Quote from: iiii on May 30, 2013, 05:01:22 PM
Though, androcur suppresses your bodys natural E production, so wouldn't you end up with ridiculously low E levels and too high T levels (without E your T will end up higher)?

While on Androcur, my E levels were fine. I had to stop taking it for 2 reasons: 1) It caused me to have depression. 2) It completely tanked my T level.

It's effects on E are only during production, so taking Androcur and E at the same time won't effect the E you take.

If after reading the paper in the link below
http://www.changelingaspects.com/PDF/The%20Lowdown%20on%20Progesterone.pdf

You still insist in taking progesterone ( Levenorgestrel, Norethisterone, Mexdroxyprogesterone Acetate, Dydrogesterone, etc) well then you will deserve what ever you get out of it....do not say: "nobody told me"

Quote from: peky on May 30, 2013, 06:42:43 PM
If after reading the paper in the link below
http://www.changelingaspects.com/PDF/The%20Lowdown%20on%20Progesterone.pdf

You still insist in taking progesterone ( Levenorgestrel, Norethisterone, Mexdroxyprogesterone Acetate, Dydrogesterone, etc) well then you will deserve what ever you get out of it....do not say: "nobody told me"

"Just eat more pies!" 

.

Quote from: PoisonEnvy on May 30, 2013, 06:10:44 PM
I heard cycling progesterone is kinda pointless since we are not genetic females. I also heard it doesn't help with redistributing fat and makes you put on muscle instead.

Well I've been getting progesterone the entire time I've been on HRT.. My muscle mass has plummeted and fat is redistributing extremely well for not even 6 months.

Quote from: peky on May 30, 2013, 06:42:43 PM
If after reading the paper in the link below
http://www.changelingaspects.com/PDF/The%20Lowdown%20on%20Progesterone.pdf

You still insist in taking progesterone ( Levenorgestrel, Norethisterone, Mexdroxyprogesterone Acetate, Dydrogesterone, etc) well then you will deserve what ever you get out of it....do not say: "nobody told me"

There are significant problems with the Curtis paper you cite.

Dr. Curtis is a general practitioner, and not an endocrinologist; consequently, his findings are suspect.  The following article, cites 20 of Dr. Curtis's findings and questions their validity.

I would urge every MtF member who is on HRT to review this article, by Dana J. Beven, PhD, especially the discussion of Dr. Curtis's work.

Should Male-to-Female Transsexuals Take Progesterone as part of Hormone Replacement Therapy for Better Breast Development?

I really hate that some people get so emotionally invested in their assertions. I don't care what anyone else takes with their HRT and the only thing I'm invested in is FACTS. The sad thing is, the medical community doesn't care enough about doing real research on trans HRT because no one is going to dump a bunch of money into this for us.

I do know, that studies based on conjugated estrogens (premarin) and synthetic progestins like MPA (provera) are NOT of any value to me because I would not consider using either of them. I would REALLY like to see some real scientific studies on the use of pure estrodiol and real human progesterone.  Anyone familiar with chemistry knows that the structure of a molecule and changing one bond or molecule can change a chemicals properties in very drastic and toxic ways.

The cellular receptors for hormones can function very differently if the structure of the attaching molecule isn't EXACTLY what it is supposed to be binding to.  Molecules from things like environmental estrogenic compounds or weak plant estrogens can bind to the receptor and therefore block out the estrodiol and progesterone that we want.  The chemistry can be very complicated and many other chemicals all work together in a feedback process to self regulate the system and prime receptors for the molecule they are designed to receive.

Quote from: Jamie D on May 30, 2013, 08:43:46 PM
There are significant problems with the Curtis paper you cite.

Dr. Curtis is a general practitioner, and not an endocrinologist; consequently, his findings are suspect.  The following article, cites 20 of Dr. Curtis's findings and questions their validity.

I would urge every MtF member who is on HRT to review this article, by Dana J. Beven, PhD, especially the discussion of Dr. Curtis's work.

Without wanting to step too deep into the fray, I would like to note though that the article you linked starts off by stating that Dana Beven is not an MD, looking at the "about the author" page, her PhD seems to be in psychology. Given this, adding a prominent "PhD" strikes me as a bit of an attempted argument from authority, in particular while simultaneously using Curtis' experience as a GP instead of an endo against him. 

