Susan's Place Logo

News:

According to Google Analytics 25,259,719 users made visits accounting for 140,758,117 Pageviews since December 2006

Main Menu

Diagnosing the absence of breasts

Started by A, October 30, 2013, 06:40:43 PM

Previous topic - Next topic

0 Members and 1 Guest are viewing this topic.

A

Sometime soon, probably next week, I'll go do a blood test to check my hormone levels. Since after quite a long time on HRT, my chest could still easily pass as male, I'm hoping it'll reveal that my estradiol is low and justify a dose increase which would hopefully make something happen.

But assuming those blood tests say that my estradiol level is fine, then I'm going to need another explanation as for why I have to fake (small) breasts with a padded bra. And possible solutions.

I know diagnosing that sort of thing should be my endo's problem, but he won't do it. Even when it was clear that my dose was insufficient and the high estradiol levels revealed by the two last tests were mistaken, his first and only explanation was "some people don't have a lot of estrogen receptors and will have disappointing results".

Which is true, but as far as I know it should be the very last thing you consider, because not only is it (to such a degree) highly unlikely, but it's also the one cause we can't verify, and to which there is pretty much no solution apart from surgery. So keeping in mind the goal of helping the patient, logically all other reasonably possible causes should be explored before giving up and saying the case is desperate.

If you people can help me, I'll be able to present my endo with alternate theories and solutions, which might eventually maybe give me breasts. Or confirm that indeed I won't ever have any natural breasts.

So here goes. I've been on HRT for over a year and a half (see signature for the exact duration), with estradiol on a low dose in the beginning, on an even lower dose for 6 good months (mistake, took Estrogel and he prescribed a minuscule dose), and then back on the initial dose for a few months, and, since July, a medium dose.

I take Estrace, micronized estradiol in pills. My now medium dose is divided in three, one in the morning, one at 14:30, and one before bed.

As for my anti-androgen, I take cyproterone acetate, in a medium dose, all in the morning.

Let me give you some blood test results. They're given in international units, with the American units between parentheses.

(I started HRT in February 2012)

June 26 2012
___Total testosterone: 0.5 nmol/L (14.4092 ng/dL)
___17ß-hydroxy estradiol: 184 pmol/L (50.1226 pg/mL)
(First blood test after starting HRT. He was gonna increase my dose to what I take now since July 2013, but I stupidly inquired about Estrogel and he prescribed a crazy low dose of it. I got a lot of crap because of that mistake.)

November 29 2012
___Total testosterone: 0.2 nmol/L (5.7637 ng/dL)
___17ß-hydroxy estradiol: 157.4 pmol/L (42.8766 pg/mL)
(Estrogel, 24 hours after applying, because blood tests on the same day gave impossibly high results. Even though this had been reported by a patient of another trans-specialized endo's who said it's what he told every patient to do, my doctor rejected this result. This is about when I switched back to my old Estrace prescription, since I realized I could never convince him that Estrogel was giving crazy numbers and that to begin with he gave me a crazy low dose.)

February 11 2013
___Total testosterone: 0.76 nmol/L (21.9020 ng/dL)
___Bio-available testosterone: 0.19 nmol/L (5.4755 ng/dL)
___17ß-hydroxy estradiol: 214.6 pmol/L (58.4582 pg/mL)
(Test done after a while of taking Estrace again. This was finally a blood test we could both agree on that showed that my levels were too low. He didn't take my numerous messages as I meant them and there was apparently a misunderstanding, so it took until my appointment in July to get an increase though. My dose was then increased by 1/3. Sadly I haven't seen much of a difference, if any.)

Now, for the effects of HRT. So far, I've noticed a little bit of change attributed to estrogen, but in most cases it's so subtle I'm not always really sure, not to mention that losing weight and killing testosterone did a lot. My hips have widened a bit, of that I'm sure. I think I've had some (SOME - I still have quite a considerable belly) fat redistribution from my belly to my thighs and such, maybe.

Apart from that, there are changes attributed to the anti-androgen, such as a modest reduction of body hair, a loss of muscle mass, the very small amounts of hair I had begun to lose in the front that came back, the disappearance of automatic erections, and less oily and slightly softer skin.

