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All my questions about HRT!

Started by shoko, November 20, 2015, 11:59:28 AM

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shoko

I guess instead of bumping up old threads I'll just start one and see what responses I can get :)

I'm 38 years old, Asian, somewhat petite (5'5" 120 lbs) and overall healthy (maybe some high cholesterol but haven't checked recently).  I plan to start HRT in January after I bank sperm.  I've been doing some searches on HRT but still have a few questions!

1. I really want to look convincing from the start, so I have a few FFS consults coming up.  I'm just not sure how long to wait - up to 2 years of HRT?  Or can some things be done earlier without bad long term effects (such as tracheal shave, revision rhinoplasty..).  People say bone won't change, but I'm not sure..

2. Risk of DVT/blood clots.  Is it real?  Especially if you fly a lot on airplanes, is there a restriction or just move around?

3. Is the one year rule before SRS necessary, how long really do you need to wait and is it for medical reasons?

4. Can you still have sex on HRT?  Or will it just stop working?  That would freak me out I think

5. I don't think I would want to stop HRT for surgery.

6. Is hair regrowth noticeable?

7. Progesterone.  I know I want to have this along with estrogen and finasteride (over spironolactone, due to thinning hair).

8. I'm thinking sublingual or transdermal but I'm afraid of patches falling off in the shower, although they say risk is lowest with transdermal.

9. Does health insurance cover these meds?


I have this fear that my body will start falling apart all of a sudden lol.  But I know the benefits will outweigh my fears overall
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Deborah

According to my endo, if you start out healthy the health risks with oral E is very low.
Love is not obedience, conformity, or submission. It is a counterfeit love that is contingent upon authority, punishment, or reward. True love is respect and admiration, compassion and kindness, freely given by a healthy, unafraid human being....  - Dan Barker

U.S. Army Retired
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Ashey

1. You can probably do FFS whenever as it's a cosmetic thing. Bone structure isn't going to change. Things like rhinoplasty are done by anyone regardless of gender. However, I would recommend waiting simply because your fat distribution will change, so whatever you get done now may not look quite the same later. I mean, the difference could be minimal, it's just my recommendation. I'd say the same about breast augmentation, because again the hormones will make changes and may affect appearance.

2. Blood clot risk is real, but it's real with cis women as well. Staying active and healthy should be a priority regardless.

3. I thought it was two years 'real-life experience' (living full-time as a woman) before the surgery but I could be wrong. I believe this is to minimize the chances of making the wrong decision or an ill-informed decision. Some end up not desiring the surgery even if they started out wanting it. It's a big decision that should be given some time and thought. I think the wait time is also to minimize the shock, easing you into the psychological and social changes first.

4. This can vary. My equipment became very estrogenized, shrunk, and my sex drive transitioned too. So this has made penetration with it undesirable and difficult for me. I have trouble maintaining erections for long enough to have sex using it, and erections often hurt but I think this might be because I keep it pulled back in my panties all the time and it's become curved as a result. However I think giving it a 'work out' regularly can negate some or most of these effects.

5. Stopping HRT for surgery is pretty necessary I believe, but I haven't really looked into it. Others here would know better than I would. But I've been off my hormones before, and it's tolerable especially after some time because it takes a bit for testosterone to come back up if you've gotten your levels down pretty low. I was off my pills for a month before, and I was fine the first 2-3 weeks. But for a week or 2 before I went back on 'em, I could tell my t-levels were up because my sex drive became more male-typical and increased, and I was a bit more aggressive and on edge. I wouldn't worry too much about it, you probably wouldn't be off 'em for tooo long.

6. Depends on what hair you're talking about. My body hair regrowth has slowed quite a lot and hairs are a lot thinner, making them hardly noticeable. Takes some time though. And you'll still get regrowth most likely, but then cis women often deal with unwanted hair as well. :P As for head hair, well.. I wouldn't rely solely on hormones. I've heard it's possible to maybe get at least some regrowth, but there are better methods out there for dealing with that.

7. You'll get varying opinions about progesterone, but I think it's beneficial. Just take notice of your body and your moods if you go on medroxyprogesterone because many have had negative effects from it including mood swings and depression. But mood swings alone aren't necessarily an indicator as estrogen alone can cause them, especially if you develop a cycle. You'll just have to figure out what your new emotional range is and see if your mood swings go to extremes or outside that range frequently.. or if negative feelings persist. This is something you should bring up with your endo.

8. This is up to you, and another thing to discuss with your endo. Pills are going to go through your liver, and I've heard this can put unnecessary strain on it, but as of now I haven't experienced any problems with it. I suppose time will tell.

9. Pretty sure it's possible depending on your provider and plan, but this will vary.

Just pay attention to what your mind and body are telling you, stay healthy and active, ask your endo questions at regular check-ups, and get your blood tested regularly. :)
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Rachel


1. I really want to look convincing from the start, so I have a few FFS consults coming up.  I'm just not sure how long to wait - up to 2 years of HRT?  Or can some things be done earlier without bad long term effects (such as tracheal shave, revision rhinoplasty..).  People say bone won't change, but I'm not sure..

