hormone replacement therapy, transgender

Estrogen Patches vs. Pills: My Experience So Far

Hi friends! How are you? You look great. Have you been working out? Is that a new outfit?

As I alluded to in my previous post, my new doctor recommended that I switch my estrogen medication. His experience w/his patients had shown a far larger success rate with pills, versus transdermal patches.

Well, I took his advice. On a busy afternoon, I stopped by the pharmacy and picked up my new prescription. For safety’s sake, he’s starting me on a low dosage of 1mg a day. For reference, I was previously on a dosage of four 0.1mcg patches, twice a week (the maximum dosage you can have prescribed).

One of the key things I’ve noticed is something my doctor also pointed out: consistency. Patches can often have variances in how the estrogen is absorbed through the skin. This is important when you’re trying do things like stop or reverse male-patterned baldness (and slow down facial hair growth), or keep your emotions in control. I’m finding he is dead-on about at least two of those points. My mood has been much more stable over the past few days. I’ve felt more alert, focused and less prone to mood swings. Even after a pretty lousy Friday evening, I was able to shake it off and say “meh, those days happen.” I’ve also experience a more-consistent slowing of facial hair growth.

Of course, there are pitfalls. It’s been said that your liver has to work extra-hard to break down the hormones in pill-based estrogen. I had a few trans women tell me exactly that before I started HRT. However, that often depends on which doctor you talk to. My doctor has told me has rarely come across a client who had significant liver problems as a result of oral hormone treatment. In my specific case, I should be fairly worry-free since my liver is already in good shape (thanks in large part to a low-carb lifestyle I’ve led for awhile now).

So, all in all, pills have been a welcome change for me. I’ll be reporting back in a few weeks, once my doctor ups my dosage, to report on any new effects.

Ciao!

hormone replacement therapy, transgender

The Change-Up

Hi friends!

It’s been more than a good long month or so since I’ve posted here (and for good reason, I’d like to think). “What has Alexia been up to”, you may be asking. Well, here’s the Cliff Notes version:

– My boyfriend & I became domestic partners, and we moved in together.
– I made another triumphant visit to my hometown, where I caught up with old friends.
– I landed a new job in the city (San Francisco, for those unclear) as a lead iOS engineer.

As part of that first bullet point, my partner put me on his Kaiser Permanent insurance. Since the time had come to give up my former insurance carrier, the time had come to pick a new primary care physician – one experienced in the care of transgender people like myself.

Kaiser’s suite of transgender services in Northern California, as it turns out, is pretty exemplary. They have a medical center based in Oakland that offers a suite of services to the trans community, and the doctor spearheading the effort to bolster those services is based in Santa Clara…just a few miles from my home. So, I made my appointment and paid my new doctor a visit.

I arrived at the Kaiser hospital & medical center in Santa Clara with just enough time to collect my thoughts over the up-to-that-moment crummy day I was having. After a bit, the nurse called me in to weigh up (I have got some weight to lose, but more on that in another post), take my blood pressure and wait for the doctor.

After a few anxious minutes, Dr. Marcos Siqueiros walks through the door and warmly introduces himself. We have a in-depth conversation about my medical history, and eventually we delve into details about my transition. How I’ve been taking hormones, how long, how I feel, etc.

This part of the conversation is an eyeopener for me. I told him that my previous doctor had recommended patches over pills to take my estrogen, citing that it was the easiest on the liver. He tells me that, for the most part, the differences in how hard your liver works in processing estrogen in either form is negligible, and pills are actually a more consistent way to keep your estrogen levels steady. Even more, he told me that other patients of his had made the switch and were amazed by the near-sudden changes they experienced. On hearing that, the first thought in my head was “I need to get him my last lab reports stat!”

Other eye-opening details about our conversation included:
– disclosing that Kaiser insurance offers facial feminization services
– saying they were in the initial planning phases of covering speech therapy under some insurance plans
– strongly recommending that transwomen be on low-carb diets

All of this was music to my ears. So, I told him that I already had a letter from my therapist recommending me for gender reassignment surgery. As long as I have that in hand, he can get me a referral to the clinic in Oakland for an initial consultation. In addition, he ordered a set of labs done so he could get a baseline reading on where I am right now.

