individual patient. Makes sense, since the blood levels really don't give a reliable indication of how someone feels or responds to HRT, for example, my blood levels had been within correct tolerances for the anti androgen, yet, I'd occasionally have undesirable side effects. Blood work is routinely done, but other functions are monitored.
What I'm saying, is there is no ONE WAY of administering HRT, and what works best is often the result of trial and error with each patient. An experienced doctor will have an established starting point and a typical way of advancing, with adjustments being made as necessary. A doctor should be flexible, and the patient realistic. I suppose you'll realize desired gains with Dr. Curtis, but the progress may be slow, minimal, and expensive; I see that this clinic is on the expensive side. You may find faster results at a lower cost elsewhere. Personally, I'd find another doctor, someone more in tune with his client.
Society refers to the "practice of medicine" becuase it is an art not a science. It really is the ultimate YMMV.
Quote from: regan on March 04, 2011, 02:29:42 PM
Society refers to the "practice of medicine" becuase it is an art not a science. It really is the ultimate YMMV.
So true! what will cure one person can kill another.
Hmm now I'm really worried. Surely there's a reason other than money why he would not prescribe them? I have my first appointment in Charring Cross in May so maybe they will prescribe them.
My friend gave me 1 months supply of Avodart which I have been taking for a few days, if I continue with these and the patches should I be ok?
By the way I was prescribed Estradot and told to change the patch every 3 days and was given 1 months supply.
Quote from: jennifer90 on March 04, 2011, 03:07:14 PM
Hmm now I'm really worried. Surely there's a reason other than money why he would not prescribe them?
He's probably got frozen assets in Nigeria too...
Even though not having AA would mean more estrogen to have similar effect, from what i read, patch are the safest method, so.. i guess high dosage of the safest methode is still better than AA + low dosage of the most dangerous way (witch is pills, once again, from what i read)
If your doctor only treat trans people, and he actualy know what it is to go though this, id say he know what he do, everyone's their method, just as you are right to not agree with his method, if thats what you want, but no matter if its the best way or not, i'm pretty sure of one thing, it cannot be totally wrong
jennifer.
I will strongly advise you against using something that is not perscribed. Host of reasons but you'll just end up annoying the Drs treating you. Not a good idea.
Continue with the perscription you have and wait till your appointment at Charring Cross in May.
I'm also still looking into storing sperm and have been advised to write a letter to a doctor at a local hospital enquiring about this, which I done yesterday. Would I be ok to start using the patches if I start storing sperm in the next few weeks?
Dr Curtis said I should stop for 3 months if I want to do that, but I'm hoping to do the storing within the next few weeks...
Quote from: jennifer90 on March 04, 2011, 05:16:35 PM
I'm also still looking into storing sperm and have been advised to write a letter to a doctor at a local hospital enquiring about this, which I done yesterday. Would I be ok to start using the patches if I start storing sperm in the next few weeks?
Dr Curtis said I should stop for 3 months if I want to do that, but I'm hoping to do the storing within the next few weeks...
In your position, I would take Dr Curtis' advice.
I'm sure we all sympathise with you, wanting to get the process moving along. But no sense in leaving things behind while you rush.
ok i know this hasn't been like posted in about 6ish month
but im with Dr Curtis as well and was prescribed the patches quite recently (yay) with no AA
He said that after 3 months he checks the blood results and then will decide if a AA is needed, he said some people wont need an AA, some people will just need a higher dose of oestrogen and some will need both AA and oestrogen i think.
x x
Quote from: pebbles on March 04, 2011, 12:52:02 PM
you can do it that way but it's dogey if you ask me the theory goes that modern estrogen's will disrupt the feedback loop between the pituitary gland lowering T anyway with just E...
although it can work I'm extremely dubious of the claims and would ask for proof ¬.¬
I agree with Pebbles. I really don't understand where some docs come up with this sort of MTF HRT regimen... and I have a strong background in science and medicine. It really baffles me. Can it work... maybe. But it's far from the "popular and most often prescribed" regimen.
Furthermore, if you are under 40 years of age, I don't see the reason to prescribe patches as they are far less effective than sublingual oral or injectable estradiol. Are patches safer, especially if you are over 40, or have a coexisting condition that may increase the clotting factors in your blood, or history of stroke, etc... Yes... patches are. But they are not the norm regimen of HRT for MTF transitioners under 40 years of age in good physical health.
You may consider getting a second opinion from another doctor.
Your dr is a quack..sorry for the frankness, but he knows nothing about HRT for a MTF.
