Thank you lotus the information is greatly appreciated and sorry if i was the cause of the recent discussion (herbal versus synthetics), i hope if nothing else people can see from this thread that i am trying to do things sensibly under a doctors supervision even if not going through official channels at this time

I do have one question and that is as my body is now used to pm if aiming for a dosage of 4mg sublingually prior to the first round of tests with e in my system would i need to start off at 2mg and work up to 4mg or would i be able to start off at 4mg?

I've got nothing but love for ya sweetie-pie,

Good question, ask the doc. Now I've read that some cycles are started similar to how you'd do a prednisone pack. (Still lacking though) again, ask the doc.

It's something like the first few days at @ 4-6 mg and then leveled back to 2mg, (I'd have to find that info)

Something to discuss with the doc!

Oh btw, I'm not a Pharma hater!

Bobie,

Please be aware that the reference to Dr. Lawrences recommended regimens for transwoman are meant for those who want to transition as quickly and completely as possible. I for one, do not see the need to be in such as rush, and, for now, am on a slow track regimen:

4 mg estradiol valerate (sublingual) (started at 2 mg)
100 mg spironolactone (started at 50 mg)
5 mg finasteride
1000 mg pueraria mirifica (optional)

I will be ramping up to 200 mg spiro

Eva, is on a faster track, so her regimen and dosages are different.

Clara

Bobie,

Please be aware that the reference to Dr. Lawrences recommended regimens for transwoman are meant for those who want to transition as quickly and completely as possible. I for one, do not see the need to be in such as rush, and, for now, am on a slow track regimen:

4 mg estradiol valerate (sublingual) (started at 2 mg)
100 mg spironolactone (started at 50 mg)
5 mg finasteride
1000 mg pueraria mirifica (optional)

I will be ramping up to 200 mg spiro

Eva, is on a faster track, so her regimen and dosages are different.

Clara

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


I think it would be helpful to show other physician recommended programs, Clara, what info do you have on it?

Thanks

Clara Im also a bit younger than you are too

My natural T level WAS likely higher than yours has been in a long time

That said I am looking for maximum feminization in the safest way possible

Ive seen Anne Lawrences site and so many others I couldn't remember them all...

This one claims to be dr recommended, this is close to what Im doing at the moment

PRE-OPERATIVE REGIMEN w/GEL MEDICATIONS
• Estradiol : 2 mg to 4 mg (sublingual) daily.
• Estradiol Gel : Apply 2 to 3 measures daily to the skin.
• Finasteride : 6 mg Propecia (divided, morning and evening) or 5mg Proscar in the morning.
• Spironolactone : 100 mg to 200 mg divided dose, morning and evening.
• Progestin : 5 mg to 10 mg daily for 10 days of the month (optional).

http://www.transgendercare.com/medical/resources/tmf_program/tmf_program_regimens.asp

More here... This is not out of line with other recommendations Ive seen....

-------------------------------------------------------------------------------

The TransGenderCare Medical Feminizing Program is based on actual transgender medical practice—the Tampa Gender Identity Program—our long-established transgender program which provided medical and feminizing hormone therapies, as well as psychotherapy and electrolysis to literally hundreds of transgender women from coast-to-coast and overseas.

Our Online Program Guide contains descriptions of our hormonal regimens that we have successfully used for years.

Typical medical strategies that are in place worldwide as well as general medical protocols for the safe use of medications are also contained.

A basic guide to understanding the human body relative to hormonal processes—includes an overview of the endocrine system and how the hormonal and chemical systems work.

Provides you with the means for managing your transition using the same medical strategies we have endorsed and successfully used for years.

http://www.transgendercare.com/medical/resources/tmf_program/default.asp

Bobie,

Please be aware that the reference to Dr. Lawrences recommended regimens for transwoman are meant for those who want to transition as quickly and completely as possible. I for one, do not see the need to be in such as rush, and, for now, am on a slow track regimen:

4 mg estradiol valerate (sublingual) (started at 2 mg)
100 mg spironolactone (started at 50 mg)
5 mg finasteride
1000 mg pueraria mirifica (optional)

I will be ramping up to 200 mg spiro

Eva, is on a faster track, so her regimen and dosages are different.