When it comes to breasts... a few weeks after starting HRT, my nipples started to hurt and itch like crazy for a while, and I was enthusiastic that something was finally happening. But apart from a little lump underneath (which I can only faintly feel now) and occasionally "puffed" nipples, there was no real change. Recently I noticed my nipples had gotten sensitive in a sexual way.

Right now, the area is still slightly painful to pressure, but nowhere as much as last summer, when bumping into something made me want to curse. I've been wearing a stuffed bra ever since I started living as a girl, in July, and after a couple of weeks, already, my chest only got slightly uncomfortable, and only after several hours of wearing it.

As for how my chest looks, as I said earlier, my chest would still have little trouble passing as a man's if I tried. The visible changes I can note compared to when I started HRT are that now my nipples seem to have mostly fused with my areolas (the whole thing is sort of a single mound instead of the areola being flat on the rest of the "breast" and the nipple protruding alone), and that maybe with imagination my chest might look like severely malnourished breasts, the whole thing looking a little rounder and flabby. But that's partly attributable to my pectoral muscles shrinking.

And most importantly, there are no breasts to speak of. Nothing is actually hanging, and I assure you that the most "breasts" my chest can look through my shirt is something slightly droopy stolen from an old man who was getting a little fat.

I guarantee you that if I go out without my padded bra (which at best simulates small A's which just look wrong on someone like me who doesn't have a delicate build at all), I'm gonna be stared at weird. Because for every other point, assuming I've gone through the extremely extenuating task of taking care of my abundant body hair, unless someone undressed me, I generally pass pretty much 100 %. I don't think I've even ever been able to make a credible male voice.

Oh, hm, personal details.

- I'm 22. I was 20, nearly 21, when I started HRT.
- My height is 165 cm (5'5").
- My weight is 60.3 Kg (133 lbs). I probably weighed 5-10 more pounds (2.26-4.53 Kg) when I started HRT.

I think you have a fairly accurate description of my situation. Don't hesitate to ask for anything else.

Now, I'm going to completely hypothetically try to give explanations for my total absence of breasts after over a year and a half of HRT.

- Because I'm anemic, my breasts don't have the required nourishment to grow. I'm not so sure about that, though, because my anemia is slight, and even though my diet isn't exactly good, there's really worse, not to mention I take a multivitamin. For the last few months I've been mostly feeding myself with oatmeal, soy milk, whole grain bread, peanut butter, whole grain pasta with red beans and tomato sauce, orange juice, yogurt and cheese. There's definitely better, but add the multivitamin and I don't see any major and obvious deficiency.

- For some unknown reason, I'd need a higher dose than what is normally prescribed for anything to happen.

- My padded bra (which shouldn't be too tight) is keeping my breasts from growing, even though I don't wear it at night or when I stay at home (which has been more than half the time this summer and 2-3 days a week in average since school started in August).

- Actually decreasing my dose for a long time right in the middle of my HRT stunted growth permanently.

- Regularly plucking the very thick and stubborn hair that grows on my areolas since I was 12-14, for which I pinch the skin to see underneath (and pinched/twisted it pretty hard before HRT made the area sensitive), has caused damage which stunted growth.

- For some reason, I would absolutely need progesterone for anything to happen at all, while normally it should just improve growth which would have started already.

- Despite my age, despite my otherwise good ability to pass, and despite my sister being above average and my mother being very large in breast size, my chest just doesn't know what "estradiol" means and will never react to it in any significant manner.

- For some reason and despite the blood test obviously showing that the estrogen reached my blood, I would not react to oral HRT in particular. But studying this hypothesis isn't very useful for now, since in any case I cannot afford Estrogel (or any other solution than pills, the only method that's covered), and because of the misunderstandings with my doctor. (Which will normally be replaced sometime in 2014 for his retirement, which is probably good news.)

- Even though my testosterone should be well under control, I would somehow have DHT levels in my blood sufficient to compete with estradiol.

