Low estrogen doses normalize testosterone and estradiol levels?

[JanePlain]

My endo and I have been talking about HRT and I felt I should read up on the latest information available.

I found it very interesting and it seems to challenge the assumption that Testosterone must be combated using drugs like cyproterone acetate.  Hopefully this generates some conversations on how best to go with HRT.

<edit and link removed by moderator>

[Dani]

Several of us transwomen have been questioning the need for Testosterone blockers, since Estradiol alone will eventually reduce our bodies own Testosterone production. However, this does not happen right away and may take a year or more of significant Estradiol to reduce the Testosterone.

Once we make the decision to transition, many of us really want to speed up the transition process. T blockers for the first year or so is still the standard of therapy. Of course, once the testes are removed, there is no need for T blockers.

[GordonG]

My understanding is that it depends on the person and the dosage of E. A "low" dose will not shut off production of testosterone, but a "high" dose can. There is no set amount for everyone. Again YMMV. It takes blood tests to monitor the hormone levels. What happens is that they keep increasing the E till the T starts to go down to the level wanted.

[Linde]

Several of us transwomen have been questioning the need for Testosterone blockers, since Estradiol alone will eventually reduce our bodies own Testosterone production. However, this does not happen right away and may take a year or more of significant Estradiol to reduce the Testosterone.

Once we make the decision to transition, many of us really want to speed up the transition process. T blockers for the first year or so is still the standard of therapy. Of course, once the testes are removed, there is no need for T blockers.

now here I have a question for the pharmacist! My feet started to swell when I started estrogen (know possible side effect), my endo prescribed spiro to battle the water retention and do a little of testosterone blocking.  My feet are back to normal now. 
I plan to get an Orchidektomie, and would not need spiro anymore after it, would estrogen get my feet to swell up again?

[JanePlain]

Several of us transwomen have been questioning the need for Testosterone blockers, since Estradiol alone will eventually reduce our bodies own Testosterone production. However, this does not happen right away and may take a year or more of significant Estradiol to reduce the Testosterone.

Once we make the decision to transition, many of us really want to speed up the transition process. T blockers for the first year or so is still the standard of therapy. Of course, once the testes are removed, there is no need for T blockers.

I am not an expert and the points about speeding up the process are certainly understandable but there seem to be a lot of studies that suggest serious health risks that go along with using too much estrogen.  At least from what I've read.  I need to say that my bringing up this study in no way is a description of, or suggestion to self medicate.  *This is why the link was removed. 

I hope it will be useful information to bring up with your doctor / endo as many are not expert in treating people with cross hormone therapy.  And while this is just one study I think the results are rather surprising and worth study.   I believe this was published in April of 2018 so its new stuff.   

Its been my understanding that Estrogen trumps Testosterone in a big way but this is the first study I've seen that tries to show this with a scientific study.

Again I am certainly no expert but the study shows that low dose estrogen (Only) reduces Testosterone to female levels.  The interesting part to me was that someone is finally doing a serious study with 51 patients and saw next to nothing different between the group that used estrogen alone.

Sex drive is a question that this study doesn't bring up but I think that dialing down testosterone levels this low is probably why that seems to be a problem with so many people.

[JanePlain]

now here I have a question for the pharmacist! My feet started to swell when I started estrogen (know possible side effect), my endo prescribed spiro to battle the water retention and do a little of testosterone blocking.  My feet are back to normal now. 
I plan to get an Orchidektomie, and would not need spiro anymore after it, would estrogen get my feet to swell up again?

Dealing with edema (Feet swelling up) has been a chronic problem for me due to non related health issues.  Spiro is (I'm told) like Lasix *Spelled?   And that means rushing to the bathroom a lot.  If that gets old you might ask your doctor about compression socks / hose.

[JanePlain]

My understanding is that it depends on the person and the dosage of E. A "low" dose will not shut off production of testosterone, but a "high" dose can. There is no set amount for everyone. Again YMMV. It takes blood tests to monitor the hormone levels. What happens is that they keep increasing the E till the T starts to go down to the level wanted.

Thats been my understanding as well.  The reason I brought up this study is that they did an actual test and looked at the results.  I'm not saying this study is right and everyone else is wrong but... I wonder if its just been assumed to be one way (And no one questioned it) and now we have some results worth talking to our doctors about?

[Dani]

now here I have a question for the pharmacist! My feet started to swell when I started estrogen (know possible side effect), my endo prescribed spiro to battle the water retention and do a little of testosterone blocking.  My feet are back to normal now. 
I plan to get an Orchidektomie, and would not need spiro anymore after it, would estrogen get my feet to swell up again?

While Estrodiol sometimes causes edema (swelling of the extremities) it is not the only cause. Many of us over the age of 60 may have edema just because we are older and our kidney function is not the best. Also, a high salt diet (potato chips) can be just as bad.

Whatever the cause, your Endocrinologist prescribed the proper medicine for your condition. Whether or not you need to continue Spironolactone or any other diuretic (drugs that help the kidneys filter out water from the blood system)  after an orchiectomey, it depends on your general health and especially your kidney functions.

One thing you can do now is to go on a low salt diet to help prevent edema in the future. You do not have to completely eliminate table salt from your diet, just avoid salty foods and use salt sparingly when you cook your food. Also, do not add any salt once your meal is on your plate. After a while, you never notice it being gone. 

[Linde]

One thing you can do now is to go on a low salt diet to help prevent edema in the future. You do not have to completely eliminate table salt from your diet, just avoid salty foods and use salt sparingly when you cook your food. Also, do not add any salt once your meal is on your plate. After a while, you never notice it being gone. 

