Quote from: KarmaGirl on February 15, 2016, 01:04:09 PM
Hi everyone,
I had an Orchie a couple of years ago. They brought my E down to half. Since then, I've always been very tired, and sluggish. When we checked my E levels, I was at 60. Which is pretty low.
So, they up'd my E by a little to help that out. My Doctor thought that I should have it higher than that, and said it might help with the Heat Flashes and sluggishness.
Does anyone have any thoughts on that? I don't want to over do the E (and risks associated with it), but I don't want to under do it either. My Doc is not a Trans doc. I use to go to the LGBT center but the wait is many months to see anyone, so my doc took over to help me out. He's been very cautious with me, but after seeing my results, thought that I should experiment a bit with the dosage and slowly (check it every two months) up it if need be.
I pass pretty well, and HRT has been good to me, but I'd like to get my libido up and just feel over all better. I'm very low on energy.
I'd love to hear from those of you that might have had something similar happen.
I'm afraid you're being underprescribed E for reasons that are not justified by science and as a result, you are suffering. Bio-identical estradiol, taken orally or non-orally is quite safe in contrast to non bio-identical estrogens which your doctor is basing their fears on. One needs to understand the differences between several forms of estrogen, this is a prerequisite, I think, for anyone prescribing sex hormones to women, whether cis or trans.
I'll sum it up for you, you can share this with your doctor. If they need additional papers, etc., let me know.
1)
Cardiovascular (3) and clotting risks (4) . Ciswomen are reported to be much less affected than men by cardiovascular complications despite pregnancy levels of estradiol and levels of up to 650 pg/ml every menstrual cycle. Their risks increase post-menopause when estrogen levels DROP. Studies have strongly suggested a
protective role for estrogen. I can provide these studies as well.
. Randomized controlled trials, the Danish and WHI (Women's Health Initiative, 2003) studies have shown estrogen taken alone or without medroxyprogesterone acetate (known to have deleterious effects on cardiovascular markers and oppose estrogen's beneficial effects on cardiovascular health) to DECREASE cardiovascular complications significantly while having no incidence on risk of stroke.
. Studies in men with prostate cancer (ages 49-91) have shown that levels up to 700 pg/ml were safe.
There were no cardiovascular complications or incidences of thrombosis. In fact, researchers stated high levels could be PROTECTIVE. They were treated with high dose injectable or transdermal (patches) estradiol. I can provide you those studies.
. Pregnant women have levels that go as high as 75,000 pg/ml and yet the risk of having a DVT or pulmonary embolism is less than 0.02 % with thromboembolism being 5 times as more likely post-partum (when levels drop) and pulmonary embolism being extremely rare during pregnancy and more common post-partum (when levels drop). I can provide you the evidence as well.
.
Am J Obstet Gynecol. 1993 Dec;169(6):1549-53."As serum estradiol levels increased throughout each phase (maximum mean estradiol 739.8 pg/ml)"
"Down-regulation of the fibrinolytic system was observed as estradiol levels increased. However, thrombin formation did not change, thus suggesting that
elevated circulating estradiol alone does not predispose to a thromboembolic event."
.
Arch Sex Behav. 1998 Oct;27(5):475-92. In this study, transsexual women were given high dose intramuscular and low to
high dose oral E. Despite 41 people being on this regimen, there was not one incidence of thrombosis (or prolactinoma).
"None of our patients developed deep vein thrombosis or embolism during cross-gender hormone therapy performed in our clinic."
"we detected no prolactinoma as described by other authors (Asscheman et al., 1988, 1989; Kovacs et al., 1994; Gooren et al., 1980)."
2)
Breast cancer risk (7). In transsexual women, breast cancer incidence is very low, equal to that of men not on HRT (as per Dr. Gooren and his team, leading specialists of HRT treatment in transwomen). Only 10 cases reported since 1968 despite decades of very aggressive, high doses of oral estrogens and non-oral estrogens (intramuscular). Only one case reported in Holland among Gooren's patients in decades of treatment, despite high doses of E for several years. Studies to support this.
. In men with prostate cancer treated with high dose estrogen over the years, since the 1960's, breast cancer is extremely rare. Supporting evidence.
. High dose estrogen has actually been used to treat ciswomen afflicted with breast cancer.
. Randomized controlled trials (the strongest form of study) showed estrogen to be either protective of breast cancer incidence or have no effect, even in women who had had breast cancer, when MPA (medroxyprogesterone acetate, linked to breast cancer) was NOT used or sparingly. I can provide studies.
. The more childbirths a woman (hence, the more pregnancies when levels of E are sky high), the lower the risk of breast cancer. On the other hand, celibate nuns are historically known to have a higher incidence of breast cancer risk.
. Breast cancer risk is highest in women over the age of 40 and especially 50,
when estrogen levels drop.
3)
Uterine cancer risk. YOU HAVE NO UTERUS
4)
Prolactinoma (2). Ciswomen have very high levels of prolactin, up to 210 ng/ml, during pregnancy and continue to have high levels during breastfeeding which can sometimes last a few years. As far as I know, prolactinoma is not more prevalent in women because of this and this has never been called into question by doctors asking mothers to stop breastfeeding their children or not become pregnant again due to risk of prolactinoma.
. In my extensive search through incidences of prolactinoma in transsexual women (and ciswomen), the only incidences reported were found to be in those women who took non bio-identical forms of estrogen orally (especially or exclusively ethinyl estradiol) with or without cyproterone acetate, known to
abnormally elevate prolactin levels. Incidences in women taking bio-identical estradiol without the above mentioned agents taken simultaneously have NEVER been reported to date.
You can ask doctor to provide
studies (not statements made by an association) that they base their fears on.
I'm on a high dose of intramuscular E. Supervised by three doctors who approve, one of whom is an author of a book on female hormones, another a trans-specialist endocrinologist from the University of Cambridge. My blood tests results show no change in clotting factors, or liver enzymes, or lipids, insulin, glucose, c-reactive protein. Nothing is out of range given my high levels of E2, which are in the range of 1,000-4,000 pg/ml. I've also been on high doses of oral bio-identical estradiol for several years. I started HRT in 2004.