- Even though I don't take such big amounts of it, the small amounts of phyto-estrogens in my soy milk would somehow compete with my medication.

- Spreading out my doses throughout the day as I do ends up never getting my blood level high enough for growth, so it's more constant, but constant at an insufficient level.

(As a reminder, this thread is assuming that my next blood test says that my estradiol level is completely sufficient.)

Oh yeah, don't suggest that I find another endo, please. I'm already travelling 2.5 hours away to see this one, and I don't have a car. The second closest one (and only other one in the province actually) is 5 hours away, and he has a pretty long waiting list. And I've already tried to find a non-endo doctor who'd do my HRT, without success.

So, uhm, there you go. You can discuss the hypotheses I've brought, or propose others. Or give experiences. Though I've never heard of such an unlucky individual that she wouldn't get breasts at all even though she started HRT in her early twenties (early enough to get hip bone widening apparently). But really, anything is welcome.

Oh yeah, by the way, I have two questions I would like to ask:

- What are the target estradiol levels your endos have told you for your HRT? I often read recommended medication dosages, or that "normal female levels" are what are aimed for, but normal female levels are 120-1404 pmol/L (32.6886-382.4571 pg/mL) depending on when it is in someone's ovulatory cycle. And such a wide range is like no clue at all.

- When I go take my blood test, how should I schedule it? Before my medication, after? How long before/after? Skip the morning dose or not? As a reminder, I take three doses a day: morning, 14:30 and before bed.

Finally, if you say blood levels, it would be very nice for everyone if you could convert your numbers so everyone understands them. I made the effort to convert to the American format because the US are definitely the place where the most members come from, so it would be nice if you did the same for everyone, no matter in what direction.

Use this converter: http://www.soc-bdr.org/content/rds/authors/unit_tables_conversions_and_genetic_dictionaries/conversion_in_si_units/index_en.html

PS: Remember that we are not allowed to give the numbers for our medication dosages, but that we can absolutely give blood level numbers.
A's Transition Journal
Last update: June 11th, 2012
No more updates
  •  

Joanna Dark

If you pass 100 percent then you're doing better than most. Maybe you're just unlucky in that area. Not all girls, trans or cis, get blessed in a busty sorta way. Breast augmentation may be your best bet. But if you think its DHT take spiro. Get on P. Can't hurt.
  •  

A

Spiro is rarely prescribed here, and anyway I think while it's tougher on the body, cyproterone acetate is more effective than it. And yeah, I plan to try to get on progesterone when I see my endo again, but he might refuse.

As for just being unlucky in that area... Just remember that I'm not talking about not being gifted in a busty way, I'm talking about a chest that still looks quite male after quite a while on HRT - the utter absence of breasts. But yeah, well, that is a possibility, but since it's the only one about which nothing but implants can be done, I'd like to keep it as the very last hypothesis. Besides, I really don't like the idea of having artificial breasts, implants. If I must, I'll get them (once I find the necessary fortune and a half -- yeah, I'm super poor), but I don't want to.
A's Transition Journal
Last update: June 11th, 2012
No more updates
  •  

Jenna Marie

Well, messing up your dosages seems the most likely, but you knew that; if it hasn't been an effective amount of E for the whole time, then it hasn't really been 18 months of [attempted] development.

The other possibility is that you're - frustratingly - a slow developer. You've had *some* changes, which isn't consistent with being totally E-resistant. I know more than one cis woman who had the sort of "sensitive, puffy nipples and breast buds" phase last for 2-3 YEARS. One said she noticed that first at ten years old, and didn't have any breasts to speak of until she was almost 14. My wife took 15 years to reach her full adult size. So it may be that 18 months, especially on variable dosages, is enough to get things started but all you need is time.

However, given the way your endo has been ignoring your concerns... it's probable that you may just have to be patient, regardless of whether you would have grown faster on a better dose for you. You'll almost certainly get the full growth you're genetically wired to, eventually.