While Curtis may not be an endocrinologist, I would argue that his education per se forced him to have at least a basic understanding of the matter. It should also be noted that a lot of GPs have a specialisation on the side, but I cannot of course say whether or not that is the case here (although his workplace might suggest it), but we cannot exclude the possibility either. It is worthy to note that his article does not seem to have been properly peer-reviewed by the way, so that makes it an "informed opinion" piece in my mind for now.

Methinks that it would make sense to look for proper peer-reviewed studies outside of the trans* area as well. There is the possibility of scenarios where HRT is applied pre-menopausal to natal females, in which the HRT regimen might then be built to mirror the natural hormone levels.

I have not finish yet find out who "Dana J. Bevan Ph.D" but so far she has not published a single peer-reviewed paper: transsexualism/GID/->-bleeped-<-, endrocrinology/pharmacology, or hormone replacement therapy.

Nor there is any technical reports by this person in the Defense Technical Information Center.

QuoteI am a biopsychologist and systems engineer who has been involved in research and development for over 35 years.  I received my B.A. from Dartmouth College in psychology and my Ph.D. from Princeton University. After finishing my Ph.D., I served on active duty with US Army, conducting pharmacological experiments at Edgewood, MD.  After leaving the Army, I participated in several technology development projects for DARPA including development of a Biocybernetics Laboratory, the Assault Breaker technology demonstration that involved smart weapons and advanced radars to provide a non-nuclear antitank alternative.  I also participated in the DARPA Discoverer II study which returned DARPA to space.  I led the evaluation of the TR-1 sensor suite for the USAF and participated in a program to upgrade the B2 bomber sensor suite.  Most recently, with Jamie Hyneman of "Mythbusters", I developed a prototype anthropomorphic "dummy" to train first responders how to deal with injuries from explosions which has now in production.

BTW "Assault Breaker" was a DARPA-initiated program under Dr. W. Perry to demonstrate the feasibility to use an air-born radar to guide munitions to multiple targets. The program run from 78 to 82, and successfully transitioned into a program of record. Part of "Assault Breaker" was the development incorporate a "High altitude Synthetic Aperture Radar,"  TR-1, under the lead of the Air Force. TR1- was to be a replacement to the U-2 "looking down" radar.

As you see nothing to "boost" her claims to know anything about hormones, endocrinology, or the treatment of GID folks

Endocrinol Nutr. 2013 May;60(5):264-7. doi: 10.1016/j.endonu.2012.07.004. Epub 2012 Sep 27.

Symptomatic meningioma induced by cross-sex hormone treatment in a male-to-female transsexual.

[Article in English, Spanish]

Bergoglio MT, Gómez-Balaguer M, Almonacid Folch E, Hurtado Murillo F, Hernández-Mijares A.


Source

Department of Endocrinology, Doctor Peset University Hospital, Valencia, Spain. Electronic address: drabergoglio@gmail.com.


Abstract


Transsexualism is defined as a strong conviction of belonging to the opposite sex in individuals without any physical intersex condition. Cross-sex hormone therapy is an important component of medical treatment of transexuals but it is not exempt from adverse effects. We report a case of a meningioma in a male-to-female transsexual patient treated with estrogens and cyproterone acetate for the past 4years. He claimed recently severe headache and visual impairment. Blood tests showed normal results. A contrast-enhanced magnetic resonance imaging (MRI) scan revealed a mass in the tuberculum sellae consistent with a meningioma. Treatment was discontinued and tumor resection was performed. Histologic diagnosis confirmed strongly progesterone receptor-positive and estrogen negative meningioma. After surgery, the patient rejected the possibility of continuing with the treatment of estrogens and cyproterone, and so triptorelin (GnRH agonist) was initiated. At 1-year follow-up the patient's symptoms had ameliorated and a MRI scan revealed no recurrence of the tumor. This is the third case reported in the literature of a meningioma after treatment with estrogens and cyproterone acetate. We consider extremely important a long-term follow-up observation of male-to-female transsexual undergoing cross-sex hormone therapy in order to detect as soon as possible the adverse effects that can be derived from this therapy.

Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

This may seem like a departure from the subject but it is actually relevant to the conversation here. I know and individual who set out to write a book about a subject that he had absolutely no personal experience with and very little personal knowledge of. His entire book was based on information he had extrapolated from the experience of others and he related it to his readers as if it was in fact something he had done and experienced in his own life. A certain segment of society bought his book and he wrote a couple of follow-ups and was  soon appearing on television shows as the guest speaker and was traveling all over the country for speaking engagements. The sole reason for it was that he had been the author of a book which had suddenly elevated him to the esteemed position of being an authority. The reason I know of this is because one of my very own experiences that I had personally shared with him years earlier was written in as if it had been something he himself had experienced.

With the dawn of the Internet came a huge influx of ->-bleeped-<-, not that it wasn't there all along, but the information superhighway made transition suddenly become a feasible possibility for many with GID issues. Along with that came the MD's who saw a need and an opportunity. Most have no idea of what they are doing other then to stick with the tried and true safe approach which has always been an HRT regimen prescribed for menopausal women who have long since passed puberty and the feminizing phase of their physical development. A few MD's have authored articles about feminizing HRT for trans women which does not depart from the menopausal women's HRT regimen, being authors makes them an authority and therefore most MD's follow their guidelines as well.

Quote from: peky on May 31, 2013, 09:08:07 AM
Treatment was discontinued and tumor resection was performed. Histologic diagnosis confirmed strongly progesterone receptor-positive and estrogen negative meningioma.

To be honest, that is neither an argument for nor against progesterone. Hormone sensitive tumours are, alas, not really a rare occurrence. It is one of the big issues with post-menopausal HRT in natal women, as a lot of breast cancer variants are oestrogen receptor-positive. Makes for an "easy" aftercare, as Tamoxifen or Arimidex can be used to ensure that any remaining tumour cells are starved, but the "easy" part only applies to the doctors -- one heck of an uncomfortable time for the women in question.

Quote from: kkut on May 31, 2013, 09:22:25 AM
But she does appear to be a doctor though... I see the Ph.D after her name.

BTW Peky, I've checked to see if you've written any papers on internet searches of doctors and papers on their relevance of being relevant. I found none! What say you?

Now, you did not really thing that my last name is really "peky," did you?

Psychology like most psychiatry are not based in any scientifically-sound theory. Yet, they are an important art and great tool for the healing of the mind and soul.

Yes, she claims to have a Ph.D. and therefore she can call herself a doctor, and therefore rightfully state her opinions in the art for which she is qualified, psychology. She does not have however any credentials or experience to provide sound medical advice in terms of HRT.

Also, like any individual in the "cyberworld" she is entitled to her opinion, and if you want to follow her advice, well that is your right.

BTW, as I pointed before, Dr. Bevan has not publish any peer-reviewed papers in psychology, books, nor she has any appointments at any research or educational organizations. All she has is her internet blogs.

As far as me, my dear lady, I express my opinions and present the facts as I see it and found them -take or live dahrling, it is a freebee

I have no need to post all my degree and accolade in the internet, and more important, I have nothing to prove to you or anybody.

Okay... Incoming wall of text, sorry. Colour me as having a way too enquiring mind when it comes to stuff like this...

Going through a couple of corresponding databases, I found three relatively recent articles that might be deemed interesting in this context:

• Spark, J.M. & Willis, J. (2012) 'Systematic review of progesterone use by midlife and menopausal women', Maturitas, 72(3), pp. 192-202. DOI: /10.1016/j.maturitas.2012.03.015
• Simon, J.A. (2012) 'What's new in hormone replacement therapy: focus on transdermal estradiol and micronized progesterone', Climacteric, 15(Suppl 1), pp.3-10.
• Mueck, A.O. (2012) 'Postmenopausal hormone replacement therapy and cardiovascular disease: the value of transdermal estradiol and micronized progesterone', Climacteric, 15(Suppl 1), pp.11-17.

