Hello ladies, I was curious about the hormone dosages after SRS? I plan on getting this surgery in 6 months my insurance covers! Now I know my endo will inform me on my dosages post surgery but I feel the need to hear it from an actual woman who had this surgery done just because I know that some doctors do things differently sometimes. If you are post op and know this or just know from research I would love to know! Also love to hear about your experience and your doctor if you feel like sharing anything else

We avoid talking about dosages on this site for various reasons. Also I am still at least a year away from GRS but your estridol dosage should mostly stay the same, perhaps a small decrease and you will stop taking a testosterone blocker because there is nothing to block.

all the talk of lowering dosages is mostly old information from back when MTF meant taking massive liver destroying amounts of estrogen to overwhelm the testosterone. Now with modern T blockers like Spiro there is no real need for the hugely high Estrogen so your E dosage should stay mostly the same. Though like any medication your doctor will monitor it over time and adjust it if they feel its getting out of wack.

Serena

Post op (as Valwen indicated) you will need to continue with self administered estradiol.  Enough to maintain the level of feminine characteristics that your genetics will permit.  It's not about the dosage though.  It's about the level of estradiol measured in your blood plasma.  That's why it's important to have it checked periodically until your Endo. determines that you have reached a steady state that works for you.

Hi Nattie,

As the forms and type of HT delivery is so variable, and we all react so differently, be guided by your Endo and blood tests. If you don't trust your Endo, find another or at least get a second medical opinion.

My programme essentially hasn't changed, with the exception of dropping Spiro from the regime. My Endo is driven by the blood test results he orders every 6 months.

Speak to you as soon as I've finished cleaning Wynternight's home. (By request  )

Huggs
Catherine

Thanks for the response everyone. This info sounds like what my endo told me. I trust my endo he's great, but it's always good to get a second opinion or other info from experiences

Hi,

Post GCS, you no longer need testosterone blockers.  Your endo will target some E level and give you what you need to get there.  The correct question is "What should my Estrogen level be post GCS?"

There are two predominant schools of thought.  One sets you at a level typical for a post menopausal woman.  The other shoots for 3 to 6 times that level.

I'm of the latter school, at least until a woman is on HRT for 40 years. Then, cut down.

Hugs

Jen

Hello Everyone, I was on HRT 9 months prior to SRS.  After SRS my estradiol dosage was increased substantially.  Seems to make a big difference.  Read here and other places that estradiol dosage is usually reduced after SRS.  I would assume most of those folks have been on HRT at least a couple of years.  In my case there might be room for improvement before dropping down to a maintenance level.  I self-inject once a week.  Most of the hot girls around me 'friends' are in the 1000+ range.  Yeah they look great........me not so much.

Thank you,
Anne

I stayed at the same dose, but I was also on a super low dose beforehand, so there was no real need to consider changing it as long as it was working. (I never took AAs, either, though my endo says she typically does take patients off of spiro post-op.) I had to go back to three-month blood tests for the first year post-op, just to be cautious; now I'm doing yearly, as I was before.

That's interesting Anne, I will probably be around a year on hrt when I get the srs so I wonder if that would be the same situation for me? So interesting how doctors have such different thoughts and ways to give you hormones.

I wonder how long before SRS one needs to be on HRT..

Quote from: shoko on November 25, 2015, 01:36:16 PM
I wonder how long before SRS one needs to be on HRT..

This really depends on your surgeon. It just varies.

The standards of care used by most in the US require one year on hormones and at least one year living full time. Though like they said it can vary.  Also there is often a long wait so starting the process of finding and choosing you surgeon early is good.

