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Masculinization after SRS

Started by galaxy, April 12, 2016, 04:30:39 PM

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SamKelley

Quote from: galaxy on April 13, 2016, 03:12:31 PM
T 0,1 ng/ml
DHT 120 pg/ml
E2 120 pg/ml (after 6 hours)
SHBG 45 nmol/l
DHEAS 2,5 ug/nl

There will be something going on that isn't showing up here. Yes your E2 is a bit low by some standards (mine is double that). Some other thoughts:

1. Check progesterone levels. Progesterone helps prevent estrogen insensitivity
2. Can you get estrone tested (E1)? E2 isn't effective if there is too much E1 to bind to estrogen receptors (E1 is far weaker than E2) - especially if you are taking estrogen orally
3. Check prolactin levels, to check for prolactinoma

Surely there is a solution, however I your doctors may not find it with as limited a blood picture as they've taken.

Good luck x

Sam
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KayXo

Quote from: SamKelley on May 15, 2016, 05:44:34 AM
1. Check progesterone levels. Progesterone helps prevent estrogen insensitivity.

If she isn't taking progesterone, there is no point as it will be VERY low. Progesterone actually downregulates (reduces) estrogen receptors and increases conversion of estradiol to estrone, making tissue less sensitive to estrogen.

Quote2. Can you get estrone tested (E1)? E2 isn't effective if there is too much E1 to bind to estrogen receptors (E1 is far weaker than E2) - especially if you are taking estrogen orally

I tend to agree with this but purely speculative at this point.

I think the problem may be not enough E but the doctors should determine this. Keep us posted. :)

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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SamKelley

Quote from: KayXo on May 15, 2016, 04:36:46 PM
If she isn't taking progesterone, there is no point as it will be VERY low. Progesterone actually downregulates (reduces) estrogen receptors and increases conversion of estradiol to estrone, making tissue less sensitive to estrogen.

I disagree Kay because the relationship between progesterone receptors and estrogen receptors is complex. Also galaxy is on cyproterone acetate which is a progestin, and progestins suppress progesterone which can lead to estrogen dominance because E has no natural antagonist P.

Whether we agree or not on this KayXo it doesn't really help galaxy! My point is that what has been provided is a pretty basic blood picture...

Galaxy for your peace of mind, I'd like to see your doctor perform a more thorough blood picture - We don't know you E1/E2 ratio, LH, FSH, prolactin, free T vs. total T, or progesterone - all components which influence demasculinisation and feminisation (and all of which are fairly common tests).

I guess the biggest red flag for me is if I don't truly believe my doctor isn't taking my experience seriously ... If that's the case then I'd be having a discussion with them about why they're not.

Hope it gets resolved soon x
Sam
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KayXo

Quote from: SamKelley on May 16, 2016, 10:04:43 AM
I disagree Kay because the relationship between progesterone receptors and estrogen receptors is complex.

Volume 18a of Elsevier's New Comprehensive
Biochemistry, Titled 'Hormones and Their Actions, Part I', editors BA
Cooke, RJB King and HJ van der Molen.  Published 1988.  ISBN
0-444-80996-1.  Dewey 612.405.
Chapter 14: Progesterone action and receptors, by
Nancy L Krett, Dean P Edwards and Kathryn B Horwitz, of the University
of Colorado Health Sciences Centre, Denver.


"Binding of progesterone to its receptors then leads not only to progestational effects, but also antiestrogenic effects by causing a reduction in estrogen secretion into the systemic circulation; by stimulating the enzyme 17B-hydroxysteroid dehydrogenase which converts estradiol to the less active estrogen estrone; and by lowering the levels of estrogen receptors in cells thereby decreasing the ability of target tissue to respond to estradiol [4]."

QuoteAlso galaxy is on cyproterone acetate which is a progestin, and progestins suppress progesterone which can lead to estrogen dominance because E has no natural antagonist P.

Progesterone levels are very low in genetic males so the additional reduction would be insignificant.

https://en.wikipedia.org/wiki/Progesterone

"Progesterone levels tend to be < 2 ng/ml prior to ovulation, and > 5 ng/ml after ovulation."

"After the luteal-placental shift progesterone levels start to rise further and may reach 100-200 ng/ml at term."

"Adult males have levels similar to those in women during the follicular phase of the menstrual cycle." Hence, less than 2 ng/ml, compared to up to 20-30 ng/ml in women during the luteal phase and much more during pregnancy.

No such thing as estrogen dominance, strictly unsubstantiated claims not backed up by science. Many of the assertions often expressed alongside this notion are also false and have been disproved by science. Many transsexual women do fine on estrogen alone and sometimes, on quite high levels. Progesterone can even make things worse for them, sometimes. I personally like it.

The only instance where progesterone is absolutely required is in women with uterus as estrogen alone can apparently increase risk of uterine cancer. But, it may have other benefits as well, for SOME women, including myself.

QuoteGalaxy for your peace of mind, I'd like to see your doctor perform a more thorough blood picture - We don't know you E1/E2 ratio

We can easily estimate this based on the route of administration, testing is not necessary. Some argue this ratio is not important as E1 and E2 interchangeably convert to each other. I really am not sure what to think of it. Am on the fence about it.

Quote, LH, FSH, prolactin, free T vs. total T, or progesterone - all components which influence demasculinisation and feminisation (and all of which are fairly common tests).

She had her prolactin levels checked many times and MRI as well to determine if prolactinoma was present. Negative, so far.

Her T will be low since she is post-op, no need for this. Progesterone is low too as she is taking no progesterone. All LH and FSH will reveal is if she's taking enough to keep away hot flashes and typical climacteric symptoms. Not if she's taking enough E for optimal feminization for her. She didn't notice any difference with progesterone and besides, she is already taking a progestogen, cyproterone acetate.

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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galaxy

Prolactin 170pg/ml
FH 0
FSH <1

Actually iam taking progesterone again. Until now no changes.
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KayXo

Your prolactin levels are VERY high. Did you have MRI again recently just to be sure?
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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galaxy

You dont tell me anything new. Waiting for the new values.
But my actually problem is massive hairloss snd acne"
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