(seems Climacteric had a special focus in that supplement)

So what is pertinent? First of all there are these two snippets:

• "Unlike some progestogens, progesterone is also not associated with an increased risk for VTE, or with an increased risk of breast cancer." (Simon, 2012, p.3)
  [Note: VTE stands for venous thromboembolism]
• "[...] unlike some progestogens, the addition of micronized progesterone does not increase VTE risk." (Mueck, 2012, p.15).
  [Note: Mueck here actually references four further studies that focus on this issue, which I have included at the very bottom for people who are interested]

What does this tell us? Nothing much at first, but when digging into the documents a bit more, we find that one of the issues that both authors raise is that the main source of knowledge in this area, namely the Women's Health Initiative (WHI) study from 2002, has some issues that need addressing in light of modern day findings. One of these is the fact that it only took into account other progestogens, but not progesterone. Amongst other things, newer research has led to the following recommendation by the International Menopause Society:

• "In general, progestogen should be added to systemic estrogen for all women with a uterus to prevent endometrial hyperplasia and cancer. However, natural progesterone and some progestogens have specific beneficial effects that could justify their use besides the expected actions on the endometrium [...] Also, progestogens may not be alike in regard to potential adverse metabolic effects or associated breast cancer risk when combined with long-term estrogen therapy"

(Quoted in Simon, 2012, p.5: Sturdee DW, Pines A; International Menopause Society Writing Group. Updated IMS recommendations on postmenopausal hormone therapy and preventive strategies for midlife health. Climacteric 2011;14:302-20)

So it seems that modern research indicates that natural progesterone does not have the same adverse effects that were associated with the progestogens that used to be prescribed previously. In many ways this is good news for the pro-progesterone faction.

Spark and Willis (2012, p.193) seemingly are heading that way too, and state that:

• "The first large scale hormone therapy trial, the Postmenopausal Estrogen/Progestin Interventions (PEPI) trial, contained a P4 and conjugated equine estrogen (CEE) arm. This trial was one of the first to show that P4 did not have the same properties as the progestin medroxyprogesterone acetate (MPA) and could be a useful adjunct to estrogen therapy."
  [Note: P4 refers to progesterone in terms of the natural hormone]

Enough of the rosiness though, as Spark and Willis (2012) also found that in their systematic review of 13 studies on progesterone use, most studies were of low methodological quality, and while the results where promising, clearly warned that:

• "Large studies designed to identify confounders, such as hormone levels, menopausal status and metabolism are required to understand the place of progesterone in clinical practice." (Spark and Willis, 2012, p.192).

Where does this leave us? Basically it would seem that progesterone isn't quite as bad as its reputation. While the current research looks promising, there is as yet insufficient evidence to simply green-light it though, as a large scale study is still required (preferably randomised, double-blind, and placebo-controlled). At this stage there is no clear evidence either way, but recent studies show a leaning toward it being beneficial.

Conclusion? Seeing as all of us are, in some ways, already involved in what might be deemed a slightly risky activity, at this stage the use of progesterone strikes me as a personal decision that is based on an individual's own risk assessment (hopefully in conjunction with their endocrinologist of course).


Mueck's references:

• Anderson GL, Limacher M, Assaf AR, et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women's Health Initiative randomized controlled trial. JAMA 2004;291:1701-12
• Canonico M, Fournier A, Carcaillon L, et al. Postmenopausal hormone therapy and risk of idiopathic venous thromboembolism: results from the E3N cohort study. Arterioscler Thromb Vasc Biol 2010;30:340-5
• Oli é V, Plu-Bureau G, Conard J, Horellou MH, Canonico M, Scarabin PY. Hormone therapy and recurrence of venous thromboembolism among postmenopausal women. Menopause 2011;18:488-93
• Canonico M, Oger E, Plu-Bureau G, et al. Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens: the ESTHER study. Circulation 2007;115:840-5

I find that most if not all of that information concerning menopausal woman and post menopausal women doesn't apply to me. Yes people get thrombosis, heart problems, tumors and everything else under the sun and I could get run over by a Mack truck on my way to the mailbox. I am not a genetic woman, surprise, surprise! I don't have their internal sexual organs. I am post male and am going to be seventy in a couple of months and have been going through a secondary puberty developing  secondary female characteristics that are evident in my avatar photo with the aid of a very effective topical progesterone oil. Estrogen alone gave me road cones for a number of years, when I started using progesterone things began to fill out. If that is of no interest to anyone then that's fine by me. So far I don't have any lumps or fibroids, just some nice titties with big nipples and aureolas that I am quite happy with.