Serena

I've been on HRT just about 8 years now. Because I had an orchie the post op levels didn't have to change. My surgeon Mr Terry set them back in 2010 and when I moved to Australia my GP here concluded as I'd been on long term care from UK there wasn't any need to change anything. Post op I hoped to convince her to up my levels because they are about the level you'd expect in a 49 year old post menopuase CIS woman and I believe in getting them in the higher range but she just refused saying that I wouldn't notice any difference in development after so long and it would just be more costly for little to no benefit. Pre orchie I was on a higher dose than now as well as an anti androgen but that was changed as it would be for someone post SRS who didn't have an orchie

Hugs

Sorcha 

I seem pretty content on a low/minimal dose.  Doctor had me on twice as much, but after surgery it felt excessive.  When it comes to chemical intake, I prefer to err on the side of less.  I feel great now, so I know I'm taking the right amount.  I have no idea what my numbers look like, nor am I concerned.

This is a question with no easy answer because everyone has different physiologic responses - but as a guide post-op dosages are usually in the range of 1/2 to 1/3 of the pre-op dosage. Taking more than this will not be beneficial and may increase the risk of adverse effects.

It is usually advisable to have the correct dose titrated individually because as I said people vary. I myself made the mistake of not doing this when I was first post-op back in the mid 1980's . This was a serious error because for reasons that no one has adequately explained to date it appears that my body makes near adequate amounts of estrogen on its own and thus the result was that taking the dose I was prescribed resulted in serum levels in the stratosphere for many years until I finally did the sensible thing and allowed some bloodwork to be done to establish the correct dosage - which in my case turned out to be almost zero.

So if you want to get it right - and I would suggest you do, then get some bloodwork done and titrate the dose accordingly.

Hopefully your doc will be less concerned with actual dosages and more concerned with your levels (that's what matters).

I am actually at the same dose I started HRT on and it seems to work ok. In fact I've even been at a higher dose and as far as my estrogen levels, they've been fine (all post-op) but my platelets did start to go up so I went back down again.

What I notice is that when I take E (orally/sublingually) within 12 hrs or so the E levels have gone down significantly so splitting it up throughout the day seems to help keep it level.

I have 1 pill of spiro and 2 of Estrodiol. I take them all in morning but maybe I should switch it up and do one pill in morning one in evening?

Quote from: Nattiedoll on November 26, 2015, 12:27:41 AM
I have 1 pill of spiro and 2 of Estrodiol. I take them all in morning but maybe I should switch it up and do one pill in morning one in evening?

Definitely check with your doctor about it but it's been my experience that this does help.

Quote from: Debra on November 26, 2015, 12:19:48 AM

What I notice is that when I take E (orally/sublingually) within 12 hrs or so the E levels have gone down significantly so splitting it up throughout the day seems to help keep it level.

I'm no medical practitioner so please don't shout if this is slightly out but an endo told me that estrogen pills are only active for about 6 hours once taken so if you have more than 1 pill to take splitting them u makes sense for a better spread of effectiveness

Hugs


Sorcha 

Quote from: SorchaC on November 26, 2015, 03:42:45 PM
I'm no medical practitioner so please don't shout if this is slightly out but an endo told me that estrogen pills are only active for about 6 hours once taken so if you have more than 1 pill to take splitting them u makes sense for a better spread of effectiveness

Hugs


Sorcha 

It's what is called "the half life." Every chemical has one. A chemical is said to be most effective up to a point of it's half life. From that point on, it's effectiveness degenerates. Some quickly, some slowly.

Cotinine is an active metabolite of nicotine that remains in the blood for 18–20 hours, thus it has a half life of 9-10 hours. Other chemicals have much longer half life, therefore producing a compounding effect, which may be good or conversely may be bad. Taking the Cotinine case, if one was to smoke one cigarette per hour over an 18 hour day, it's not rocket science to work out smoking will have a compounding effect that may not be good for your health.

Similarity, thanking this Oestrogen case with a half life of 6 hours, you can see the body would be see-sawing between just enough to maintain function to deprivation. This oscillating supply may not be conducive to good overall health.

Thus, it could be wise to say, that for any medication, good or bad you're on, it is to your advantage to know it's half life. Any Pharmacist worth their trade, should know the respective values.

Speak to as soon as I finish de licking the kids hair.

Huggs
Catherine