Quote from: Ritana on March 21, 2016, 03:21:47 AM
The units are p/mol.
Laura was right. Made more sense.
QuoteI was browsing the internet last night, and i found this info on a health website:
Surprisingly, caffeine intake can actually increase estrogen. As part of my post vfs instructions, i was asked to give up coffee and caffeine for two months. I wonder whether this might have had an effect?
This effect is more likely when E is taken ORALLY as caffeine and estradiol are both metabolized via digestive tract by similar enzymes and affect each other's metabolism so that both end up increasing in the body. I definitely noticed this in the past, good and bad. Couldn't sleep at night, restless and hyperactive but breasts grew more.
I doubt it has had any impact on you.
QuoteI will go through the info you provided, kay. However, I am unclear as to why I've been warned by doctors that estradiol can cause cancer, blood clotting and possible breast cancer in transwomen.
Because they haven't researched the matter thoroughly and they are:
- assuming that because HRT caused breast cancer in the 2003 WHI study (on ciswomen) that hormones cause breast cancer but when you look more closely, you realize that the WHI study used non-bio-identical forms, that estrogen alone without medroxyprogesterone acetate caused a non significant decrease in breast cancer, that another randomized controlled trial was done with bio-identical estradiol and another progestin with results opposite to the WHI...there was no increase in breast cancer and an actual significant decrease in women who started HRT before 50 or in women who used estrogen alone. They also probably don't know that unlike ciswomen, the rate of breast cancer (as per those reported in the literature) is significantly less (like way less) in transwomen (around 4/100,000 vs. 170/100,000) and much closer to that of men not on HRT (1 in 100,000), DESPITE prescribing high doses of estrogens and progestogens to this population for several decades. Then you have men with prostate cancer, who despite taking very high estrogen doses, have rarely been found to develop breast cancer. I explained the rest to you above...there are so many findings and observations that suggest this is not the case. Doctors just don't have the time to do and compile all this research. We, the patients, can help them.
and by the way, in a recent paper on transsexuals, it is noted
J.D. Weinand, J.D. Safer / Journal of Clinical & Translational Endocrinology 2 (2015) 55-60"There is no increase in cancer prevalence or mortality due to transgender HT."
"While some guidelines for transgender medical care express
concerns for elevated cancer risk with certain hormone regimes,
current data suggest that the risk of cancer may not rise."
"Although studies are small, overall cancer incidence in transgender
men and transgender women to-date has not been found to be different
than their respective male and female controls [5].
There are no reports of change in breast cancer specific risk among
transgender individuals on estrogen compared to secular trends of
male breast cancer incidence. Rates are lower relative to secular
trends of female breast cancer rates."
I researched breast cancer in transsexual women and so far noted a total of 17 cases since 1968. This is very little considering the tens of thousands treated.
- As far as clotting goes, the studies found to observe a significant increase in clotting were using non bio-identical forms of estrogens. It was found that bio-identical estradiol, being native to the body was much less adverse and if taken non-orally, even less so. My own blood tests confirm this. I have high levels, up to 14,000 pmol/L and my clotting factors remain normal. Need I say more? I will...
J Clin Endocrinol Metab. 2003 Dec;88(12):5723-9.
Venous thrombosis and changes of hemostatic variables during cross-sex hormone treatment in transsexual people"The large differential effect of oral EE and oral E(2) indicates that the prothrombotic effect of EE is due to its molecular structure rather than to a first-pass liver effect (which they share)."
"In conclusion, we have shown that treatment of MtF transsexuals with sex steroid hormones (CPA combined with E2 or EE) affects the hemostatic balance with a very pronounced difference in the effects of oral EE compared with the effects of both td E2 or oral E2. Oral EE induces a clinically relevant prothrombotic state."
J Clin Endocrinol Metab. 2012 Dec;97(12):4422-8. "Historically, high-dose estrogen in the form
of ethinyloestradiol or conjugated equine estrogen (CEE) was
used to suppress testicular function and induce feminization.
In
view of the procoagulant nature of these older estrogens and the
inability to use plasma estradiol levels to guide treatment, this
protocol was changed in 2004 to oral estradiol valerate"
Minerva Ginecol. 2014 Feb;66(1):91-102."Micronized estradiol (E2) and its estere valerate (EV), is more easily metabolized by the liver than ethynylestradiol (EE). This causes minimal metabolic impact »
Obstet Gynecol. 1990 Apr;75(4 Suppl):9S-14S; discussion 15S-17S."Although oral conjugated equine estrogens have been used extensively, they introduce types of estrogen, such as equilin, that are not naturally found in humans and that can produce a pronounced hepatic response."
Maturitas. 2015 Mar 9."The hemostatic profile of women taking CEE was shown to be more prothrombotic than that of women using oral estradiol"
Andrologia. 2014 Sep;46(7):791-5.« Ethinyl oestradiol, due to its chemical structure, was in 2003 identified as a major factor in the occurrence of VTE. Most clinics do not prescribe ethinyl oestradiol any longer"
J.D. Weinand, J.D. Safer / Journal of Clinical & Translational Endocrinology 2 (2015) 55-60"Other compelling data suggest that
the incidence of venous thromboembolism (VTE) among transgender
women appears associated with the presence of a hypercoaguable
risk factor, including the use of an especially
thrombogenic estrogen (ethinyl estradiol) which is no longer used
[3]. Gooren et al. (2008), reported no increase in VTE among 2236
male-to-female (MTF) transgender individuals on HT from 1975 to
2006 compared with controls, with the exception of those who used
ethinyl estradiol, for which there was a 6e8% incidence [4]."