(Also, a bra can't damage developing breasts or impair them in growth - at least, not without causing you so much pain that you'd notice! You'd have to be basically binding for that to happen.)
  •  

A

I hope I do end up with something. Though for now I'm not exactly being encouraged. I mean, even though things can take a long time, I haven't noticed any real changes since the dose increase. If it were progressing, but slowly, I'd be annoyed but confident, but since it's been basically a tiny bit of growth in the beginning then almost nothing, I'm worried. Especially since my endo, the only real health professional I can consult about this, seems to say that the only explanation is that it's hopeless.

Thanks for the helpful reply though. I'm encouraged that you don't seem to find total hopelessness likely.
A's Transition Journal
Last update: June 11th, 2012
No more updates
  •  

Ms Grace

Is consulting a different endo a possibility? It may not make a lot of difference but could help ease your concerns one way or the other. Regrettably breast development is largely determined by genetics, pumping in extra E wouldn't make a lot of difference if your E receptors aren't doing the job, sorry to say.  :-\
Grace
----------------------------------------------
Transition 1.0 (Julie): HRT 1989-91
Self-denial: 1991-2013
Transition 2.0 (Grace): HRT June 24 2013
Full-time: March 24, 2014 :D
  •  

A

As I said in my post (with its length I'm getting the feeling no one is reading all of it, sigh), nope, it's not a possibility. And as I also said in my post, my genetics should go for above average breasts, which only adds to my worries.
A's Transition Journal
Last update: June 11th, 2012
No more updates
  •  

Joanna Dark

Here's a question: how has HRT changed you? Like has your skin softened, your face  rounded out, have the apples of your cheeks come in on your face, body hair growth halted, facial hair growth slowed a lot, etc, etc.

All those things happened to me along with my personality getting much more femme and I already was femme, but I stopped enjoying a lot of masculine things like sports and I'm almost exclusively into men where before I was bisexual and could be with a masculine woman, but not a femme one. IDK, all I do know is HRT has really changed me both physically and personally. Ironically I think I'm less emotional as I was hyper emo before and simply don't react as rash and emotionally to problems like I did pre-HRT.
  •  

Jenna Marie

(Genetics are weird, though... I didn't mention that part b/c it's less reassuring. :( My mom's a 34B, and I'm considerably larger than that.)

Incidentally, cis girls also have major hormone fluctuations during puberty, especially when it's just getting underway. This may have *delayed* your full growth, but I do sincerely believe it won't have ruined anything. And it's still possible that your body is preparing, and the responsiveness in the first few weeks was it laying the groundwork for a sudden growth spurt once all the pieces are in place. Some women develop that way, and some slow and steady; you might be either and still end up with perfectly respectable results.

I forgot, I also didn't address the E levels b/c mine were never tested and so honestly I have no idea what any of it means. My endo believes in getting T down to female levels and then as long as she and I are happy with the results there is no need to run estrogen levels. I'm OK with that, particularly as I hear these stories about doctors who use E level tests to muck about with dosages that seemed to be working!
  •  

A

Quote from: Joanna Dark on October 30, 2013, 09:11:28 PM
Here's a question: how has HRT changed you? Like has your skin softened, your face  rounded out, have the apples of your cheeks come in on your face, body hair growth halted, facial hair growth slowed a lot, etc, etc.

All those things happened to me along with my personality getting much more femme and I already was femme, but I stopped enjoying a lot of masculine things like sports and I'm almost exclusively into men where before I was bisexual and could be with a masculine woman, but not a femme one. IDK, all I do know is HRT has really changed me both physically and personally. Ironically I think I'm less emotional as I was hyper emo before and simply don't react as rash and emotionally to problems like I did pre-HRT.

I did say some effects HRT has had on me in my first post, but I'm going to assume you did read it well and only want more details.

My skin has softened and thinned a little, not a ton, but mostly it's only gotten less oily and better-looking for that reason.

I lost muscle mass, though I would sure appreciate it to reduce some more. I've had a little bit of fat redistribution, maybe (or might just be hopeful thinking and weight loss) but it's nowhere near female levels. My hips, the bones, grew a little, though, for sure, giving me a kinda feminine figure. Kinda.

