Well - not quite!
Can I apologise for keeping this in lay terms? I want to give the info without all of the physiology and endocrinology. I'm happy to expand.
When we look at how we respond to hormones we have to appreciate that a hormone, say hormone A (HA) doesn't work by itself. It needs other hormones and more interestingly it need the receptors that it binds to on cells to make it do anything. In practice our bodies tend to be pretty ell flooded with hormones and the life the hormone has in the circulation is greater than the body needs it to be present. So how to control that? Well if the body also modulates the level of receptors for the hormone and then the level of hormone doesn't really matter.
(I've got $50 to spend and nothing to spend it on.)
The level of those receptors is often under the control of another hormone (or usually half a dozen at least).
But, there is an additional control, how about if you let cells display the receptor but the cell gets 'worn out' responding to the hormone so it binds the receptor but doesn't do anything? The feedback mechanisms in our body then tell the hormone producing place to produce more, because it hasn't had an effect. This is tightly controlled but can get a bit dysregulated.
Ok. So what, what if we want to manipulate all of that? One of the king pin hormones is gonadotrophin. It has more effects than we want to go into. But if we block its production we can cause heaps of down stream effects.
Not all good, and that is why we need endocrinologists playing with this stuff. I'm not.
One effect is that we turn off oestrogen receptors. We make cells not express them.
OK instant terror for people like us. I WANT MY E! Sounds like a TV advert (possibly a bad pun).
Some bright spark in the IVF world found that by turning off E receptors for a while they made the cells MORE responsive to E when it was reintroduced. See my bit above about cells getting bored with too much hormone being present.
So in the IVF world where we want to get woman to respond to E when she didn't before, even though she had high levels of circulating E, this came as a bit of a surprise, and a really good idea.
So where does this fit for us?
Same way.
I will slow down here and not go into too much but when we go onto AA and E we have several responses. One is we change levels of SHBG, it gets rid of T, the expectation is that T receptor levels increase, we block them with AAs. Ahh yes AAs don't stop production of T, they prevent it binding to the receptors. (BTW this isn't true but will do for now, if someone wants to hang me, I'll tell the whole story)
You then have your level of E receptors, we all have them, we then flood the body with E and Hy presto Cindy turns into a blonde bimbo.
No.
We respond slowly to E, we often have 'odd' levels of E and some of us don't respond well to E at all
What to do.
Ahh some bright spark says lets give GnHr to MtF and hope we activate their E receptor function.
Clever that, very clever.
So the idea is to suppress the cells from up regulating E receptors; and
then hit the body with High dose E and wham bam thank you Mam, the body goes nuts increases the receptor level, AND the cells are responsive. If you are trying to get preggers you are and if you are MtF you start getting effects.
Simple really.
As I said I have simplified this and please I hope I wasn't condescending I certainly didn't want to be.
Oh for people who self medicate, I hope you followed so you can do without medical advice
Sorry
Cindy
