Quote from: p on August 29, 2017, 03:27:24 PM
This post from Silly Trans Woman covers pretty much the same info as the sheet my doctor gave me: http😕/sillytranswoman.blogspot.com/2011/03/risks-associated-with-hormone-use.html
There are some things mentioned on that post that are incorrect. Please do not blindly accept assertions, always ask for research to support assertions and read the research FULLY, remain critical at all times. Also, double-check with your doctor/pharmacist. 😉
Quoteside effect: increased risk of blood clots (which can cause other problems)
Small risk with bio-identical estradiol, even smaller and almost negligible non-orally, ESPECIALLY AT DOSES typically prescribed to transwomen.
Quotelifestyle change: try not to sit for long periods of time without getting up; quit smoking(!!!); eat a healthy diet; get 90 minutes of exercise a week; inform all of your doctors about your medication so that they can help manage your other meds and help you decide if you need to stop your HRT, say, for a couple of weeks before a procedure;
I sit for long periods of time. I think we needn't be more cautious than ciswomen are, especially considering many of them are on birth control pills which raise the risk to a greater extent and some are pregnant (with estradiol levels SEVERAL fold higher than ours, in the thousands).
Quotemy doctor recommends switching to injections or patches after age 35 because some studies show that these delivery methods present less of a clotting risk than pills
Pills containing ethinyl estradiol have been found to increase risk several fold in women after the age of 35, sometimes those doses were also quite high. Ethinyl estradiol is NOT bio-identical estradiol and impacts hepatic markers to a much greater extent.
Quoteside effect: increased risk of developing a tumor of the pituitary gland called a prolactinoma
VERY rare, despite in the past, very aggressive/high doses of estrogen including non bio-identicals. Only 8 cases reported, all of them on non bio-identical estrogens and/or progestogens. If on cyproterone acetate, one must be cautious, monitor more closely, as 5 of the 8 cases were associated with this progestogen and it tends to raise prolactin levels. Pregnant women and breastfeeding women have VERY high prolactin levels, these do not CAUSE prolactinomas. It's important to realize that higher prolactin levels is perfectly natural with estradiol and progesterone but on non native forms, the effect might be more marked and this is where the problems begin.
Quoteloss of libido
High enough E in some women may mitigate this or progesterone, or even avoiding suppressing T too much.
Quoteinability to maintain an erection
I am post-op. T levels very low. I get clitoral erections and engorgement when aroused. Regardless of E and P levels.
Quotedecreased volume of ejaculation
I still have a significant amount of ejaculate post-op. I'm a very sexual being, by nature and let myself go. I don't think about it, I react. 🙂
Quoteside effect: mood changes (depression, anxiety, suicidal thoughts)
This should NOT occur, if it does, quickly find out cause: too low T, too low E, cyproterone acetate/medroxyprogesterone acetate/finasteride/dutasteride, or environmental
Quoteside effect: possible increased risk of gall stones (this one is on Silly Trans Woman but wasn't on my doc's fact sheet)
Orally, estrogen can perhaps cause this or too low sex hormones or a progestogen. The cause and effect is hard to pinpoint. Eating enough fat could perhaps prevent this from occurring as it keeps the gallbladder active and spewing bile out instead of letting it sit there and accumulate (i.e. gallstones).
Quoteside effect: possible increased risk of breast cancer (this is actually a controversial one
So far, no increase in risk has been noted in transsexual women relative to cismen despite decades of aggressive, high dose HRT. In ciswomen, high dose estrogen is used to treat advanced breast cancer and is, at least, as effective as anti-estrogens. In randomized controlled trials, estrogen alone or without medroxyprogesterone acetate, was shown not to increase the risk in ciswomen or EVEN significantly decrease the risk!
Quotefollow the recommended schedule for mammograms for a woman of your age
Mammograms involve radiation to the breasts and can slightly increase risk of cancer. This risk is worth taking in ciswomen considering their risks of breast cancer BUT in transwomen, it's not because the risk of breast cancer does not increase and mammograms may increase it, slightly. We aren't ciswomen, we weren't exposed to the same things over time, patterns are distinct from them. Sadly, many doctors overlook this. I personally never intend to take a mammogram.
QuoteTo screen you for conditions that could make HRT more dangerous. You should talk with your doctor about any conditions you have (circulatory, heart, liver, kidney, & mental illness come to mind) or family history that might increase these risks to you.
Bio-identical HRT can reduce cardiovascular risks, has not been found to harm liver and can even prevent fatty liver, has no negative impact on kidneys AFAIK and improves mood in many, can prevent mental illnesses. If anything, IMHO (I'm not a doctor), but based on studies, bio-identical HRT should be indicated to reduce health risks, improve longevity and quality of life.
Anti-androgens can, however, present some risks, I agree although Spiro can reduce blood pressure. 🙂
My 2 cents. Take with a grain of salt, as always. Do your own research, have a doctor monitor you and discuss options with them. Be PROACTIVE in your treatment, understand what is going on, what you are taking. 😉