My partner and I left hand in hand, with a smile on my face. I walked out of that building with the sense that I was beginning to take another big step in my journey.

hormone replacement therapy, transgender

My 9-Month HRT Follow Up

Hi hi!

Today, I paid my doctor a visit to evaluate my hormone levels after 9 months.

I actually hadn’t seen the lab report from my 6 month follow-up, so I was interested in seeing how I was doing. After a little chit-chat and catching up, my doctor prints out my report and breaks things down for me.

The Good
The report mentions the “reference interval” range of testosterone for average adult males up to 40 years old is between 348-1197. Mine, by comparison, is at 8. So, my testosterone levels are minimal. I joked “doc, I could’ve told you that before I transitioned.” *rimshot*

The So-So
My estrogen level was at 46.5. My doctor tells me that the average range for women needs to be in the hundreds, so I’m being bumped up from 2 patches, twice a week to 3 patches, twice a week. To think I was moody before…

The “Let’s Keep An Eye On It”
The most notable thing my doctor pointed out was that my prolactin level was at 26.3. As a preventative measure (he assured me it’s rare that someone at that level would show anything concerning), I’m being sent to get an MRI. This is to ensure that my pituitary gland looks ok and has no abnormal growths. Am I a little nervous? Sure. However, he assures me that there are plenty of options for treatment should anything arise.

As a bonus, my doctor rewrote my prescriptions with my new name. That was nice.

I’ll be posting another update once I hear the results of my MRI back. Until then, be good to each other and GO SHARKS!

transgender

8 Months

Hi friends!

First up, cue up this song on Spotify. It’s appropriate for this post.

Have it up and playing? Good. Let’s begin.

It’s not quite 6AM on a Monday. I sit here huddled up on my couch with my laptop and a strong cup of coffee, reflecting on the 8 months on hormones that have gone by. It seems like I recall my 3 month HRT anniversary, then 5 months. The rest seem like a bit of a blur. As time goes by, the daily doses of testosterone blockers & the bi-weekly swapping of my estrogen patches become a routine part of my day, no more than my coffee in the morning or figuring out what’s for dinner.

The changes keep on coming, too, but they become “little victories” as opposed to these “it’s finally happening” sort of moments. The other day, I had noticed that my bottom lashes had finally grown out too, to a fairly significant length. My reaction? “Great. Now I won’t look like my eyes are half done every morning.” HA! I’ve noticed my figure begin to fill out a bit more now too, though, so my clothes are starting to fit a lot better.

That all said, it’s easy to take the road I’ve taken for granted with each passing day. I’m lucky to have the friends I do, to remind me that I should always be thankful and appreciative. My friends Jason & JD got me a little gift to ensure that never happens. As a gift to commemorate my legal transition, they went out and got me this piece of artwork. It’s fitting they used one of the first photos ever taken of me looking most like the woman I am now.

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Even more moving is the inscription on the back of the frame. It reads:

This is to remind you how truly beautiful a human being you are; inside, outside, all over. You inspire, you entertain, and you radiate happiness. Be you, always.

Those words are a loving reminder of who I’ve become, and the work it’s taken me to get here.

Every time I see this painting, I can’t help but ponder the road behind me, the people I’ve met, the people I’ve helped by sharing my experience, and the road that lies ahead. I suppose that’s what art is supposed to do: move you.

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I walk by it every day.

hormone replacement therapy, transgender

HRT: Week 24

Hi folks!

Here we are again. After a few weeks of switching things up on my blog, let’s get back to basics with another weekly update on my hormone replacement therapy.

I seem to have hit a growth spurt of sorts. Things I hadn’t felt since a few weeks after starting hormones, like pain in my hips & sore chest, suddenly came back. More importantly, I seem to have finally reached the point a lot of trans-folk refer to as “second puberty”. Aside from STILL being constantly hungry, I’ve noticed a sudden change.

That change? ACNE!!

Not only did it sneak up on me, it hit me with all the force of a sixteen-wheeler. The breakouts are more than a little embarrassing, and now I have to kick my skin care game up a few notches to ensure my face doesn’t feel like a pizza.

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My complexion, right about now.

I’m REALLY hoping this subsides in a few months. Meanwhile, aside from proper skin care, I may need to slow down on my performances just so I don’t abuse my face with heavy makeup.