"Venous thrombosis events (VTE) were reported in MTF individuals
as early as 1976, when a 29-year old transgender woman
with no history or risk factors for VTE presented with pulmonary
embolism after beginning estrogen therapy of diethylstilbestrol
(DES) [7]. A 1978 paper also observed an occlusion of the middle
cerebral artery during estrogen therapy in a transgender woman,
where the patient was reported using mestranol, a 3-methyl ether
of ethinyl estradiol [8]."
So, remove conjugated equine estrogens (CEE), ethinyl estradiol (EE) and diethylstilbestrol (DES) from the mix and you end up with a much reduced incidence of clotting risks. You have studies in transsexual women where bio-identical estradiol is exclusively used or is the major estradiol component, in low, medium and high doses. And only once do we have an incidence of deep vein thrombosis, in someone with a GENETIC PREDISPOSITION/MUTATION.
Archives of Sexual Behavior, Vol. 27, No. 5, 1998"The incidence of thromboembolic events during cross-
gender hormone treatment in our patients was zero."
Exp Clin Endocrinol Diabetes. 2005 Dec;113(10):586-92."Sixty male-to-female transsexuals were treated with monthly injections of gonadotropin-releasing hormone agonist (GnRHa) and oral oestradiol-17beta valerate for 2 years to achieve feminisation until SRS."
"Two side effects were documented. One, venous thrombosis, occurred in a patient with a homozygous MTHFR mutation."
Two other studies, outside the transsexual realm.
Menopause. 2006 Jul-Aug;13(4):643-50."Oral E(2), with or without NETA, produced no net activation of coagulation but improved fibrinolysis."
Fertil Steril. 1997 Sep;68(3):449-53.« Compared with placebo, oral E2 replacement therapy resulted in a significant decrease in fibrinogen and apo B and a significant increase in plasminogen."
Several studies also show that when estradiol is given non-orally, even in high doses, coagulation is not adversely affected. This shouldn't be surprising given pregnancy's low rate of DVT and pulmonary embolism.
Quote from: Ritana on March 21, 2016, 04:33:48 AM
Here is a link on how caffeine affects estrogens effects
http://www.livestrong.com/article/494320-does-coffee-raise-estrogen-levels/
Phytoestrogens are 1,000 x weaker than estradiol and could actually end up blocking it by binding to receptors. So, I doubt that coffee increases estrogenic effects through this mechanism.
The inverse relation between caffeine intake and estrogen levels, I strongly question until I actually see the data which I cannot due to non-access. Also, association is not causation. This is always important to remember.
J Lab Clin Med. 1980 Apr;95(4):603-8.
Impaired elimination of caffeine by oral contraceptive steroids."The effect of OCS on the disposition and elimination of caffeine was examined. Caffeine (250 mg) was administered orally to 13 healthy males, nine healthy females taking no OCS, and nine healthy females on OCS. The t1/2 (beta) was significantly prolonged in women on OCS (10.7 +/- 3.0 hr vs. 6.2 +/- 1.6) (p less than 0.001) as compared to women taking no OCS. Women on OCS had a significantly lower total plasma clearance (0.79 +/- 0.21 ml/min/kg vs. 1.3 +/- 0.35) and free clearance (1.12 +/- 0.28 ml/min/kg vs. 1.97 +/- 0.57) that women not taking OCS."
"We conclude that OCS impair the elimination of caffeine."
This is line with my experience. This is why I don't drink any more caffeine. Tobacco, by the way, has the opposite effect. BUT, if you aren't taking E orally, irrelevant unless you are taking high amounts (like me) which you aren't.
Quote from: Laura_7 on March 21, 2016, 04:47:45 AM
Clotting is a side effect of oral intake of estrogen.
More so, by non bio-identicals as these recirculate again and again through the portal vein. It's important to mention that not only is the route important but the type of estrogen is equally important such that two different types of estrogen taken orally can have widely different effects on coagulation, as studies have pointed out.
Quote from: Laura_7 on March 21, 2016, 05:09:36 AM
It might help even out some of the side effects the OP described.
In Ritana's case, if her side-effects are caused by lack of estrogen, bio-identical progesterone will, at best, mask symptoms temporarily, do nothing or make things worse because it is anti-estrogenic. Until her optimal estrogen is not figured out by doctor, I personally don't think it's a good idea to add P. I know I suggested it earlier for sleep but I should have added that it is best, first to determine what is causing what, determine the optimal E dose for her and then perhaps, if need be, add P if certain symptoms persist and can be improved by P. Her doctor need to determine this. All we can do is give some guidance which can then help her figure out things with her doctor.
Quote from: Ritana on March 21, 2016, 07:50:30 AM
I am not sure i can compare myself to menopausal cis-xomen as my biology is not the same and the effects of the estrogen reduction might not be the same, even though I am a posop girl.
It's the same. Symptoms of too little sex hormones in women and men are identical.
. headaches, following decrease of hormones but soon goes away
. hot flashes, night sweats
. dry skin, hair, and vagina, older looking skin, wrinkles, less elastic, heals slower, thinner hair and skin
. breast shrinkage, less firm, sags more
. weight increase, increase in appetite
. memory not as good
. insomnia
. moody, sad, angry, impatient, irritable, anxious
. low energy
. osteoporosis
. diabetes
. libido decrease
. increase in cardiovascular risks, etc.
