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Estrogen Patches Prescribed?

Started by JaimeJJ, March 04, 2011, 11:00:59 AM

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JaimeJJ

I have just been prescribed estrogen patches by my private doctor in london! Yay!

I thought that I would be prescribed an anti androgen too but my doctor said I don't need them I only need the patches.. Is this right? I was quite concerned about this as I thought I'd need an anti androgen to lower testosterone as well as estrogen.. Is this right??
"everyone thinks that i have it all, but it's so empty living behind these castle walls"
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spacial

To be frank jennifer, this is a decision that your Dr will have made, based upon the observations.

Can you speak to him again and ask him why he hasn't perscribed an antiandrogen. It does seem strange, but he really needs the benefit of the doubt.

Let's face it, you don't hire a mechanic then fix the car yourself!
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atheris

Quote from: jennifer90 on March 04, 2011, 11:00:59 AM
I thought that I would be prescribed an anti androgen too but my doctor said I don't need them I only need the patches.. Is this right?

Is this right? Well, typically, no, it isn't. Very often, when someone begins HRT, an anti androgen will be initially prescribed, and the patient will be observed for any negative reactions. At a later point in time, estrogen will be added. What happens, is the anti androgen lowers the level of testosterone in the body so a lower dosage of estrogen is needed to achieve the desired feminization. Without the anti androgen, a higher dosage of estrogen would be needed, and with the higher dosage goes an increased chance of negative side effects. The aim is to achieve maximum feminization with the lowest levels of anti androgen and estrogen. Without an anti androgen, a higher dosage of estrogen would be needed for similar gains. Sometimes, both the anti androgen and estrogen are initiated at the same time. Sometimes, rarely, estrogen alone is prescribed; the client may not tolerate the anti androgen, or the prescribing physician may not be educated on modern HRT protocols for transitioning patients.

There's enough information concerning HRT theory and suggested regimens on the Internet; you may wish to copy some of this information and discuss it with your doctor. You may also consider finding a doctor, perhaps an endocrinologist, who has experience working with HRT for transitioning patients. You can also contact your local LGBT Center, and ask for a recommendation for a doctor.
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JaimeJJ

My doctor is a specialised doctor who only deal with trans patients, and is actually a FTM. He looked at my blood test results which I provided to him and said my t levels were in normal range and then gave me these estrogen patches. I asked him about an anti androgen too and he said I don't need one, the patches are enough. I said every trans person I have spoken with online was also prescribed an AA and he said you don't need them that's an old way of medicating and the patches are enough for now. I am so confused...
"everyone thinks that i have it all, but it's so empty living behind these castle walls"
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pebbles

you can do it that way but it's dogey if you ask me the theory goes that modern estrogen's will disrupt the feedback loop between the pituitary gland lowering T anyway with just E...

although it can work I'm extremely dubious of the claims and would ask for proof ¬.¬
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atheris

The "old way" of medicating used a different form of estrogen which had a greater risk of side effects. An anti androgen was also used.

I'm not familiar with a medical doctor who specializes exclusively in trans patients. What, exatly, is his specialty, endocrinology? Your t levels are in the normal range for a female?
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JaimeJJ

Yes my doctor is a private doctor I travel to london to see, his name is Dr Curtis and is very well known in the UK, google him.

Although I trust him, I am just unsure about why he hasn't prescribed me any anti antrogen. If he os so specialised in this matter, should I just take his word and go along with this? Its not like I havnt asked him...
"everyone thinks that i have it all, but it's so empty living behind these castle walls"
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rejennyrated

Having read some, what I would frankly consider to be imbecilic and shortsighted papers about progesterone written by Dr Richard Curtis, my opinion of his ability as an endocrinologist is so poor it is quite literally off the scale! ::) My view is that just because someone may have been trans and may be a doctor, that does not equate to an automatic qualification to treat the condition.

However, there are many people who have gotten perfectly satisfactory results with him so my advice would be that, as you chose him, presumably in full knowledge of all the other possible private doctors like Michael Perring, and various others who operate in this field, you should at least give Dr Curtis a fair chance to prove himself.

Even though Dr curtis is quite literally the last person on earth that I would personally choose I would still strongly advise against chopping and changing at this early stage. It is not fair to anyone.

If, after a few months, things are not progressing as you would wish, then maybe review things, but for now stick with the doctor you have chosen and see what transpires.
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atheris

It's impossible to know what Dr. Curtis's priority is, the maximum obtainable feminization results with safety, or the maximum obtainable profit margin with slow, but eventual feminization. He does offer convenience, doesn't he?

Many doctors administer HRT without ever doing blood work to determine testosterone or estrogen blood levels, preferring to rely upon the response of each individual patient. Makes sense, since the blood levels really don't give a reliable indication of how someone feels or responds to HRT, for example, my blood levels had been within correct tolerances for the anti androgen, yet, I'd occasionally have undesirable side effects. Blood work is routinely done, but other functions are monitored.