Hi Jamie Jennifer,
Did you stick with Dr Curtis and did he ever prescribe you the AA's as the estrogen has worked wonders on you. You are very attractive.
Work permitting, I may be visiting him in the next few weeks?
Thanks.
Hi Jaime Jennifer
I am exactly where you were when you started this thred. I have been on patches prescribed by Dr Curtis for 3 weeks now and I am due to go back in December for a review. I also asked about an AA such as Spironalactone as almost everyone seems to be on the stuff here. Dr C also said AA may not be needed but he would review this after 3 months. He said if the Estragen alone can do the job I save myself the physical cost of taking an AA as they can often make people feel unwell and can upset your system. I have to say the patches do leave marks but I am ever hopeful they will have some effect for me. The skin on my face has improved and I have increased breast tissue. However the hair on my body if not as yet affected. I am still getting a 5'0clock shadow although I am now well into getting laser to treat this. Sigh...... What sort of results did you get after 4 months on the patches?
Thanks
Jenna xx
Jenna, what is the name of the brand he has prescribed you? I cannot recall the name of the one he prescribed me but when I ran out of them, my GP checked and they had stopped making that specific patch and he put me on a similar one, which just fell off after taking a bath or going the gym, that's why I asked to be changed to Sandrina gel. Next time you go back in December if I were you I would ask if he would switch you to that as he does prescribe.
From 4 months I was gaining breast tissue but that is all really, I think my face might have rounded out a bit but I wasn't living full time and was only dressing at weekends, gluing in hair extensions and putting make up on and going to night clubs, but I passed pretty well then anyway.
Quote from: Jaime Jennifer on March 04, 2011, 11:00:59 AM
I have just been prescribed estrogen patches by my private doctor in london! Yay!
I thought that I would be prescribed an anti androgen too but my doctor said I don't need them I only need the patches.. Is this right? I was quite concerned about this as I thought I'd need an anti androgen to lower testosterone as well as estrogen.. Is this right??
great you started e but how do i say this ? your doctor is a idiot! lol look all good to be on e but as long as you have T the battle will cause less e to take effect and the T will undo wat the e does. unless you do a high dose of e which causes well breast cancer quite easily! um has you doctor done this before because my doctors the best in his field in my country. now you need blockers to get rid of T because the safe doses of e can't do that quick. just saying maybe get him to discuss with another doctor :) any who YaY for your e patchs ! :)
and ps 4 months hrt will a full A cup :) but i had the breast tissue prior because of blockers :)
Lil Devil, suggest you do some research before dissing my doctor, even by reading up the post. My t levels were in their 100's before taking E and are now at a single figure of 6. That is proof that the E cancels out the T. My doctor is also one of the best of his field in the UK.
Quote from: Jaime Jennifer on October 23, 2011, 10:59:34 AM
Lil Devil, suggest you do some research before dissing my doctor, even by reading up the post. My t levels were in their 100's before taking E and are now at a single figure of 6. That is proof that the E cancels out the T. My doctor is also one of the best of his field in the UK.
:) well all good just thought you would enjoy the same things as me :) soz i think i missed your less than 100 post:) your a lucky case :) comes with the only European genetics must be gr8 having started with low T :) :) you should hugs your doctor :) and doesn't the UK got injections ? may i ask y you chose not to use that method ? it does offer the best and cheapest results :) any who sorry again :) meant no offence
Quote from: Jaime Jennifer on March 04, 2011, 11:00:59 AM
I have just been prescribed estrogen patches by my private doctor in london! Yay!
I thought that I would be prescribed an anti androgen too but my doctor said I don't need them I only need the patches.. Is this right? I was quite concerned about this as I thought I'd need an anti androgen to lower testosterone as well as estrogen.. Is this right??
According to my doctor, who has been working with trans people for over 30 years, estrogen will have a T reducing effect. How much depends on the individual. He typically prescribes both E and an anti-androgen, does a blood test a few months later and makes adjustments, and three months later, again. He does this for the first year. After that it's a blood test every six months, as long as you're on HRT.
That tells me the body changes all the time. As long as there is regular testing and adjustments are made along the way, I don't see any problem with what your doctor initially prescribed.
Jaime
I am on Estradot 100mic patches and I change them every 3 days. I have both gone to the gym and obviously showered. I have had a bath on change days. So far they pretty much stay intact but do leave an annoying ring of glue.
I was thinking of self medding Spiro today. I looked online to get idea of prices. However I now am having second thoughts. Would a low dose be ok? Failing that I continue to drown myself in Spearmint tea and Soya milk ???
