AA: HRT Advice
Here is a recent Ask Abbey question that I got, my hope is to give a broad understanding of the process and hopefully get others on the right track.
Q: Hiya abbey.
I wont take up to much of your time. I just want to ask you, my doctor started me on 2mg of esteofem daily but wont give me anything else because they really don’t know what I have to take. She told me to ask around hence why I am here. The esteofem has yielded good results so far(boobs are growing fast and my waist is getting curvy) but want to be taking the right things. I have done some research and apparently I should also be on “spiro.”
Can you advise me on what else I should be taking so i can inform my doctor.
A: Hi Ashley,
The estrofem is a good start, after being on it for a while you may raise that dose a little. The average estrogen dose can be anywhere from 2mg to 8mg per day.
You are correct about Spiro, it is an antiandrogen called Spironolactone (Aldactone): http://en.wikipedia.org/wiki/Spironolactone
The tests my doctor runs are:
The first 4 are the most important, the lipid panel, TSH, and Vitamin D are more for general health. The prolactin level is important to watch at first because HRT can increase those levels, especially in someone who already has elevated levels. If you have high prolactin levels before hormones it could be explained by a Prolactinoma, which is a benign tumor on the pituitary gland. They can be treated with medication or surgery but are not an immediate cause for alarm. Spiro is a Potassium-sparing diuretic so it can cause elevated potassium levels in your blood. It is important to monitor your levels for the first year or so to watch out for Hyplerkalemia but
Now for the your testosterone and estradiol levels.
As you can see, my numbers are quite different now.
That pretty much covers the basics, some people also take progesterone, but the results are very controversial as to whether they do anything or not. They are usually claimed to help in breast development and increase sex drive, as well as make you more moody. Not surprising because it is the hormone that spikes during a females menstrual cycle during and after ovulation. My doctor does not prescribe it so I do not know as much about it, but if you do decide to research it and try it, do so after you have your estrogen and testosterone levels where you want them.