What I'm saying, is there is no ONE WAY of administering HRT, and what works best is often the result of trial and error with each patient. An experienced doctor will have an established starting point and a typical way of advancing, with adjustments being made as necessary. A doctor should be flexible, and the patient realistic. I suppose you'll realize desired gains with Dr. Curtis, but the progress may be slow, minimal, and expensive; I see that this clinic is on the expensive side. You may find faster results at a lower cost elsewhere. Personally, I'd find another doctor, someone more in tune with his client.
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regan

Society refers to the "practice of medicine" becuase it is an art not a science.  It really is the ultimate YMMV.
Our biograhies are our own and we need to accept our own diversity without being ashamed that we're somehow not trans enough.
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rejennyrated

Quote from: regan on March 04, 2011, 02:29:42 PM
Society refers to the "practice of medicine" becuase it is an art not a science.  It really is the ultimate YMMV.
So true! what will cure one person can kill another.
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JaimeJJ

Hmm now I'm really worried. Surely there's a reason other than money why he would not prescribe them? I have my first appointment in Charring Cross in May so maybe they will prescribe them.

My friend gave me 1 months supply of Avodart which I have been taking for a few days, if I continue with these and the patches should I be ok?

By the way I was prescribed Estradot and told to change the patch every 3 days and was given 1 months supply.
"everyone thinks that i have it all, but it's so empty living behind these castle walls"
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regan

Quote from: jennifer90 on March 04, 2011, 03:07:14 PM
Hmm now I'm really worried. Surely there's a reason other than money why he would not prescribe them?

He's probably got frozen assets in Nigeria too...
Our biograhies are our own and we need to accept our own diversity without being ashamed that we're somehow not trans enough.
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Asera584

Even though not having AA would mean more estrogen to have similar effect, from what i read, patch are the safest method, so.. i guess high dosage of the safest methode is still better than AA + low dosage of the most dangerous way (witch is pills, once again, from what i read)

If your doctor only treat trans people, and he actualy know what it is to go though this, id say he know what he do, everyone's their method, just as you are right to not agree with his method, if thats what you want, but no matter if its the best way or not, i'm pretty sure of one thing, it cannot be totally wrong
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spacial

jennifer.

I will strongly advise you against using something that is not perscribed. Host of reasons but you'll just end up annoying the Drs treating you. Not a good idea.

Continue with the perscription you have and wait till your appointment at Charring Cross in May.
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JaimeJJ

I'm also still looking into storing sperm and have been advised to write a letter to a doctor at a local hospital enquiring about this, which I done yesterday.  Would I be ok to start using the patches if I start storing sperm in the next few weeks?

Dr Curtis said I should stop for 3 months if I want to do that, but I'm hoping to do the storing within the next few weeks...
"everyone thinks that i have it all, but it's so empty living behind these castle walls"
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spacial

Quote from: jennifer90 on March 04, 2011, 05:16:35 PM
I'm also still looking into storing sperm and have been advised to write a letter to a doctor at a local hospital enquiring about this, which I done yesterday.  Would I be ok to start using the patches if I start storing sperm in the next few weeks?

Dr Curtis said I should stop for 3 months if I want to do that, but I'm hoping to do the storing within the next few weeks...

In your position, I would take Dr Curtis' advice.

I'm sure we all sympathise with you, wanting to get the process moving along. But no sense in leaving things behind while you rush.
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Erin H

ok i know this hasn't been like posted in about 6ish month

but im with Dr Curtis as well and was prescribed the patches quite recently (yay) with no AA
He said that after 3 months he checks the blood results and then will decide if a AA is needed, he said some people wont need an AA, some people will just need a higher dose of oestrogen and some will need both AA and oestrogen i think.

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JennX

#18
Quote from: pebbles on March 04, 2011, 12:52:02 PM
you can do it that way but it's dogey if you ask me the theory goes that modern estrogen's will disrupt the feedback loop between the pituitary gland lowering T anyway with just E...

although it can work I'm extremely dubious of the claims and would ask for proof ¬.¬

I agree with Pebbles. I really don't understand where some docs come up with this sort of MTF HRT regimen... and I have a strong background in science and medicine. It really baffles me. Can it work... maybe. But it's far from the "popular and most often prescribed" regimen.

Furthermore, if you are under 40 years of age, I don't see the reason to prescribe patches as they are far less effective than sublingual oral or injectable estradiol. Are patches safer, especially if you are over 40, or have a coexisting condition that may increase the clotting factors in your blood, or history of stroke, etc... Yes... patches are. But they are not the norm regimen of HRT for MTF transitioners under 40 years of age in good physical health.

You may consider getting a second opinion from another doctor.
"If you want the rainbow, you gotta put up with the rain."
-Dolly Parton
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Meshi

Your dr is a quack..sorry for the frankness, but he knows nothing about HRT for a MTF.
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