My Wife and I will be seeing the endocrinologist soon, I have my referral letter from my therapist who I have been seeing for the last year. Our question is myself the MTF. And when I start HRT, will the testosterone blockers be the first then the estrogen to follow? I have read where both seem to be taken at the same time. After seeing a urinary doctor a couple years ago he performed a testosterone test which then came back very low (which I was happy to hear because I never liked normal male/female sex). If I could get some feedback from the network. Always with love and kindness Melissa Marie     

Hi Melissa Marie,

I don't think there is any set regimen.  It depends on the endocrinologist, and your age and health.  I have read many accounts here where trans girls get estradiol right off the bat.  That was not my experience.  I am older (58) and just started hormone therapy a few weeks ago.  I got a very low dose of spironolactone and finasteride.  I was hoping for a more aggressive regimen, but I think there were reasons.  I was on lisinopril for high blood pressure, and that medication can cause elevated potassium levels.  So can spironolactone, so there may have been some concern there.  I also smoked occasionally, and that significantly increases the risk of thromboembolism with estrogens, so again, I think that was just being cautious. Now that I have stopped smoking completely and I am off lisinopril, I hope I will get a change in my hormone prescriptions.

You're so lucky your wife supports you on this!  I wish you all the best.

With kindness,

Terri

It varies from doctor to doctor.  I started on E and then added the spiro, then upped the dose of E.

The whole thing took three months...

Jennifer

the above is similar how I started.  E first then spiro then finastride. 

I started on E. My endo was very open about the process- since E suppresses T, the idea was to get the E level in a target range first then adjust the T. From my point of view the other positive was seeing how my body / mental state responded to E sooner. But it's basically all about the blood tests. So I hope you're ok with needles.

I started E and Spiro in very low doses, then they were up'd depending on blood test results on a regular (quarterly) basis... After all, low inductor doses determine the exact ongoing regime... but each to their own (medical practitioner wise)

Katy xx

I started very low doses of Spiro and E at the same time, about 8 weeks ago.  After 6 weeks I saw a different doctor and they upped my Spiro dose to what they considered a "base-level" dose as opposed to what the other doc was prescribing which was half that.  A week later after they got my blood test results back they also doubled my E dosage.

So, basically after almost 2 months on "low dose" HRT, I just had my prescriptions doubled!  And woo wee, I tell ya.  That E is a powerful thing.  I ran up to a coworker today (my only ally at work) and said, "I NEED A HUG!" for no reason.  LOL.

My doctor started me on spiro (same dose today) and E together (it was increased 50% at month 3).

My T was low to begin with and it crashed.

It differs from doctor to doctor. In my case I was started on E and Sprio was added 6 weeks later. Hugs
Mariah

It all depends on your particular case. I am borderline diabetic, a little oversight for my age,  in my later period of life (50+), but I have never smoked. I am an occasional wine drinker. When my initial blood tests were done my doctor found that my T was very low for a male, so put me on Oestrogen only (no blockers). My dosage was increased 4 times over a period of 9 months and now I am on the cusp of a transition dose. My T levels are basically very low less than 0.9 and my Oestrogen levels normal for a  woman in her late 30's. My Doctor tells me now that effectively I am now hormonally female, but you have to remember I have been on this HRT regime now for nearly 2.5 years.

It varies from doctor to doctor, perhaps even clinic to clinic & region to region. Age and general health history may also be factors

I have noticed a change from long ago. THese days there appears to be more of a likelihood you'll get started on an AA as the blood workup is done and a baseline established. THen after a month or two later when you return and the vampires once again do their thing, and you aren't bouncing off walls or otherwise having a bad reaction to a lowered T level, then E is added.