Clara, please point out where it suggests it's a fast track program? (Not a throw down here people, relax please).

Thanks

My point to Bobie was simply to be aware of the context in which Lawrence's advice on dosage is given.

She's giving typical initial dosages for preoperative transsexual women and post-operative transsexual women who want to transition to full time life as women, and in most cases as fast as possible. But every patient is different and will respond differently to the meds, at which point the endo will make adjustments to the regimen to keep the feminization moving. Lawrence does not start out at the high end of the ranges stated in the recommendations sited.

Her own website states:

"Typically I start with an “average” dosage of oral estradiol (e.g., 2 mg TID). Six to eight weeks later, I add spironolactone, 100 mg BID. Subsequently I add more estrogen or spironolactone as needed to achieve desired feminization, to eliminate spontaneous erections (a useful index of free testosterone), and to achieve measured serum free testosterone levels in the normal female range. Ordinarily I don’t check serum estradiol levels; if obtained, I like to see levels approximately one-third to one-half of the normal female midcycle peak."

Clara

Ok thanks, (Lotus trying to keep up)


I find this odd,

Ordinarily I don’t check serum estradiol levels; if obtained, I like to see levels approximately one-third to one-half of the normal female midcycle peak."

You know I have a bone to pick here, lol. Why wouldn't be a priority to monitor E levels?. I've read contrary to her statement..

You know I have a bone to pick here, lol. Why wouldn't be a priority to monitor E levels?. I've read contrary to her statement..

Well, good luck finding two endos that agree completely on a treatment strategy....LOL.

Clara

I feel that starting on PM and NBE for my first three months makes my doc's initial 2mg dosage WAY too low for me....

I understand docs like to start slow and gradually increase dosages and that all makes perfect sense to me...

I had a good start on 3 months of NBE but try telling a doc that

Hell if Lotus cant get an endo to listen, what chance do I have LOL....

Anyway I was on a high dose of PM when I started on E...

It went RIGHT to work on me from the first 2mg pill I could feel it

From what Ive read about people just starting out on HRT it takes a while to kick in just like NBE does....

SO I count my time on NBE as my low initial dose period and I have kinda slowly ramped up to the relatively high dose of E Im on now

Of course my doctor likely wont see it that way Im SURE...

Ive been on HRT for 2 months now and I will see her in a month for blood tests.....

I cant wait to see what she says when my E level is obviously gonna be way high for a 2mg dose with no AA LOL

Then I gotta tell her the MPA sucks and why,also will have to explain why micronized bio identical P is better... And ask why progesterone at all on a starting regime???

By the way I feel all this E and the spiro likely has my T VERY low.... So we get to talk about Spiro and likely some pretty high E levels, sigh... Then theres the Dutasteride...

So I get to tell her about the gel Im trying thats much safer from a clotting perspective especially compared to oral E and MPA from SEVERAL recognized studies... I also get to point out that Im 45 and a heavy smoker so why am I not on patches, gel or both??? Oh cause thats not cheap... So why not go with injections then due to my age and smoking???

We can argue about all that but one thing she wont be able to argue about with me at least is the results of MY program

I dont think she's gonna recognize the 25-30 lbs lighter WOMAN thats going to walk in there

Been thinking, any blood tests to get baseline results at this point are going to be pointless, my pre hrt baseline no longer exists after all the pm i have taken over the last month, i suspect to get a baseline of any use would require 1-3 months off hrt, given how tough the last 7 days off pm has been on me and the fact im still mid job for someone (i work construction, cant wait to change) i just dont want to do that at the moment, so for better or worse this evening i started a trial run of pharma, 4mg (split morning and evening) of estrofem estradiol taken orraly , i was going to try 2mg sublingually but when i tried to take one sublingually i gave up after 15 minutes of the tablet just sitting there, guess its the film coating and im also taking 100mg of spiro (split 50mg morning and evening), being young i may need to double the spiro but im taking it easy on the spiro until i have done some bloods, yes im still going to go see my gp and ask for the bloods, i just couldnt go any longer without either pm or pharma, i will be very glad when my emotions are back to normal as they have been all over the place this week

Bobie, you are right and wrong about the blood work. A panel would not show an E level out of the ordinary because the active part of PM , Miroestrol, does not show up at all. But it would have told you your T level.
And if you have online Estrofem it will not dissolve as it is in a different kind of pill form. Standard scrip E comes in a non coated blue oval shape that dissolves easily in the mouth...I do it two or three times a day, and it doesn't even taste bad. But the online stuff is different.
I would still try for a blood panel when you can.

Oh i will get blood tests samantha, i will try and have a word with my gp on monday if i can then go from there, yes i remember clara mentioning that pm wont show in normal e tests, my t being well down was my reasoning behind a baseline being pointless, not that this was a reason but its also probably easier if i go see the gp having already been on something rather than talking about taking it, makes it (i think anyway) harder for them to refuse care (national health service here), thanks for the info on the pills, what is standard script e called then?

Same name...Estrofem...but what we get at the pharmacy here is tabulated differently than overseas. IDK why. But the online pills people get are like yours rather than mine. Sarah had some of those before she got her scrip.

Bobie you should go back on the PM then get your blood test, or stay on the the pharma and get in there real soon....

The PM wont show up on the blood tests.... Mine after 3 months of high dosages of NBE all came out in the normal male range yet I had a good start with breast growth....

Tell the doc you are TG and that you have been on herbs to feminize but you want to start pharma HRT....

The doc will want to see healthy "male" results before prescribing

My Estrofem from Novo Nordisk, Denmark dissolve just fine under the tongue, just takes a while... Been working fine for me

EvaMarie i will try and get some bloods done early next week, at the moment this is just a trial, meaning i want to be sure it wasnt the pm i had been taking making me want to transition, the gp however is very unlikely to be able to prescribe to me, we dont have informed consent here so the process of getting hormones through official channels is a slow one and nearly always apparently requires living in roll first (theres no way i can pass at the moment so thats just cruel) with a long waiting list unless you go private which i cant really afford to do, is your estrofem film coated? how long do they take to dissolve?

If at the end of this trial run i still want to transition i will get myself on the waiting list with the nhs, i may even do that anyway to save time, assuming my gp will do them i will continue to get regular bloods done in the meantime

Cruel, unreasonable, and foolish.

Clara