Quote from: JennaRising on October 23, 2011, 12:01:50 PM
Jaime
I am on Estradot 100mic patches and I change them every 3 days. I have both gone to the gym and obviously showered. I have had a bath on change days. So far they pretty much stay intact but do leave an annoying ring of glue.
I was thinking of self medding Spiro today. I looked online to get idea of prices. However I now am having second thoughts. Would a low dose be ok? Failing that I continue to drown myself in Spearmint tea and Soya milk ???
be careful if you must because Spiro does pose risk to the liver or kidneys i never remember which :) i think don't try but if you must don't pass a quarter of the maximum :) but please don't self medicate because that can be very dangerous :) but spiro never hurts if e isn't enough :) now i ain't saying doing it just trying to make sure if your gonna anyways that you don't end up in need of a transplant :)
Quote from: LilDevilOfPrada on October 23, 2011, 12:10:54 PM
be careful if you must because Spiro does pose risk to the liver or kidneys i never remember which :) i think don't try but if you must don't pass a quarter of the maximum :) but please don't self medicate because that can be very dangerous :) but spiro never hurts if e isn't enough :) now i ain't saying doing it just trying to make sure if your gonna anyways that you don't end up in need of a transplant :)
Thanks for the reply. I am not sure if I will order Spiro online. I may wait a while longer to see what the E does on it's own. It just seems as if everyone is "popping" Spiro on here as if it's miraculous. There must be something in it?
Jaime Jennifer - in answer to your question. If it works then stick with it i guess. It seems to be working well for you and it's easy maintenance too. Sounds like you have struck lucky without having to take too many pills :)
Quote from: JennaRising on October 23, 2011, 12:21:10 PM
Thanks for the reply. I am not sure if I will order Spiro online. I may wait a while longer to see what the E does on it's own. It just seems as if everyone is "popping" Spiro on here as if it's miraculous. There must be something in it?
Jaime Jennifer - in answer to your question. If it works then stick with it i guess. It seems to be working well for you and it's easy maintenance too. Sounds like you have struck lucky without having to take too many pills :)
its just spiRo is the cheapest and safest blocker that's y :) but doesn't do it all that's y i am also on finpecia because spiRo doesn't effect T which makes your hair longer and thicker :) but yea cheap and safe main reasons
Quote from: Jaime Jennifer on October 23, 2011, 08:37:45 AM
Hi girls..
So weird I was just coming on here to make a post about HRT and here is my old thread back to life!
I was on the patches alone for about 4 months and then I asked Dr Curtis to switch me to gels as they left big horrible marks on my stomach and kept falling off they were so annoying. I have had really good results, my E levels are within normal female range and my T level is at 6, which I'm told should be now at 0.
Whilst being treated by Dr C, I had my appointment at Charing Cross. On my second appointment the doctor said he wanted to put me on their hormones, i.e. an AA and estrogen tablets and an injection of some sort. Dr C thinks I should just stick with the gel I'm on sice ive had such good results (i.e. B cub bra size) and considers me to pass 100%.
I don't know what I should do....
You have had such good results :D
I hope i do with the patches that Dr C gave me, if you t levels is only 6 then you don't need an AA which is a good thing, less drugs in the body :)
Do the patches really fall of all the time, if they do then i might go for the gel as well.
I'm starting my first patch tomorrow omg i'm sooooo excited hehe.
I think i might do a blood test 1 month from now and see how my t levels are.
x x
Salisha - the very best of luck, I am just 3 weeks ahead of you. It feels great when you start. I put my first patch on infront of Dr C in his office. I could not wait ;D
Jenna - thank you, it looks like we will be experiencing the effects of hormones at around the same time hehe
How are the patches for you, do they stay on like in the shower etc ?
x x
Quote from: salisha on October 23, 2011, 01:46:25 PM
Jenna - thank you, it looks like we will be experiencing the effects of hormones at around the same time hehe
How are the patches for you, do they stay on like in the shower etc ?
x x
hey you :) i am 4 months ahead :) but on oral :) i would also love up know how patchs hold up :)
Quote from: JennaRising on October 23, 2011, 12:01:50 PM
Jaime
I am on Estradot 100mic patches and I change them every 3 days. I have both gone to the gym and obviously showered. I have had a bath on change days. So far they pretty much stay intact but do leave an annoying ring of glue.