My face might have rounded out a little, but I wouldn't say a lot. Not sure it actually did. Mostly I think it's that I lost weight, which made my relatively prominent cheekbones show more, for a slightly more attractive result, though I was never very attractive to begin with. But not sure I'd call it more feminine-looking. My eyes' shape has changed to something more feminine-looking, a little.

Body hair did reduce, but nowhere near satisfactory levels. I'm still pretty much a gorilla if I stop taking care of it altogether. There's still man-level density hair every part of my body where one can possibly have hair, apart from the middle-top back. It took me 14 hours to wax it all off myself, last Friday. And the one time I spent the crazy money to have it done professionally, it took her 5 hours, and she didn't do any of the areas normally hidden by panties (and christ, there's a lot of work on my butt), and she skipped some pretty large blond areas that she was convinced was peach fuzz but isn't.

My facial hair, no idea. I started laser precisely when I started laser. So it did reduce, but well.

Psychologically... well, the termination of erections and of the horrible, guilty, atrocious need to masturbate obviously made me happier. I think HRT might have made me a little bit more confident and outgoing. It assuredly

But nearly all of the effects I've gotten so far are because of the low testosterone, not estrogen.

Quote from: Jenna Marie on October 30, 2013, 09:17:50 PM
(Genetics are weird, though... I didn't mention that part b/c it's less reassuring. :( My mom's a 34B, and I'm considerably larger than that.)

Incidentally, cis girls also have major hormone fluctuations during puberty, especially when it's just getting underway. This may have *delayed* your full growth, but I do sincerely believe it won't have ruined anything. And it's still possible that your body is preparing, and the responsiveness in the first few weeks was it laying the groundwork for a sudden growth spurt once all the pieces are in place. Some women develop that way, and some slow and steady; you might be either and still end up with perfectly respectable results.

I forgot, I also didn't address the E levels b/c mine were never tested and so honestly I have no idea what any of it means. My endo believes in getting T down to female levels and then as long as she and I are happy with the results there is no need to run estrogen levels. I'm OK with that, particularly as I hear these stories about doctors who use E level tests to muck about with dosages that seemed to be working!

Thanks for the other nice message. Though don't worry about being reassuring or not. The goal is to diagnose, not to reassure.
A's Transition Journal
Last update: June 11th, 2012
No more updates
  •  

Ms Grace

Quote from: A on October 30, 2013, 09:05:20 PM
As I said in my post (with its length I'm getting the feeling no one is reading all of it, sigh), nope, it's not a possibility. And as I also said in my post, my genetics should go for above average breasts, which only adds to my worries.
Yes, sorry, it was a bit TL;DR... did scan over it though.  :)
I imagine it is possible to have some large and small breasted sisters... depends on which side of the family they get their boob genes from. My sister has to be an F or even a G cup... I sincerely hope I don't get that large! One of the other points above about time being another factor - some cis women don't fully develop until their late teens or early twenties - could be factor for you too.
Grace
----------------------------------------------
Transition 1.0 (Julie): HRT 1989-91
Self-denial: 1991-2013
Transition 2.0 (Grace): HRT June 24 2013
Full-time: March 24, 2014 :D
  •  

pebbles

Not always I'm a 36A and my boobs are barely noticeable, and I had nearly X4 the normal female dose of estrogen at one point. The only difference is my nipples poke out abit more. It's just genetics.
  •  

A

Quote from: Grace_C on October 30, 2013, 10:53:49 PM
Yes, sorry, it was a bit TL;DR... did scan over it though.  :)
I imagine it is possible to have some large and small breasted sisters... depends on which side of the family they get their boob genes from. My sister has to be an F or even a G cup... I sincerely hope I don't get that large! One of the other points above about time being another factor - some cis women don't fully develop until their late teens or early twenties - could be factor for you too.
Maybe, maybe. Zero is a bit much (or a bit nothing) though.