Quote from: kkut on May 31, 2013, 10:46:44 AM
Well, I don't know who you are? Which is sort of my point.

Interested? Want to meet Honey?  over a cup of coffee, tea, wine?

Progesterone is great!

I agree Shantel.

Topical creams are the way to go. I still haven't seen a single article posted that specifically administers the hormones with anything other than pills. How the vast majority of endocrinologists (or people leading these studies) haven't discovered that administering hormone pills isn't a red flag in itself is a clear indication of how far behind medical practice is for transgender hormone treatment.

Get with the program, medical science! We weren't meant to EAT such large amounts of any hormone!

Shantel: Indeed, these studies aren't 100% relevant regarding trans women because they are not about trans women, and not even about "adult", fertile-aged women (I know someone past menopause is still very much an adult, but I can't find the term for "not a child and not an elderly person either").

However, let's face it, there's next to nothing regarding trans people, and realistically speaking, this nothingness is going to last. So we do with what we have, which is much better, you'll admit, than guessing! Not to mention individual experience is sadly not usable to prove anything, and varies a lot. It's hard to go saying progesterone has great effects (or doesn't) when on one side there are people saying it had awesome effects on them, on the other some saying it didn't do anything good, and to the other extreme reports of progesterone-related cancers.

peky: Yeah, what Dr Curtis says makes sense, but like pretty much everything I've seen on the subject, it's still mostly deductions. Not that it makes anything he says invalid, but it's annoying because no one ever has real definite proof on either side. D: Well, you'll say I haven't read much, which is true, but not a lot is accessible to me. I'm not familiar enough with sciences and English to be reading those violently smart-worded texts. (Not to mention research is very low on the list of things I like to do.)

Theo: That was a very nice post. First time I see a true attempt to look at both sides seriously.

Jennygirl: The reason they prescribe pills is that other forms of administration are either expensive/misadapted for trans people (transdermal), controversial/not really proven safe (injections) or not yet approved everywhere (implants). I don't think anyone in their right mind thinks pills are inherently superior. Many however might think that an individual is not at enough risk to justify the massive added cost, which isn't stupid. Not to mention that sublingually taking a pill is better, and I've had no one tell me yet how much better it is. Who knows, maybe it's almost as good as other methods, for a fraction of the price.

Been almost a year now on a new protocol, with significant additional progesterone.  My NP says my breasts are very healthy, and I have experienced good growth. 

Quote from: Theo on May 31, 2013, 05:32:12 AM
Without wanting to step too deep into the fray, I would like to note though that the article you linked starts off by stating that Dana Beven is not an MD, looking at the "about the author" page, her PhD seems to be in psychology. Given this, adding a prominent "PhD" strikes me as a bit of an attempted argument from authority, in particular while simultaneously using Curtis' experience as a GP instead of an endo against him. 

While Curtis may not be an endocrinologist, I would argue that his education per se forced him to have at least a basic understanding of the matter. It should also be noted that a lot of GPs have a specialisation on the side, but I cannot of course say whether or not that is the case here (although his workplace might suggest it), but we cannot exclude the possibility either. It is worthy to note that his article does not seem to have been properly peer-reviewed by the way, so that makes it an "informed opinion" piece in my mind for now.

Methinks that it would make sense to look for proper peer-reviewed studies outside of the trans* area as well. There is the possibility of scenarios where HRT is applied pre-menopausal to natal females, in which the HRT regimen might then be built to mirror the natural hormone levels.

Dr. Bevan is a practicing biopsychologist.  Her credentials are more than satisfactory for the purpose of reviewing the errors and lapses in Dr. Curtis's "analysis."  Bevan's critique is labeled as a "science review."

Part of the problem, too, with Curtis can be found here:

Dr Richard Curtis: transsexual doctor faces investigation

Britain's first transsexual doctor is under investigation following complaints that he provided inappropriate treatment to patients wishing to change gender.

The London-based GP is accused of prescribing sex change hormones "to several patients" that were not appropriate and also ignoring restrictions placed on his practice....

In another case, it was alleged Dr Curtis, 46, prescribed sex change drugs to patients under 18, without the specialist knowledge or skills to do so.

"... without the specialist knowledge or skills ...

That alone would give me pause.