Does this answer your question? Believe me, you will check your patch is in place at least a dozen times each day at first. :)
Quote from: JennaRising on October 23, 2011, 01:56:43 PM
Does this answer your question? Believe me, you will check your patch is in place at least a dozen times each day at first. :)
ohhh lols sorry i didn't see that, silly me and yay good, i can imagine me checking it while im just walking to the kitchen and stuff hehe :)
Thank you x
Quote from: LilDevilOfPrada on October 23, 2011, 01:50:02 PM
hey you :) i am 4 months ahead :) but on oral :) i would also love up know how patchs hold up :)
heyyyy, i guess they hold up pretty well hehe :)
x x
Estradot is what Dr C initially prescribed me. They were fine in terms of sticking, they always stayed on after showering and gym etc, but when I ran out of the supply he gave me and went to my GP for more, I went to 7 different chemists looking for it but nobody had them in stock, there has been "manufacturing problems" and are now unavailable - not sure if that is the case but my GP had to prescribe a different brand which were larger and they fell off easily, to the point where I was lucky if I got 2 days out of them and I could hear them crunch when I walked! Not nice!
So if you have trouble getting the patches from your GP, I would reccomend getting Dr C to prescribe the Sandrina gel.
Saying all that, I think I might get my GP to give me what CX have prescribed from next week and get these AA injections and tablets just to lower my T level.. I've been so confused lately trying to figure out what's best!
Quote from: Jaime Jennifer on October 23, 2011, 02:42:53 PM
Estradot is what Dr C initially prescribed me. They were fine in terms of sticking, they always stayed on after showering and gym etc, but when I ran out of the supply he gave me and went to my GP for more, I went to 7 different chemists looking for it but nobody had them in stock, there has been "manufacturing problems" and are now unavailable - not sure if that is the case but my GP had to prescribe a different brand which were larger and they fell off easily, to the point where I was lucky if I got 2 days out of them and I could hear them crunch when I walked! Not nice!
So if you have trouble getting the patches from your GP, I would reccomend getting Dr C to prescribe the Sandrina gel.
Saying all that, I think I might get my GP to give me what CX have prescribed from next week and get these AA injections and tablets just to lower my T level.. I've been so confused lately trying to figure out what's best!
:) as far as i know there's only the implant injection which can be free in some places and well super expensive in others. they inject it to the stomach region and ppl say its very painful to no pain but if you can get them do it its worth zero T all til time :) for me it would be £500 pounds every three months for it :) pills work just fine by the way :)
Quote from: Jaime Jennifer on October 23, 2011, 02:42:53 PM
Estradot is what Dr C initially prescribed me. They were fine in terms of sticking, they always stayed on after showering and gym etc, but when I ran out of the supply he gave me and went to my GP for more, I went to 7 different chemists looking for it but nobody had them in stock, there has been "manufacturing problems" and are now unavailable - not sure if that is the case but my GP had to prescribe a different brand which were larger and they fell off easily, to the point where I was lucky if I got 2 days out of them and I could hear them crunch when I walked! Not nice!
So if you have trouble getting the patches from your GP, I would reccomend getting Dr C to prescribe the Sandrina gel.
Saying all that, I think I might get my GP to give me what CX have prescribed from next week and get these AA injections and tablets just to lower my T level.. I've been so confused lately trying to figure out what's best!
Ohhh he prescribed me estradot as well, but i got a 3 month supply just to be on the safe hehe :)
Personally if you t levels is only 6 then i don't think you should get the AA it will put more pressure on the body as you will be taking 2 drugs, also females natural T levels are usually something like 16 to 35, so you t levels are perfectly fine :)
But that's just my opinion you do what you feel is right :)
x x
Hi all,
I'm seeing Dr C next week with the results of my blood tests and will hopefully be leaving with a prescription.
I can't believe how well timed this thread is, although now I'm a little apprehensive.
Are you all happy with the results from his hrt regime? Should I be asking for gel instead or are the patches still ok? Which is more available?
Also, how much do the prescriptions cost if they're not prescribed by an NHS doctor?
Thanks :)
Quote from: salisha on October 23, 2011, 03:07:32 PM
Ohhh he prescribed me estradot as well, but i got a 3 month supply just to be on the safe hehe :)
Personally if you t levels is only 6 then i don't think you should get the AA it will put more pressure on the body as you will be taking 2 drugs, also females natural T levels are usually something like 16 to 35, so you t levels are perfectly fine :)
But that's just my opinion you do what you feel is right :)
x x
I'm glad someone pointed out that women do have a recognised level of testosterone..