Clara

Clara dear,

I'm gonna fuss at you, we are sorely lacking your program listed in the Personal Program Section, (long overdue) what do ya think?

Clara Im also a bit younger than you are too

My natural T level WAS likely higher than yours has been in a long time

That said I am looking for maximum feminization in the safest way possible

Ive seen Anne Lawrences site and so many others I couldn't remember them all...

This one claims to be dr recommended, this is close to what Im doing at the moment

PRE-OPERATIVE REGIMEN w/GEL MEDICATIONS
• Estradiol : 2 mg to 4 mg (sublingual) daily.
• Estradiol Gel : Apply 2 to 3 measures daily to the skin.
• Finasteride : 6 mg Propecia (divided, morning and evening) or 5mg Proscar in the morning.
• Spironolactone : 100 mg to 200 mg divided dose, morning and evening.
• Progestin : 5 mg to 10 mg daily for 10 days of the month (optional).

http://www.transgendercare.com/medical/resources/tmf_program/tmf_program_regimens.asp

More here... This is not out of line with other recommendations Ive seen....

-------------------------------------------------------------------------------

The TransGenderCare Medical Feminizing Program is based on actual transgender medical practice—the Tampa Gender Identity Program—our long-established transgender program which provided medical and feminizing hormone therapies, as well as psychotherapy and electrolysis to literally hundreds of transgender women from coast-to-coast and overseas.

Our Online Program Guide contains descriptions of our hormonal regimens that we have successfully used for years.

Typical medical strategies that are in place worldwide as well as general medical protocols for the safe use of medications are also contained.

A basic guide to understanding the human body relative to hormonal processes—includes an overview of the endocrine system and how the hormonal and chemical systems work.

Provides you with the means for managing your transition using the same medical strategies we have endorsed and successfully used for years.

http://www.transgendercare.com/medical/resources/tmf_program/default.asp

Hi Eva,

Progestins being optional is from it competing with E?

What have you found on regarding it?,

Some info on recommended blood tests and dosages...

http://www.hemingways.org/GIDinfo/FeldmanTables.pdf

A lot of info here

http://www.hemingways.org/GIDinfo/hrt_m2f.htm

Id personally LOVE to have a good doc working with me but its very hard to do here in rural western SD unfortunately

Some info on recommended blood tests and dosages...

http://www.hemingways.org/GIDinfo/FeldmanTables.pdf

A lot of info here

http://www.hemingways.org/GIDinfo/hrt_m2f.htm

Id personally LOVE to have a good doc working with me but its very hard to do here in rural western SD unfortunately

Thanks Eva, good stuff!!

Id personally LOVE to have a good doc working with me but its very hard to do here in rural western SD unfortunately

Lol, ain't that the truth!!, it's hard to find a good one in the hood too!, if your able and lucky to get one that actually listens to ya it makes healthcare so much easier, right?

Hi Eva,

Progestins being optional is from it competing with E?

What have you found on regarding it?,

Well nothing conclusive and Ive read everything I could find for a long time now

I have tried Medroxyprogesterone Acetate but I do NOT like the way that makes me feel at all...
From what Ive read MPA is prescribed because its cheap.... Its nothing like bio identical P though.... I have tried that too and I dont like that much either

For ME anyway at first it feels great for the first 5-7 days then I turn into a super bitch LOL

If I was to cycle again it would be near the 1st of next month... IF I do I will likely only go 5-7 days then stop while it feels good

I dont agree with everything on this site (but Im NOT a doc either ) but he makes a very good case for progesterone being unnecessary for a MTF... Id think thats true too but after a few years it might be a benefit for breast growth

http://www.gender.org.uk/gendys/2009/47curtis.htm

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