Estrogen Do’s and Don’ts
So, you’ve decided to move forward to change your body. You’ve gone to your G/P, got referred to a shrink to get diagnosed with Gender Dysphoria, and received your first letter of recommendation for surgery. It also came with a referral to an endocrinologist and a P.H.D. Your Endo will examine you and prescribe your (HRT) Hormone Replacement Therapy. This regimen consists of estradiol and a testosterone blocker, normally Spironolactone. This is what (WPATH) World Professional Association for Transgender Health recommends—for good reasons explained later in this article.
If you do not go the recommended/ legal way of WPATH and are thinking of acquiring and dispensing hormones yourself, it will come with some very serious risks to your body. I’m often told by them, “I know what I’m doing. I have researched every aspect, why pay a Dr. to do something I can do myself, besides I don’t have healthcare.” Most girls that I spoke with followed a detailed plan with WPATH, with the funding to do so properly. They did it because of the problems their self-medicating idealism caused. Others have come to sites like this, which assisted them in this venture before anything bad occurred.
Consider the effects of hormone therapy as a second puberty, and puberty normally takes years for the full effects to be seen. Taking higher doses of hormones will not necessarily bring about faster changes, but it could endanger your health. This is the main reason for following the WPATH method of transformation. The following is a list of things that can occur when you go onto an estrogen regimen. Consider what this involves and what could happen without a doctor.
Production of too many red blood cells.
Blood clot in a deep vein or lung.
Abnormal cholesterol levels.
High blood pressure
Easier bruising than normal
Caution is essential when reading about hormone regimens that promise specific, rapid, or drastic effects. While it is possible to make adjustments in medications and dosing to achieve certain specific goals, the way your body changes in response to hormones is more dependent on genetics and the age at which you start rather than the specific dose, route, frequency, or types of medications you are taking.
There are four areas where you can expect changes to occur with hormone therapy: physical, emotional, sexual, and reproductive.
Changes that you might expect are skin that might become drier and thinner. Your pores become smaller and there will be less oil production. You may become more prone to bruising or cuts. It’s common to notice in the first few weeks that the odors of your sweat and urine will change. The maximum effect will occur within three to six months. Slowing of scalp hair loss. This will begin one to three months after treatment begins.
Your body will redistribute your weight. Fat will collect around your hips and thighs, and the muscles in your arms and legs will become less defined and have a smoother appearance, as the fat just below your skin becomes thicker. Hormones may not have a significant effect on the fat in your abdomen. You can also expect your muscle mass and strength to decrease. For most people, things usually settle down after a period. I encourage you to take the time to learn new things about yourself and adjust to unfamiliar feelings and emotions through exploration. Familiarize yourself with them.
While psychotherapy is not for everyone, many people find that working with a therapist during transition can help in becoming comfortable with these new thoughts and feelings, getting to know your new body and self, and in helping with coming out to family, friends, or coworkers. In developing a greater level of self-love and acceptance.
Estrogen is going to change the way your brain processes everyday events and occurrences. What a male doesn’t think twice about is now affected in many ways. Keep in mind that everything you have done in the past, including decision making, learning new things and fitting them into your life, even intimacy, you did as a male. Life was pretty routine in the decades that passed and in the ways you did it. Adding estrogen, while taking the testosterone away, changes everything. Your brain tries to blend the new emotional input. Try as it will, some things just don’t work right in the old mindset and emotional outbursts happen when they don’t.
Crying is common, but impatience, anxiety, and the feeling of confusion and misunderstanding sets in. Everyone talking to you about everyday things resembles rhetoric, making the temper flare. An important consideration for taking the proper amount of estrogen. Too much estrogen often gets a person in trouble with their loved ones and even the law. Doing more estrogen than prescribed won’t change your body any faster. Instead, it slows it down as your body senses too much and closes your estrogen receptors, rendering your daily dose useless. In a fitting analogy, estrogen is to the body as the trigger is on a gun. It begins the process of female growth telling your body to change and/or grow differently.
You may find that you get erotic pleasure from different sex acts and different parts of your body. Your orgasms may feel like more of a “whole body” experience and last longer, but with less peak intensity. Also, those morning erections will diminish to mostly having none. It is not uncommon to become asexual while on HRT and sometimes this continues after surgery as they dropped the Spironolactone from the regimen. This seems to multiply with age, so the younger you begin HRT, the more likely your libido will return.
It is best to assume that within a few months of starting hormone therapy, you could permanently and irreversibly lose the ability to create sperm. Some people may maintain a sperm count on hormone therapy or have their sperm count return after stopping hormone therapy, but it is best to assume that won’t be the case for you. If procreating after surgery is in your plans, it would be wise to seek a cryogenic lab to freeze your sperm.
There are risks as well. If the testicles are removed through an orchiectomy or vaginoplasty, you can stop taking testosterone blockers, and may take a lower dose of hormones, but you should remain on a minimal dose of hormones until a minimum age of 50. This will help prevent a potentially severe weakening of the bones, otherwise known as osteoporosis, which can cause serious and disabling bone fractures. The intake of grapefruit, or products with grapefruit juice in it, should be avoided while taking estrogen as well.
Most people have been told by their Dr. that HRT/Estradiol can cause cancer. But there is also a possibility of ingesting an overdose actually prescribed by the physician because the patient deceives the Physician about nicotine usage. Nicotine plugs up the estrogen receptors, therefore lowering the absorption rate of the estradiol, so a lower test level of estradiol will occur. For example, when ingesting oral estradiol, each 1 Mg. tablet raises levels approx. 70 ppd. But nicotine causes the reading to be falsely lower while the levels are correct, causing the Dr. to prescribe more estradiol to raise an already higher level than your body actually requires per day (200 ppd). The physician doesn’t explain this because many girls think that the higher levels of estradiol they take, the more rapidly they will change and so girls will use nicotine before testing. This is not only dangerous but could lead to serious health and welfare problems. Symptoms of an estrogen overdose include the following:
Excessive vaginal bleeding 2 to 7 days after overdose (for CIS females)
Fluid retention/sudden weight gain.
Emotional changes, including irritability and anxiety disorders.
Nausea and vomiting.
Difficulties in urination
If I had only one piece of advice to give you girls that are about to embark on becoming a female, it would be patience. Trust me when I say this, it will happen in due time and not before. Surgery is the only alternative to changing your body into a female appearing woman. The estrogen actually allows you to feel like one as well as changing it. This is your journey, and you should take care of yourself while your transition occurs, but also enjoy it to the fullest. It will be over before you know it. I know this to be true. There are going to be milestones along the way; I treasure the first time I felt my breasts move while traversing down a flight of steps, and seeing a friend and hearing them say, “OMG, how you’ve changed!” Because beauty is only skin deep, it’s very important to take the time to enjoy the ride you’ve waited and dreamed so long for. It is truly worth every day, both good and bad. Good luck in all of your choices!
Huggz and be safe
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Ms. Tia Tracy
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