Bone will not change. Some fat will redistribute and features will soften. No comment on FFS.

2. Risk of DVT/blood clots.  Is it real?  Especially if you fly a lot on airplanes, is there a restriction or just move around?

Bio identical E has a very low risk. My doctor has me take an aspirin a day.

3. Is the one year rule before SRS necessary, how long really do you need to wait and is it for medical reasons?

For me, the surgeon I want requires it and multiple letters. My insurance also requires the same.

4. Can you still have sex on HRT?  Or will it just stop working?  That would freak me out I think

Yes but for me as time went on and circumstances changed, it is not very important to me, at least for now.

5. I don't think I would want to stop HRT for surgery.

Discuss it with the doctor and understand why.

6. Is hair regrowth noticeable?

I have regrowth but need transplants.

7. Progesterone.  I know I want to have this along with estrogen and finasteride (over spironolactone, due to thinning hair).

I take spiro and finasteride.

8. I'm thinking sublingual or transdermal but I'm afraid of patches falling off in the shower, although they say risk is lowest with transdermal.

I did E pills and now IM.

9. Does health insurance cover these meds?

Mine dos but I use a federal program which is cheaper (my E cost $15.00 for 10 ml of 20 mg/ml delestrogen). Insurance is $20 for 5 ml. Plus where I go the LGBT primary care owns the pharmacy and 1000's of trans go there. I am there with family

HRT  5-28-2013
FT   11-13-2015
FFS   9-16-2016 -Spiegel
GCS 11-15-2016 - McGinn
Hair Grafts 3-20-2017 - Cooley
Voice therapy start 3-2017 - Reene Blaker
Labiaplasty 5-15-2017 - McGinn
BA 7-12-2017 - McGinn
Hair grafts 9-25-2017 Dr.Cooley
Sataloff Cricothyroid subluxation and trachea shave12-11-2017
Dr. McGinn labiaplasty, hood repair, scar removal, graph repair and bottom of  vagina finished. urethra repositioned. 4-4-2018
Dr. Sataloff Glottoplasty 5-14-2018
Dr. McGinn vaginal in office procedure 10-22-2018
Dr. McGinn vaginal revision 2 4-3-2019 Bottom of vagina closed off, fat injected into the labia and urethra repositioned.
Dr. Thomas in 2020 FEMLAR
  • skype:Rachel?call
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KayXo

Quote from: shoko on November 20, 2015, 11:59:28 AM
1. I really want to look convincing from the start, so I have a few FFS consults coming up.  I'm just not sure how long to wait - up to 2 years of HRT?  Or can some things be done earlier without bad long term effects (such as tracheal shave, revision rhinoplasty..).  People say bone won't change, but I'm not sure..

No bone change. Give it 2-3 yrs on an effective HRT regimen. Some need aggressive dosing, some don't. It depends. Tracheal shave, rhinoplasty, won't make a difference. 

Quote2. Risk of DVT/blood clots.  Is it real?  Especially if you fly a lot on airplanes, is there a restriction or just move around?

This has been observed in those exposed to estrogen that is NOT bio-identical like Premarin (usually high doses but also lower) and ethinyl estradiol (in birth control pills). Bio-identical estradiol has shown to be much safer, especially if taken non-orally and actually protect against this. I have a study that corroborates this. Best to avoid those estrogens then and probably your doctor will too.


Quote3. Is the one year rule before SRS necessary, how long really do you need to wait and is it for medical reasons?

In most places in the world, to be sure this is what you want, that you get used to living as a woman, etc. I think it's reasonable, sensible. :)

Quote4. Can you still have sex on HRT?  Or will it just stop working?  That would freak me out I think

I never did but, if I can still get erect now and aroused, post-op, I don't see why not. Androcur can have a negative effect on libido as can not enough estrogen. Progesterone (bio-identical) sometimes helps also.


Quote5. I don't think I would want to stop HRT for surgery.

Non-oral bio-identical estradiol, bio-identical progesterone, finasteride (dutasteride) have not shown to increase the risk of clotting (which is the issue when you get surgery, due to immobilization) so therefore should be ok to continue but most surgeons ignore this and still insist you stop. :( Some anti-androgens need to be stopped weeks before.

Having said that, please follow doctor's order, always. :)


Quote6. Is hair regrowth noticeable?

Depends how much you lost, where, for how long, age, genetics, your regimen, etc.


Quote7. Progesterone.  I know I want to have this along with estrogen and finasteride (over spironolactone, due to thinning hair).

Bio-identical progesterone is best but other progestogens like Duphaston and Proluton Depot have shown to be relatively safe as well. Some say it is beneficial, others not. Trial and error.

Quote8. I'm thinking sublingual or transdermal but I'm afraid of patches falling off in the shower, although they say risk is lowest with transdermal.

Risk is lowest with bio-identical estradiol and a little more, non-orally, thus injections, pellets, transdermal, gels in that category. Sublingual, you inevitably end up swallowing.

I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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shoko

Thanks for the responses!  I saw the Endocrinologist yesterday and had everything cleared up.  I can't wait to start next month
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