Quote from: pebbles on October 31, 2013, 02:28:34 AM
Not always I'm a 36A and my boobs are barely noticeable, and I had nearly X4 the normal female dose of estrogen at one point. The only difference is my nipples poke out abit more. It's just genetics.
Uhm, I don't want to be playing Mrs. Know-it-all here, but looking at your picture, 1. you have a skinny body type, and skinny women don't look weird if they're flat-chested and 2. your breasts are noticeable, actually, though on the small side. Your chest doesn't look odd for a girl at all, because you have a breast size that fits with the rest of your body.

Here, I may have lost weight, but I'm everything but a small build. Even if I had A-cup breasts, with my body, I think it would still look extremely odd. Because big women aren't supposed to have very small, let alone nonexistent, breasts.

I've heard it a lot, that many women have little to no breasts and don't look odd. Thing is, all of these are also very thin. If you see a flat-chested woman who isn't thin and you don't think it looks odd, you may be stretching the concept of open-mindedness a little.
A's Transition Journal
Last update: June 11th, 2012
No more updates
  •  

luna nyan

Hi A,

Your numbers aren't too far off what my endo would want for someone transitioning.  T could be a fraction lower, and E a fraction higher, but it's not frighteningly out of target ranges.

My last test results had T at 8.9 ng/dl and E around 234pmol/L.  Now my situation is different in that I'm on HRT to keep things at bay and avoid transition, hence the deli erately higher T.  My endo said to me that he targets 290 or so on E for transitioning dosages.

I suggest that you discuss what target hormone level your endo wishes to achieve and go from there.  If your numbers are pretty much the same as last time then there may be scope for increasing dosages.  Also consider the possibility of switching administrative method.
Drifting down the river of life...
My 4+ years non-transitioning HRT experience
Ask me anything!  I promise you I know absolutely everything about nothing! :D
  •  

FrancisAnn

It must just be the genetics. For myself I'm a B cup and growing after moderate estrogen for only 3-4 months.
mtF, mid 50's, always a girl since childhood, HRT (Spiro, E & Fin.) since 8-13. Hormone levels are t at 12 & estrogen at 186. Face lift & eye lid surgery in 2014. Abdominoplasty/tummy tuck & some facial surgery May, 2015. Life is good for me. Love long nails & handsome men! Hopeful for my GRS & a nice normal depth vagina maybe by late summer. 5' 8", 180 pounds, 14 dress size, size 9.5 shoes. I'm kind of an elegant woman & like everything pink, nice & neet. Love my nails & classic Revlon Red. Moving back to Florida, so excited but so much work moving
  •  

A

Quote from: luna nyan on October 31, 2013, 06:27:18 AM
Hi A,

Your numbers aren't too far off what my endo would want for someone transitioning.  T could be a fraction lower, and E a fraction higher, but it's not frighteningly out of target ranges.

My last test results had T at 8.9 ng/dl and E around 234pmol/L.  Now my situation is different in that I'm on HRT to keep things at bay and avoid transition, hence the deli erately higher T.  My endo said to me that he targets 290 or so on E for transitioning dosages.

I suggest that you discuss what target hormone level your endo wishes to achieve and go from there.  If your numbers are pretty much the same as last time then there may be scope for increasing dosages.  Also consider the possibility of switching administrative method.

Are you sure you're in the right numbers? Like, the right units? Because you're using the international unit for estrogen and the American unit for testosterone, which doesn't make sense. And honestly, I've heard a lot of target levels for transition, but 290 pmol/L as a target level for transitioning... I have never heard something so very low, really. I should say that the normal range for MEN goes up to 242 pmol/L. In other words, none of my blood tests so far have been higher than normal estradiol levels for men.

And uhm, as I said already, changing how I take my estrogen is not possible, at least not until I'm rich. Pills are the only thing that's covered.

Quote from: FrancisAnn on October 31, 2013, 06:40:52 AM
It must just be the genetics. For myself I'm a B cup and growing after moderate estrogen for only 3-4 months.

I'm very sorry, but I can hardly tell you anything else than "please read the whole topic".
A's Transition Journal
Last update: June 11th, 2012
No more updates
  •  

AnnaSelbdritt

Numbers are insignificant because it varies for us all, we are all different in what levels work for us.
(Assuming you're not "genetically flat-chested" and hopeless) if you're not developing you do not have the right dose. Can you talk to the endo and try something new?
  •  

Doctorwho?