I went pretty much salt free several years ago, The only salt I ingest is that contained in the foods.  And I don't eat chips at ll.  I keep a pretty well controlled diet because of my Type II diabetes, which I manage, 20 years after being diagnosed with it, still with Medformin.
the edema in my foot correlated pretty much exactly with me starting estrogen, and went away after a few days on spiro. 
What I really want to know, how it will be after an Orchidektomie, when spiro might be stopped.  Is here anybody who has experience of the swelling of the feet will return at that time?

[JanePlain]

I hope you don't have to deal with edema.  My feet swell up like balloons and its pretty uncomfortable.  i can barely remember the last time I wasn't wearing compression hose.  I will say this - they work great.  Salt stopped being a problem for me after avoiding it for a few months.  Then food with salt tasted just awful.  Like it seemed like it was 10x saltier. 

[luckygirl]

Once I stopped spiro post SRS, I started to get mild bloat and edema. It comes and goes now. Almost cyclically as a cis woman might experience. It is frustrating as my shoes and rings become problematic in regards to fit. Otherwise, it doesn't bother me. As to the OPs original question, IM Estrogens will overpower the gonads and kill T in the proper amount. That amount is dependent on the subject as everyone is different.

[Paige]

One thing I found interesting in this study is that they used Premarin for this study.  Does anyone still use this?  I thought most transgender people are using estradiol now.

Also it looks like they had substantial testosterone reduction on low dose.  I've been on a low dose of estradiol for over 3 years and my last test in July had my testosterone levels at male normal range.

Paige

[Linde]

I hope you don't have to deal with edema.  My feet swell up like balloons and its pretty uncomfortable.  i can barely remember the last time I wasn't wearing compression hose.  I will say this - they work great.  Salt stopped being a problem for me after avoiding it for a few months.  Then food with salt tasted just awful.  Like it seemed like it was 10x saltier.

My fee are OK now after I take spiro.  My wife stopped to use extra salt in our food about 20 years ago, and yes, everything with salt can taste terrible.  I have he same with sugar, being diabetic I try to avoid any extra sugar.  Now I am so sensitized to sweetness, I can taste it in almost every prepared food, bread included!  Because of this, I started to bake my own bread, using mostly ancient grains in it.

[CindyLouFromCO]

now here I have a question for the pharmacist! My feet started to swell when I started estrogen (know possible side effect), my endo prescribed spiro to battle the water retention and do a little of testosterone blocking.  My feet are back to normal now. 
I plan to get an Orchidektomie, and would not need spiro anymore after it, would estrogen get my feet to swell up again?

That's a sign of estrogen dominance.  Mine have done that too.  I just went from 100 mg Progesterone to 200 mg Progesterone.  One can also cut back in estrogen.  But who would want to do that 🙂

I quit taking AA's 3 years ago..  They are not healthy and are synthetic.  Remember nicotine is also FDA approved for human consumption.

My T stays in the 30's.

[Linde]

I quit taking AA's 3 years ago..  They are not healthy and are synthetic. 

My T stays in the 30's.

As a person with a pretty extensive education in biochemistry, I would like to mention that "synthetic" means nothing.  Many medications are synthesized from natural substances (very often plants), by extracting the essential substances and using those pure substances to make medications.  Cannabis oil is one example for this or quinine is another one.
This si the reason why the term synthetic means nothing in the pharmaceutical field.
A pharmacist can certainly explain this even better!

[CindyLouFromCO]

As a person with a pretty extensive education in biochemistry, I would like to mention that "synthetic" means nothing.  Many medications are synthesized from natural substances (very often plants), by extracting the essential substances and using those pure substances to make medications.  Cannabis oil is one example for this or quinine is another one.
This si the reason why the term synthetic means nothing in the pharmaceutical field.
A pharmacist can certainly explain this even better!

Yeah I'm clueless.  It's probably not synthetic at all.  What could it be synthetic if in nature anyways?

However it's made, it's not natural.  It's not good for you in the long run. 

I don't think synthetic pot is good for people in the long run also.

[luckygirl]

Cindy pointed out that P helped her as a diuretic, unfortunately, I personally didn't enjoy that side effect.  In fact, I gave up on the stuff since all I noticed as change  was that it drove me a bit mad.

[AnneK]

They are not healthy and are synthetic.  Remember nicotine is also FDA approved for human consumption.

I get annoyed at those who assume something that's created or manufactured is somehow harmful, while anything natural is good..  We can't forget that poison mushrooms are natural.  As for nicotine, it is used to help reduce & stop smoking.  It is also far from being the most harmful component of smoke.  It's a matter of balancing the risks vs benefits.

Smoking pot is definitely harmful, just like tobacco.  However, there may be some components that are medically useful, so extract or synthesize them.

[Devlyn]

I get annoyed at those who assume something that's created or manufactured is somehow harmful, while anything natural is good..  We can't forget that poison mushrooms are natural.  As for nicotine, it is used to help reduce & stop smoking.  It is also far from being the most harmful component of smoke.  It's a matter of balancing the risks vs benefits.

Smoking pot is definitely harmful, just like tobacco.  However, there may be some components that are medically useful, so extract or synthesis them.

Crude oil and uranium are all natural. Don't fall for buzzwords. 

[AnneK]

Crude oil and uranium are all natural. Don't fall for buzzwords. 

I prefer organic uranium!   

That's another thing that annoys me, people misusing the word "organic".  It means carbon based, but somehow got hijacked into meaning healthier.  Well, just about everything we eat or drink, other than water, is organic as it's all carbon based.

http://projects.thestar.com/organic-milk/