And I had such a nice complexion too. Ugh. Well, until next time friends!

hormone replacement therapy, transgender

HRT: Week 15

Hi friends!

It’s Tuesday and, as you’ve come to expect, here’s my weekly hormone replacement therapy update.

This week, it’s less about outward-facing physical changes and more about hormone levels. Last week, I alluded to my doctor having blood work done to check my hormone levels, to see if my Estradiol dosage was going up.

Well, those results came back last night. My doctor informed me that my testosterone levels were very low (11, to be exact) and my estrogen levels were high. So, no need to up my estrogen dosage.

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Right now, there isn’t a huge need to up my dosage anyway, even if I physically needed it. Changes are happening more quickly than I anticipated, so I need to stay on my steady pace and not let my body get ahead of me.

Until next time, friends!

 

hormone replacement therapy, transgender

HRT: Week 8

Alrighty, then. After doing some backtracking, I figured out that I’ve finished week #8 of my hormone therapy. Ok, it actually just took going back and seeing that I had finished my second 30-day supply of spironolactone. To that, I say…

Derp, indeed.

Ok, onto the matter at hand. This week, I didn’t notice a whole lot going on other than:

  • Increased skin sensitivity: my face cuts way more easily now when I’m shaving, and my laser hair removal treatments hurt like crazy, as opposed to when I first started them (I hadn’t yet started HRT at that point).

Aside from that, I’ve been on a good streak with emotional progress. I’ve come out to quite a few more people (one is a very good friend I’ve known for a better part of a decade…if she’s reading this, hi!!!) and I managed to get myself out to a couple more public places with little-to-no incident. In fact, some guy asked one of my friends I was with that night “So, what’s up with your single friend?”

Granted, I have no intention of dating anyone right now…but I’ll take that as a compliment.

hormone replacement therapy, transgender

HRT: Weeks 5-7

Hi all! Been a little while, hasn’t it?

Wow, I’ve been caught up in all kinds of life events. I moved to my own place, caught up with old friends, working like a mad-woman, and have been performing like crazy lately. I’m not entirely sure how I keep balance of it all but I suppose the occasional cocktail helps. 😉

All that said, I’m here to give you an update on how my hormone replacement therapy is going. Here are the big things I’ve noticed:

  • Breast tissue growth: My chest has been more sore than usual, so I naturally assumed I was about to drop dead on the stop. Ok, kidding. One day, my arm grazed my chest and I could tell something was different. I felt around a bit (mind out of the gutter, you!) and noticed something that wasn’t there – a small “bud” underneath. OMG, they’re actually starting to grow!
  • Continued mood swings: The smallest things seem to get to me, even more so than before. I had my first instance where a small comment almost made me break down into tears. It’s only a matter of time before the inevitable happens and I go into a full-on Peter Parker-style cry-fest.

    A straight-up ugly cry.
  • Facial structure changing: I’m noticing that my face is thinning out a bit & features are getting just a bit softer. I’ll take it.

I’m coming up on two whole months of HRT next week (wow, who’d have guessed I’d have made it this far), and wondering if and when my doctor wants to schedule some follow-up blood work & assess my current dosages. He seems to be harder to get a hold of than the President, so I must be patient.

Until next time!

hormone replacement therapy, transgender

HRT: Week 4

Wow, it’s been a month already?!? Time flies when your emotions are all over the place.

Basically.

Joking aside, though, the major changes I’ve seen are:

  • Mood Swings: Oh, they are starting. So far, I haven’t gone from zero-to-cryfest yet, but I am definitely feeling less and less in-control of my feelings.
  • Increased Appetite: I am ready to eat anything and everything in sight. Thankfully my low-carb eating habits help keep that somewhat at bay, but I’m finding it harder to stay away from my local Chipotle…or WingStop…or Starbucks…or [insert restaurant here].

As an aside, I’ve noticed that I have seen some more muscle definition in my lower body (thighs specifically), but I think the weeks’ worth of elliptical & stair master time in the gym have helped there.

My doctor is keeping on the same dosage I started out with for now, and I’m to have a follow-up in the next month to look at my hormone levels & check for any irregularities & if then is a good time to start raising my dosages.

Cheers!