Quote from: A on October 31, 2013, 01:45:01 PM
changing how I take my estrogen is not possible, at least not until I'm rich. Pills are the only thing that's covered.
There are however at least four different chemistries available in pill form that I know of, and I'm only a baby student, so a grown up adult endocrine doctor will probably have a few more options.

Interestingly a small minority do have a genetic difference which renders them insensitive to the most commonly used of those chemistries - namely Estradiol-Valerate. If you happened to be one of those affected then you would fare better by switching to estradiol-hemihydrate, or better still conjugated estrogens (premarin) - I know lost of people don't like it, and I can't say I wonderfully keen myself, but it does work well for some people that don't respond to the alternatives.

The final alternative is Ethinyl Estradiol. Again lot's of doctors don't like it, this time because it carries higher risk factors than the other systems, but again if you can't work with any of the others it does work for some people...
  •  

A

Quote from: Doctorwho? on October 31, 2013, 03:44:10 PM
There are however at least four different chemistries available in pill form that I know of, and I'm only a baby student, so a grown up adult endocrine doctor will probably have a few more options.

Interestingly a small minority do have a genetic difference which renders them insensitive to the most commonly used of those chemistries - namely Estradiol-Valerate. If you happened to be one of those affected then you would fare better by switching to estradiol-hemihydrate, or better still conjugated estrogens (premarin) - I know lost of people don't like it, and I can't say I wonderfully keen myself, but it does work well for some people that don't respond to the alternatives.

The final alternative is Ethinyl Estradiol. Again lot's of doctors don't like it, this time because it carries higher risk factors than the other systems, but again if you can't work with any of the others it does work for some people...
I take micronized estradiol. That's what Estrace is. I thought that was supposed to be the best form of molecule one could take since it's bioidentical. That or I'm mistaken.

As for Premarin, I don't know about "conjugated", but it's not the same thing at all, and not only does it tend to be highly uneffective, but as far as I know it's also by far the most risky thing you can take when it comes to estrogen. It's also one of the reasons why doctors are overly cautious and greatly exaggerate the risks of HRT. Anyway, even if I wanted to take Premarin, the only product that's covered for it is a vaginal cream.

Now, bashing Premarin aside, I looked up ethinyl estradiol, and apparently there's a whole lot of products are covered for it. I guess when I next talk to him I can ask about it, but if it's something more risky and not especially proven more effective, I doubt he'll see any reason to give me that. Not to mention that all products with ethinyl estradiol in it are in the coverage category of anovulants, unlike Estrace, meaning that they're probably not indicated for HRT. Another obstacle.

And estradiol valerate... there isn't a single covered product that contains it.

Anyway, in short, the reason I said pills are the only covered method isn't that they say "pills are the only way of taking hormones". It's more like Estrace is the only decent and usable product I see on the list. See for yourself if you feel like it. https://www.prod.ramq.gouv.qc.ca/DPI/PO/Commun/PDF/Liste_Med/Liste_Med/liste_med_cor_2013_10_01_en.pdf

Quote from: AnnaSelbdritt on October 31, 2013, 03:20:05 PM
Numbers are insignificant because it varies for us all, we are all different in what levels work for us.
(Assuming you're not "genetically flat-chested" and hopeless) if you're not developing you do not have the right dose. Can you talk to the endo and try something new?

I am quite certain that numbers are very significant, given that many (most?) doctors will use them as their sole guideline. And I'm pretty sure they don't differ all that much between people. You're putting things very simplistically, and I'm afraid this is the very opposite of what I'm looking for here.

As for talking to the endo and trying something new... I should have detailed all of that above. So like about half of the posters so far, I'm going to have to ask you if you really read the topic well.
A's Transition Journal
Last update: June 11th, 2012
No more updates
  •  

kelly_aus

Having read the thread thouroughly, I do have some ideas - I've had a similar issue..

But as I don't wish to be called an idiot  and told to  read the thread thoroughly, I'll keep them to myself.
  •